Insurance & Coverage
Coverage That Works As Hard As We Do
Calora Health is committed to making in-home medical care accessible. We work with Medicare and select insurance plans to minimize out-of-pocket barriers for patients across Mississippi.
Medicare
Calora Health accepts Medicare for covered in-home medical services. Medicare Part B covers medically necessary home visits when provided by a qualified clinical provider — including evaluation and management visits, chronic care management, and certain preventive services. Patients are responsible for their applicable Medicare copayment (typically 20% after the Part B deductible). We recommend patients review their specific plan details or contact our office for guidance prior to scheduling.
What Medicare may Cover
-
In-home evaluation and management visits
-
Chronic Care Management (CCM) services
-
Behavioral health evaluation and medication management
-
Palliative care consultations
-
Certain preventive screenings and immunizations
-
Diagnostic lab and imaging orders placed during visits
Coverage is subject to individual plan terms and medical necessity determination. This is general guidance — not a guarantee of benefits.
Common Conditions That Qualify
Patients managing the following conditions frequently qualify for Medicare-covered in-home visits:
-
Diabetes (Type 1 or Type 2)
-
Congestive Heart Failure
-
Chronic Obstructive Pulmonary Disease (COPD)
-
Hypertension
-
Chronic Kidney Disease
-
Dementia or cognitive decline
-
Depression, anxiety, or other behavioral health conditions
-
Post-surgical or post-hospitalization recovery
-
Cancer or other serious illness requiring symptom management
Who Qualifies for Medicare-Covered In-Home Medical Visits
Medicare Part B may cover your in-home medical visit if you meet the following criteria:
This means leaving home requires significant effort — you need a cane, walker, wheelchair, or assistance from another person, or your provider has determined that leaving home could worsen your condition. You can still leave for medical appointments or occasional personal reasons and remain eligible.
You are managing a chronic illness, recovering from a hospitalization or procedure, or have a condition that requires ongoing clinical monitoring and cannot be safely managed without professional oversight.
​
​
Medicare requires that a licensed provider (including a nurse practitioner) conduct a face-to-face evaluation — either in person or via approved telehealth — within 90 days before or 30 days after care begins.
​
Services must be ordered and documented as medically necessary. Calora Health providers document all visits in compliance with Medicare requirements.
​
​
​
​
What “Homebound” Actually Means
Many patients don’t realize they qualify because they misunderstand the homebound definition. You do not have to be completely unable to leave home. You may be considered homebound if:
-
Leaving home requires a walker, cane, crutches, wheelchair, or special transportation
-
You need help from another person to leave home safely
-
Your provider believes your health could worsen if you leave home regularly
-
Leaving home takes considerable and taxing effort
Attending medical appointments, religious services, or occasional family events does not disqualify you from homebound status.
Important Note:
Coverage determinations are made by Medicare based on individual circumstances and medical necessity. Calora Health cannot guarantee coverage for any specific patient prior to a formal review. Contact our team and we will help you verify your benefits before your first visit.
Private Insurance
We are actively working to expand our insurance participation. Patients with private insurance plans are encouraged to contact our office directly. We will verify your specific benefits and advise on coverage prior to scheduling your first visit.
Self-Pay Options
Patients without insurance coverage or whose plans we do not currently accept may access services through our self-pay program. Transparent, upfront pricing is provided before any visit is confirmed. Contact our team to discuss rates and payment arrangements.
Questions about coverage?
601-863-0258 | support@calorahealth.com