For more information, call us at 1-800-MEDICARE. Your Medicare home health services benefits aren't changing and your access to home health services shouldn’t be delayed by the pre-claim review process. Medicare will review the information and cover the services if the services are medically necessary and meet Medicare requirements. This helps you and the home health agency know earlier in the process if Medicare is likely to cover the services. Under this demonstration, your home health agency, or you, may submit a request for pre-claim review of coverage for home health services to Medicare. If you get services from a home health agency in Florida, Illinois, Massachusetts, Michigan, or Texas, you may be affected by a Medicare demonstration program. The home health agency should give you a notice called the Advance Beneficiary Notice" (ABN) before giving you services and supplies that Medicare doesn't cover. This should be explained by both talking with you and in writing. The agency should also tell you if any items or services they give you aren't covered by Medicare, and how much you'll have to pay for them.
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