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YOUR RIGHT TO CHOOSE A HOME HEALTH AGENCY

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We often take calls from patients, family members and caregivers concerned that their Doctor does not want to refer them to Caring Professional Services for various reasons, such as “We only refer to Agencies we work with”. The fact is that if you’re an original Medicare participant you have the right to choose your service providers including Home Care Agencies; you do not have to accept an Agency recommend by your doctor.  If you are in an HMO you can also request to choose an Agency with their network of which Caring Professional Services participates in many of them.

The following is a quote from the US Government Official Booklet for Medicare Home Health Care Benefits for people with Original Medicare:

Your right to choose a Home Health Agency

“If your doctor 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. Your choice should be honored by your doctor, hospital discharge planner, or other referring agency. You have a say in which agency you use, but your choices may be limited by agency availability, or by your insurance coverage. (Medicare Advantage Plans or other Medicare health plans may require that you get home health services from agencies they contract with.)”

You can download a complete copy of the Medicare booklet from our website (HERE) or directly from the US Government – CMS (HERE)

If you are part of an HMO things are a little different, most HMO’s use MSO’s to manage things like Home Health Care and Medical Equipment, most MSO’s such as One Homecare Solutions, Univita, AllMed, Coastal Care Services and ContinueCare you are still allow to choose a Home Health Agency but you have to choose from a short list that they contract with but you still have a choice. CHOOSE WISELY!

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