My dad is 86, has Parkinsons plus other issues. He has been in and out of the hospital due to falls. He is at home now, currently receives outpatient PT 3x/week; he has had in home PT before but I didn't find it very helpful. His doctors would like him to have a nurse come to the house to monitor his catheter but I was told by the rehab hospital that he can't have both outpatient PT and home visits from a nurse - he would have to switch to in home PT to get nursing at home.

Google seems to think there is a way to set up both services. Does anybody know which is true? Next time I'm with him I'll attempt to use the medicare website, but I don't have his info with me currently.

I she a vet? With my dad, once we got the VA involved, we were able to get him a lot more care.

No, not a vet.

He has medicare and Blue Cross Blue Shield.

PT here. Own outpatient clinics. If you set up home health for nursing, the outpatient PT will get screwed. MC will pay them and then in about 6 months take back all the money. Have it happen a few times a year when people try this. The ONLY way I know of it being possible is to do home health, but then the home health company pays the outpatient PT (basically subcontracting) bc they cannot provide the services. No home health company will agree to this bc they have their own PTs. I've never seen this happen but have heard it's possible.

Thanks. Certainly don't want that to happen.

The issue here is that for Medicare to pay for home health services, you have to meet the Medicare definition of homebound (which does not mean that you are entirely unable to leave your home, but generally that this is difficult).

To qualify for Medicare to pay for in home nursing care, you have to be certified by a provider as homebound by Medicare's rules, and then would not qualify for outpatient PT.

88planoAg said:

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No, not a vet.

He has medicare and Blue Cross Blue Shield.

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I may be wrong, but that sounds like an Advantage plan problem. Good luck

I have a poor opinion of Advantage plans. They are cheaper (at least for the base cost), but you get what you pay for.

I have a Supplemental plan (Plan F). I can see any doctor who takes Medicare and I don't need to get the permission of some medical plan idiot for procedures, doctors visits, or anything.

When I had my gall bladder removed in 2024, I didn't have to get any insurance approval at all. Wen I went to the emergency room in 2025 for a pulmonary embolism, I didn't need to get approval and the plan paid for everything. When it is time for a colonoscopy, it is up to me, not the insurance company

While Plan F does cost more per year, I think that it has the lowest total out of pocket costs available.

That said, I must admit that I'm certainly no expert on this. It might not be an Advantage plan problem at all.