Home Health Care
Home Health Care
Professional medical care and support services provided in the comfort and safety of your own home
What is Home Health Care?
Medicare Requirements:
- You must be homebound
- You need skilled nursing care or therapy services
- Your doctor must order home health services
- The home health agency must be Medicare-certified
Key Features:
- Goal is to return to baseline functional status safely in the home
- Care is part time or intermittent
- Typically visits are 2x a week depending on physician order and insurance coverage
- Often less expensive than facility care
- Personalized, one-on-one attention
- Recover in familiar surroundings and maintain independence and dignity
Eligibility
Common Reasons for Home Health Care:
- Recovery from surgery or illness
- Chronic conditions (diabetes, heart disease)
- Wound care needs
- Medication management
- Physical therapy needs
- Recent hospital discharge
What "Homebound" Means:
- Leaving home requires considerable effort (i.e. use of assistive device, special transportation, or help from another person) due to illness or injury or leaving your home is not recommended due to your condition
- You may leave for medical treatment or short infrequent absences for non medical reasons (i.e. a walk or a family event like reunion or funeral)
- You can still get home health care if you attend adult day care or religious services
- You don't need to be bedridden
- Homebound status may be temporary, short, or long term
Services Provided
Skilled Nursing Services:
- Wound care and dressing changes
- Medication management and teaching
- IV therapy and injections
- Vital signs monitoring
- Disease management
Therapy Services:
- Physical therapy (strength, mobility)
- Occupational therapy (daily living skills)
- Speech therapy (communication, swallowing)
- Respiratory therapy
- Nutritional counseling
Additional Services:
- Home health aide services for personal care
- Medical social work and counseling
- Medical equipment and supplies
- Laboratory services
- Patient and family education
- On-call nursing support
Your Home Health Care Team
Registered Nurse (RN)
Provides skilled nursing care and coordinates your care plan, conducts home safety evaluation and assessment, wound care, medication education and individual health education
Physical Therapist
Helps improve strength, mobility, and balance
Occupational Therapist
Helps with daily activities and home safety
Speech Therapist
Evaluates and treats difficulties with speech, language, communication, and swallowing
Home Health Aide
Assists with personal care and daily activities
Medical Social Worker
Helps connect patients and families to community resources
Insurance and Cost
Medicare Coverage:
- Medicare will cover part-time or intermittent care
- Medicare will not cover 24/7 care and will not cover custodial or personal care if you do not also need skilled nursing care or therapy
- Medicare Part A covers home health services (100% coverage) after a hospitalization or SNF stay
- Medicare Part B covers home health services if you have not had an inpatient or SNF stay
- Medical equipment and supplies are covered by part B, typically 80% is covered by Medicare after you meet the part B deductible (20%)
- Must use Medicare-certified agency
- Before starting home care, the home health agency should tell you what Medicare will cover (get this in writing)
Other Insurances:
- Most commercial insurance covers home health
- There is usually a co-pay if primary insurance is commercial
- Medicaid covers home care services in most states
- Veterans may qualify through their VA benefits
- Some agencies offer sliding scale fees
Questions to Ask Agencies:
- Are you Medicare-certified and licensed?
- What services do you provide?
- How quickly can you start services?
- Do you have 24/7 on-call coverage?
- How do you handle emergencies?