Which client scenario is most likely to qualify for Medicare home health coverage?

Medicare home health coverage is designed to support individuals who require skilled services due to a medical condition, and it typically includes services like nursing care, physical therapy, and in some cases, personal assistance if it falls within a medically necessary context. The correct scenario highlights clients who have mobility issues and need a personal assistant, as their care requirements are likely related to a medical need that requires oversight and assistance, qualifying them for Medicare home health services.

To be eligible for coverage, clients must be homebound, requiring skilled nursing services, and have a physician’s plan of care that details the services needed. Although individuals receiving daily occupational therapy may have ongoing care needs, the key focus is on the requisite medical necessity linked to home health services rather than daily engagement with therapy alone. Similarly, clients residing in assisted living facilities typically do not qualify because their care needs may be met by the facility's staff, which would not be considered home health services. Lastly, a lack of a physician's care plan undercuts eligibility requirements since Medicare mandates that a formal plan be in place for coverage approval. Thus, the scenario of clients requiring personal assistance closely aligns with the qualifying criteria for Medicare home health coverage.