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Question/Topic
How does UMP cover home health care?
Answer/Article

You must receive preauthorization from UMP for home health care services when visits are daily, or treatment is expected to last more than three weeks.

UMP covers medically necessary services provided and billed by a licensed home health agency for medical treatment of a covered illness or injury. These services must be part of a treatment plan written by your provider (such as a physician or advanced registered nurse practitioner [ARNP]). The provider must certify that you are homebound and that you would require hospital or skilled nursing facility care if you did not receive home health care. The following services are covered and do not require preauthorization:

  • Visits for part-time or occasional skilled nursing care and for physical, occupational, and speech therapy.
  • Related services such as occasional care (less frequently than daily visits, and under two hours per visit) from home health aides and clinical social services, provided in conjunction with the skilled services of a registered nurse (RN), licensed practical nurse (LPN), or physical, occupational, or speech therapist.
  • Disposable medical supplies as well as prescription drugs provided by the home health agency.
  • Home infusion therapy.

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UMP definition: "respite care"
How does UMP cover physical, occupational, speech, and neurodevelopmental therapy?
How does UMP cover hospice care (including respite care)?
KBID 849
Date Modified 12/29/2009
Date Created 10/7/2008

The Certificate of Coverage (COC) is the source of coverage provisions offered under UMP. If information given here is inconsistent with the UMP COC, the rules in the COC will apply. Also, the COC may have additional information on this subject.

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