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Insurance

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Home Care Specialists offers direct billing to most insurance plans. We have dedicated reimbursement specialists who understand the billing process for each individual insurance. Our expert staff is available to verify benefits, obtain necessary approval and authorizations prior to service as well as to track your insurance claims to insure payment is processed quickly and correctly. Below is a brief list of some of the insurances that Home Care Specialists accepts:

Insurance Plans:

AetnaBlue Cross (MA)Federal SupplementalMedicare
Always Health PartnersCarecentrixHarvard Pilgrim My Care Family 
Ambetter

Cigna

Medicaid (MA) Tufts Health Plans
Anthem (ME)Commonwealth Care AllianceMedicaid (ME) United Healthcare
Anthem (NH)Element CareMedicaid (NH) 

Wellforce

... and many more. If you don't see your insurance plan listed please call 1-800-698-8113 and a member of our team can assist you.

 

In todays complicated world having insurance coverage does not always mean that your insurance will pay for all equipment or services. There are many instances in which patients may still be responsible for payment, here are a few of the most common situations:

Co-Pays: Co-pays are cost sharing amounts that are determined by your insurance and are usually fixed percentage or dollar amounts.

Deductibles: Deductibles can vary greatly depending on insurance plans, types of products and the timing of the expense. Deductibles typically reset each year either with the calendar year or when your plan renews. Deductible amounts are often overlooked, and it is important that you contact your insurance plan with any questions on when deductibles are applied and how much.

Coverage Termination: Coverage termination can occur for many different reasons, some of the most common are:

  • Your insurance coverage ends leaving you with no health insurance.
  • Your insurance plan changes and no longer covers your equipment.
  • You fail to re-qualify the medical necessity for your equipment.
  • You change insurance plans and your new plan does not cover your equipment or requires that you be re-evaluated / re-tested prior to covering the costs.

It is extremely important that you notify Home Care Specialists, Inc of any changes to your insurance plan as soon as possible. It is also important that you follow your insurance guidelines for re-qualification or re-evaluation as necessary for ongoing coverage. You will be held financially responsible for all amounts not covered by your insurance plan.

 

Coverage Guidelines:

Most insurance plans also dictate the clinical coverage guidelines for equipment as well as how often patients may receive certain items. Medicare policies are often the basis for many insurance plan guidelines However, these guidelines may vary depending on your health insurance and the required items so it is very important that you check and follow the guidelines for your specific plan.  If you need assistance in verifying coverage guidelines for your plan please contact ua at 1-800-698-8113 and we will be happy to assist you.

Medicare Coverage Policies:

        Patient Lifts                                               CPAP / BIPAP    

        Commodes                                                Support Surfaces (Mattresses) 

        Walkers                                                     Oxygen  

        Hospital Beds                                           Wheelchairs  

        Nebulizers                                                Wheelchair Accessories 

        Wheelchair Cushions