Insurance Coverage for VNA Services
Home health care provided by the Visiting Nurses Association of Cape Cod is Medicare- and Medicaid-approved.
Medicare coverage
Medicare Home health care agencies receive reimbursement for all covered services administered during the 60-day period of treatment known as an Episode of Care. These services include:
- Intravenous drug injections
- Artificial feeding and hydration
- Oxygen therapy
- Wound care
- Catheterization
- Colostomy care
- Oral medication administration
- Rehabilitative therapies (physical, occupational, speech)
Massachusetts regulations stipulate that Medicare coverage will neither extend to patients requiring 24-hour care, nor to patients requiring only home care services such as bathing, dressing, meal-delivery, shopping, laundry or light house cleaning. In order for patients to qualify for Medicare coverage, they must be in need of intermittent skilled care (nursing, physical therapy, speech language pathlogy) — defined as services given on fewer than seven days a week for less than eight hours a day.
We accept all forms of payment—including government reimbursements and out-of-pocket pay.
Medicaid coverage
- MassHealth Basic and MassHealth Standard plans cover homecare services, with the exception of Social Work.
- PCP authorization on the MMIS website may be required and we will contact your physician's office.
- PT, OT, are limited to 20 visits per year and ST is limited to 35 visits per year, though in difficult cases, additional visits may be authorized by a MassHealth case manager.
Case management assistance
Our case managers work closely with each patient to determine eligibility for state and federal assistance. We also educate patients to better understand the extent of their home health care and hospice care coverage.
