Pathfinder Home Health

Medicare Eligibility

Medicare covers all home health services for covered seniors provided that the following criteria are met:

  • Your physician must order the services prescribed.  A verbal or written desire to have home health services wll not be paid by Medicare unless it is supported by a written order duly signed by your physician (HIM 11…204.5).
  • The services must be reasonable and medically necessary to the treatment of an illness or injury. Reasonable and medically necessary means the services of a Skilled Nurse is needed to keep you safe and ensure that the orders prescribed by your doctor will be implemented effectively (HIM 11…203.1).
  • You must be home bound.  In order to be homebound, you must have a medical condition that restricts your ability to leave your place of residence without assistive devices like a cane, or assistance of another person or if leaving your home is medically contraindicated.  Examples of home bound patients are: a patient paralyzed from a stroke, blind or senile, loss of upper extremity strength making it hard to open doors, a a patient who underwent a surgery and is restricted by his doctor to certain specified and limited activities, a patient with heart disease ordered to stay away from any form of stress or physical activity, a patient who finds it a considerable taxing effort to leave home, a patient experiencing shortness of breath when ambulation more than 20 feet, and a patient with a psychiatric problem (HIM 11…204.11)
  • Skilled nursing and/or home health aide services must be provided on an intermittent basis within a specified period of time.  You must have a potential to improve your general health status leading to an improved quality of life (HIM 11…205.1)
McKinney
  • 1515 Heritage Dr., Ste. 214
    McKinney, TX 75069
  • 214-491-1626
  • Fax: 214-491-1627
  • Toll Free: 877-558-9920
Athens
  • 311 South Palestine
    Athens, TX 75751
  • 903-677-8301
  • Fax: 903-677-8310
  • Toll Free: 877-390-7827
Huntsville
  • 116-D Medical Park Lane
    Huntsville, TX 77340
  • 936-291-7284
  • Fax: 936-436-9308
  • Toll Free: 855-294-7284
The Woodlands
  • 24800 Pitkin Rd., Ste. B
    Spring, TX 77386
  • 281-364-9161
  • Fax: 281-298-1458
  • Toll Free: 800-955-9161
Beaumont
  • 5550 Eastex Freeway, Suite EE
    Beaumont, TX 77708
  • 409-924-9906
  • Fax: 409-924-7338
  • Toll Free: 877-924-9906
Katy
  • 1260 Pin Oak Road,
    Suite 111
    Katy, TX 77494
  • 281-574-3701
  • Fax: 281-574-3710
  • Toll Free: 866-315-2824
Corpus Christi
  • 3765 South Alameda Street, Suite 251
    Corpus Christi, TX 78411
  • 361-884-4299
  • Fax: 361-888-8914
  • Toll Free: 800-456-9050
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