What is a requirement for Medicare to pay for home health visits?

For Medicare to cover home health visits, a key requirement is that the individual must be confined to the home. This is essential for Medicare reimbursement because it demonstrates that the person has an illness or injury that limits their ability to leave their residence without considerable effort or requires assistance.

Being homebound means that leaving home requires a significant amount of effort due to the individual's health condition. This criterion ensures that Medicare resources are allocated to those who truly need healthcare services delivered in their home environment rather than in a hospital or nursing facility. Additionally, home health services must be deemed necessary by a doctor, and there should be a plan of care in place.

The other options do not align with Medicare's specific guidelines for home health services. For instance, residing in a nursing home doesn't fulfill the home confinement requirement, individuals under 65 may still qualify for Medicare under specific circumstances, and requiring hospitalization is not a prerequisite for receiving home health care services. Thus, being confined to the home is the primary focus for eligibility in such instances.