Choosing and Working with a Medicare Home Health Agency
Adapted from Medicare & Home Health Care, Centers for Medicare & Medicaid Services. The selected guidance concerns Medicare coverage and payment, not a recommendation for medical treatment. Numbered page references below refer to the linked source publication.
Coverage can depend on medical necessity, the setting, provider participation, and your plan’s rules. Use the cited publication for the full conditions and check the plan year when comparing costs or enrollment choices.
Choosing a Home Health Agency
Finding a Medicare-certified home health agency
If your doctor or allowed provider decides you need home health care, you may choose an agency from the participating Medicare-certified home health agencies that serve your area. Home health agencies are certified to make sure they meet certain federal health and safety requirements. Medicare.gov can help you find a home health provider (Medicare.gov/care-compare/?providerType=HomeHealth).
You have a say in which agency you use, and your doctor (or allowed provider), hospital discharge planner, or other referring agency should honor your choice. However, your choices may be limited by agency availability, or by your insurance coverage. If you have a Medicare Advantage Plan or other Medicare health plan, it may require that you get home health services from agencies they contract with. Call your plan for more information.
Home health agency checklist
Use this checklist when considering a home health agency.
Name of the home health agency: __________________________________________
Question Yes No Comments
1. Is it Medicare-certified?
2. Is it Medicaid-certified (if you have both Medicare and Medicaid)?
3. Does it offer the specific health care services I need, like skilled nursing services or physical therapy?
4. Does it meet my special needs, like language or cultural preferences?
5. Does it offer the personal care services I need, like help bathing, dressing, and using the bathroom?
6. Does it offer the support services I need, or can it help me arrange for more services, if I need them? (Note: Medicare doesn’t usually cover these types of services.)
7. Can the staff give the type and hours of care my doctor or allowed provider ordered, and can they start when I need them?
8. Is this agency recommended by my hospital discharge planner, doctor (or allowed provider), or social worker?
9. Is staff available at night and on weekends for emergencies?
10. Has the agency explained what Medicare will cover and what I must pay out-of-pocket?
11. Does the agency have letters from satisfied patients, family members, and doctors/ providers that testify to the home health agency provviiddiinngg ggoooodd ccaarree??
Special rules for home health care
In general, most Medicare-certified home health agencies will accept all people with Medicare. An agency doesn’t have to accept you if it determines that it can’t meet your medical needs. An agency shouldn’t refuse to take you because of your condition, unless the agency would also refuse to take other people with the same condition.
Medicare will only pay for you to get care from one home health agency at a time. You may decide to end your relationship with one agency and choose another at any time. Contact your doctor or allowed provider to get a referral to a new agency. You should tell both the agency you’re leaving and the new agency you choose that you’re changing home health agencies.
Find out more about home health agencies
Your State Survey Agency, which inspects and certifies home health agencies for Medicare, can give you information about home health agencies. Ask them for the state survey report on any home health agency you’re considering.
In some cases, your local long-term care ombudsman may have information on the home health agencies in your area. Visit ltcombudsman.org, or call the Eldercare Locator at 1-800-677-1116.
To find out more about home health agencies, you can:
- Ask your doctor (or other allowed provider), hospital discharge planner, or social worker
- Ask friends or family about their home health care experiences
- Use a senior community referral service, or other community agencies that help you with your health care
Getting Home Health Care
You need a doctor or allowed provider’s order to start and continue home health care. Usually, once you’ve been referred for home health services, staff from the home health agency will come to your home to talk to you about your needs and ask you some questions about your health. The home health agency will also talk to your doctor about your care and keep your doctor updated about your progress.
Your plan of care
Your home health agency will work with you and your doctor or allowed provider to develop your plan of care. A plan of care lists what kind of services and care you should get for your health condition, including any services provided over the phone or via video. You have the right to be involved in decisions about your plan of care. Your plan of care includes:
- What services you need and how they’ll be provided
- Which health care professionals should give these services
- When and how often you’ll get these services
- The medical equipment you’ll need
- What results your provider expects from your treatment
Your home health agency must give you all of the home care listed in your plan of care, including services and medical supplies. The agency may do this through its own staff or through an arrangement with another agency. The agency could also hire nurses, therapists, home health aides, and medical social workers to meet your needs.
Your provider and home health team will review your plan of care as often as necessary, but at least once every 60 days. If your health condition changes, the home health team should tell your provider right away. Your home health team will:
- Review your plan of care and work with your provider to make any necessary changes.
- Tell you about any changes in your plan of care. If you have a question about your care, or if you feel your needs aren’t being met, talk to both your provider and the home health team.
- Teach you (and family or friends who are helping you) to continue any care you may need, including wound care, therapy, and disease management. You should learn to recognize problems like infection or shortness of breath, and know what to do or whom to contact if they happen.
Your rights when you get home health care
In general, as a person with Medicare getting home health care from a Medicare-certified home health agency, you have the right to:
- Get a written notice of your rights before your care starts
- Have your home and property treated with respect
- Be told, in advance, what care you’ll be getting and when your plan of care is going to change
- Participate in your care planning and treatment
- Get written information about your privacy rights and your appeal rights
- Have your personal information kept private
- Get written and verbal information about how much Medicare is expected to pay and how much you’ll have to pay for services
- Make complaints about your care and have the home health agency follow up on them
Visit Medicare.gov to learn more about your rights and protections. You can also call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
Where to file a complaint about the quality of your home health care
If you have a complaint about the quality of care you’re getting from a home health agency, you should call either of these organizations:
- Your state home health hotline. Your home health agency should give you this number when you start getting home health services.
- The Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) in your state. You can call 1-800-MEDICARE to get the phone number for your BFCC-QIO.
Home health care checklist
This checklist can help you (and family or friends who are helping you) monitor your home health care. Use this checklist to help make sure that you’re getting quality care.
When I get my home health care Yes No Comments
1. The staff is polite and treats me and my family with respect.
2. The staff explains my plan of care to me and my family, lets us participate in creating the plan, and lets us know ahead of time of any changes.
3. The staff is properly trained and licensed to perform the type of health care I need.
4. The agency explains what to do if I have a problem with the staff or the care I’m getting.
5. The agency responds quickly to my requests.
6. The staff checks my physical and emotional condition at each visit.
7. The staff responds quickly to changes in my health or behavior.
8. The staff checks my home and suggests changes to meet my needs and ensure my safety.
9. The staff has told me what to do if I have an emergency.
10. The agency and its staff protect my privacy.
Source and further reading
Medicare & Home Health Care — Centers for Medicare & Medicaid Services. Public domain U.S. government educational material, accessed October 28, 2026. Fynoptic has selected sections, removed print navigation, and reformatted the text for this guide. The agency does not endorse Fynoptic.