Maxim Healthcare is a home health agency, not a government program you enroll in

Maxim Healthcare is a private company that sends nurses, aides, and therapists to people's homes. They are not a benefit you sign up for through Medicare, Medicaid, or your state — they are a service provider that works with those programs and with private insurance. If you need home health care, your doctor orders it, your insurance (or Medicare/Medicaid) pays for it, and then Maxim may be one of several agencies your insurance network includes.

The confusion happens because Maxim's name appears on insurance paperwork and Medicare lists. That does not mean you "enroll" with Maxim the way you enroll in Medicare. It means Maxim is contracted to deliver the care your insurance has already approved.

Maxim operates in most U.S. states and handles skilled nursing, physical therapy, occupational therapy, speech therapy, home health aide services, and infusion therapy. They also run staffing services for hospitals and facilities. This guide covers what to know if Maxim is listed as a provider on your insurance or if your doctor's office mentions them.

Key Takeaways

  • Maxim Healthcare is a private home health company contracted by insurance plans and Medicare, not a program you sign up for directly.
  • Your doctor must order home health care first — Maxim cannot start services without a physician's order and insurance authorization.
  • You do not choose Maxim; your insurance network or Medicare assigns them, though you can request a different agency if one is available in your area.
  • Maxim's services are covered by Medicare Part A (if you may have access to), most Medicaid programs, and private insurance plans that include home health benefits.
  • If you have questions about your Maxim services, your first call should be to your insurance company, not Maxim directly, to confirm what is covered.

How home health gets ordered and who pays

Home health care starts with a doctor's order. Your physician — usually after a hospital stay, surgery, or a change in your condition — writes an order for skilled nursing, therapy, or aide services. That order goes to your insurance company or Medicare for approval. Once approved, the insurance company tells you which agencies are in their network. Maxim may be one of them.

Medicare Part A covers home health if you meet three conditions: a doctor orders it, you are homebound or have difficulty leaving home, and you need skilled care (nursing or therapy, not just personal care). Medicaid covers home health in every state, but the rules vary by state — some states cover more services than others. Private insurance plans vary widely; some cover home health generously, others do not cover it at all.

You do not pay Maxim directly in most cases. Your insurance or Medicare pays Maxim a set amount per visit or per episode of care. If you have a copay or coinsurance, you may owe that to Maxim at the time of service, but Maxim bills your insurance first.

What services Maxim provides at home

Skilled nursing means a registered nurse or licensed practical nurse provides wound care, medication management, catheter care, IV therapy, or monitoring for conditions like heart failure or diabetes. This is the most common home health service and is covered by Medicare and most insurance plans.

Physical therapy helps you regain strength and mobility after surgery, stroke, or injury. A physical therapist comes to your home, assesses what you can and cannot do, and designs exercises to improve function. Medicare and most insurance plans cover this if a doctor orders it.

Occupational therapy focuses on helping you do daily tasks — bathing, dressing, cooking, managing money — after an illness or injury. An occupational therapist adapts your home or teaches you new ways to do these tasks. Coverage depends on your insurance.

Speech therapy addresses swallowing problems, voice issues, or speech difficulties after stroke or other conditions. A speech-language pathologist works with you at home. Medicare covers this; private insurance coverage varies.

Home health aide services provide personal care — bathing, dressing, toileting, grooming — but only if a nurse or therapist is also visiting for skilled care. Medicare does not cover aide-only services; Medicaid does in some states; private insurance varies. This is a common source of confusion because people often need aide help but do not may have access to for it under their insurance.

How to know if Maxim is in your insurance network

Your insurance company maintains a list of home health agencies in your area. You can find this list by calling the customer service number on your insurance card and asking, "Which home health agencies are in my network?" or by logging into your insurance company's website and searching their provider directory.

If your doctor orders home health care, they will submit the order to your insurance. Your insurance will either approve it and assign an agency from their network, or ask for more information before approving. You should receive a letter or call telling you which agency will be coming and when to expect the first visit.

If Maxim is assigned and you prefer a different agency, call your insurance company and ask if another home health agency in your network serves your area. Not all agencies serve all neighborhoods, so availability matters more than preference. Your insurance company can tell you which agencies actually operate in your zip code.

What to expect on your first Maxim visit

The first visit is an assessment. A nurse or therapist will come to your home, review your medical history, ask about your current condition, and examine you or assess your abilities. They will ask about your home setup, who lives with you, what medications you take, and what your goals are. This visit usually lasts 60 to 90 minutes.

After the assessment, the Maxim clinician will create a plan of care — a document that says what services you need, how often, and for how long. This plan goes back to your doctor for approval and to your insurance for authorization. You should receive a copy.

Subsequent visits are shorter — usually 30 to 60 minutes — and focus on the specific service: the nurse changes a wound, the therapist leads exercises, the aide helps with bathing. Visits are scheduled in advance, though the exact time window may be broad (for example, "between 9 a.m. and 1 p.m. on Tuesday").

Common reasons Maxim or home health services get denied or stopped

Insurance companies deny home health orders or stop paying for services when they believe you no longer need skilled care. This happens when you improve faster than expected, when your condition stabilizes and no longer requires nursing or therapy, or when your insurance company decides the service is not medically necessary.

If your insurance denies the order or stops payment, you have the right to appeal. Ask your doctor's office or Maxim's billing department for the denial letter, which will explain the reason. You can then ask your doctor to provide more detail about why the care is still needed, and submit that to your insurance for reconsideration.

Services also stop when your doctor discharges you from home health — this happens when you have reached your goals, your condition has improved enough that you no longer need skilled care, or you are moving to another level of care (like a nursing home). Maxim will give you notice before the final visit.

How to contact Maxim or report a problem

For routine questions about your Maxim visits — scheduling, what to expect, preparing for a visit — call Maxim's patient services line. The number should be on paperwork you received when services started. If you cannot find it, call your insurance company and ask for Maxim's contact information.

For billing questions, call Maxim's billing department. If you received a bill you do not think you should owe, ask Maxim to explain what the charge is for and whether your insurance should have paid it. If you believe there is an error, ask for a detailed explanation in writing.

If you have a complaint about the quality of care — a clinician was rude, services were not provided as scheduled, or you believe the care was inadequate — you can report it to your state's home health licensing board or to Medicare's complaint system (if you are on Medicare). Your insurance company can also investigate complaints about network providers.

Frequently Asked Questions

Can I choose Maxim, or does my insurance assign them?

Your insurance assigns the agency based on their network and what is available in your area. You cannot request Maxim specifically, but you can ask your insurance if another agency is available if you prefer not to use Maxim. Availability depends on your location.

What if I do not want Maxim to come to my home?

You can decline services, but that means you are also declining the home health care your doctor ordered. If you decline, tell your doctor and your insurance company. Your doctor may be able to order services from a different agency if one is available in your network.

Does Maxim cost me anything out of pocket?

In most cases, no. Medicare and Medicaid cover home health with no copay. Private insurance may require a copay or coinsurance per visit, which you would owe Maxim. Ask your insurance company what your out-of-pocket cost is before services start.

How long will Maxim services last?

That depends on your condition and your insurance approval. Some people receive home health for a few weeks after surgery; others receive it for months if they have a chronic condition. Your doctor and insurance company determine the length. Maxim will tell you the approved number of visits when services start.

What if Maxim does not show up for a scheduled visit?

Call Maxim when ready and ask why. Missed visits should be rescheduled within 24 hours. If this happens repeatedly, report it to your insurance company. You can also file a complaint with your state's home health licensing board.