Home Health, Skilled, and Custodial Care Services – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare covers medically necessary home health and skilled care delivered in the member’s residence—including skilled nursing, skilled rehabilitation (PT/OT/ST), skilled teaching, wound care, medication/disease management, and eligible synchronous telemedicine/remote monitoring—while excluding custodial/domiciliary care, private‑duty nursing, respite, homemaker/personal care, care by unlicensed family/caregivers, and services beyond member‑specific visit/benefit limits. Coverage requires a written order from an authorized practitioner (M.D./D.O./P.A./N.P.), delivery or supervision by licensed professionals, documentation in a plan of care showing the services are skilled and intermittent/part‑time (typically <4 hours/day unless justified), physician‑directed medical management as applicable, alignment with InterQual® Home Care criteria, and adherence to member benefit limits/prior authorization rules.

"A written order and direction from a treating practitioner or specialist (M."