Does TRICARE cover home health care?
Quick Answer
TRICARE covers skilled home health care including nursing, therapy, and aide services when medically necessary and authorized.
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Key Takeaways
- Skilled home health is covered
- Authorization required
- Must be medically necessary
- Custodial care not covered
Detailed Answer
Home health care provides medical services in your home when appropriate.
Covered Services
- Skilled nursing care
- Physical therapy
- Occupational therapy
- Speech therapy
- Medical social services
- Home health aide services
Eligibility
- Homebound or difficulty leaving
- Need skilled care
- Under physician care plan
- Authorization approved
Authorization Required
- Prior authorization needed
- Provider or agency submits request
- Reviewed for medical necessity
- Recertification required periodically
Not Covered
- Custodial care (help with daily living only)
- 24-hour private duty nursing
- Homemaker services
- Non-skilled care
Finding Providers
- Home health agencies in network
- MTF may coordinate
- Regional contractor can assist
- Must be TRICARE-authorized agency
Related Questions
What services does TRICARE cover?
TRICARE covers preventive care, doctor visits, hospitalization, surgery, mental health, maternity, prescriptions, and more with some requiring authorization.
What services require prior authorization?
Prior authorization is needed for many inpatient stays, some surgeries, specialty services, DME, and certain high-cost procedures regardless of plan.
What do most military families add to their TRICARE coverage?
Supplemental health insurance is the most common addition — it covers dental, vision, and out-of-pocket costs that TRICARE leaves uncovered. Life insurance and a legal will are also highly recommended.
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