A doctor, patient, or family member can initiate service. However, Medicare, Medicaid, and most Insurance Plans require doctor oversight. Once the doctor prescribes Home Health Care, he/she authorizes a coordinated treatment plan, commonly called a “Plan of Care” and periodically reviews services and the patient’s progress. If a doctor does not prescribe Home Health Care, but the individual still desires services, a Private Duty Agency can suggest a Plan of Care to meet a wide variety of needs and budgets. While some insurance plans may pay for Private Duty services, they are typically an out-of-pocket expense.