What is Home Health Care?Home Health Care is skilled nursing care and certain other health care services, like physical therapy, speech therapy & occupational therapy, that you get in your home for the treatment of an illness or injury.
Who is Eligible for Home Health Care?All Medicare beneficiaries can receive home health care benefits.
Medicaid, private insurances, managed care organizations and workers' compensation may pay for home health services but benefits vary between plans. Please call us to discuss your individual situation at 1-800-479-4712.
How Can I Get Home Health Care?To get Medicare home health care:
- Your doctor must decide that you need medical care in your home, and make a plan for your care at home.
- You must need at least one of the following: intermittent (not full time) skilled nursing care, physical therapy or speech therapy services.
- You must be homebound. This means that you are normally unable to leave home. Being homebound means that leaving home is a major effort. When you leave home, it must be infrequent, for a short time, or to get medical care.
- The home health agency caring for you must be approved by the Medicare program.
To receive home health benefits through a source other than Medicare, your physician will need to send orders for home health care to the agency of your choice. Once the orders are received by the home health agency, they will verify benefits and be in contact with you to discuss your specific situation and set up care.
What Does Medicare Cover?
- Skilled nursing care on a part-time or intermittent basis. Skilled nursing care includes services and care that can only be performed safely and correctly by a licensed nurse (either a registered nurse or a licensed practical nurse).
- Home health aide services on a part- time or intermittent basis. The aide provides services that support any services the nurse provides. These services include help with personal care, such as bathing, using the toilet, or dressing. These types of services do not need the skills of a licensed nurse. Medicare does not cover home health aide services unless you are also getting skilled care such as nursing care or other therapy. The home health aide services must be part of the home care for your illness or injury.
- Physical therapy, speech therapy and occupational therapy for as long as your doctor says you need it.
1. Physical therapy, which includes exercise to regain movement and strength to an area of the body, and training on how to use special equipment or do daily activities, like how to get in and out of a wheelchair or bathtub.
2. Speech therapy, which includes exercise to regain and strengthen speech skills.
3. Occupational therapy, which helps you become able to do usual daily activities by yourself. You might learn new ways to eat, put on clothes, comb your hair, and new ways to do other usual daily activities. You may continue to receive occupational therapy even if you no longer need other skilled care.
- Medical social services to help you with social and emotional concerns you have related to your illness. This might include counseling or help in finding resources in your community.
- Certain medical supplies like wound dressings, but not drugs or prescriptions.
- Medical Equipment. Medicare usually pays 80 percent of the approved amount for certain pieces of medical equipment, such as a wheelchair or walker.
What Does Home Health Care Cost the Patient?Home health care is completely covered under Medicare. Durable medical equipment is covered under Medicare Part B and typically covers 80% of the cost.
Home health care benefits covered by sources other than Medicare will vary between plans. Please call us to discuss your individual situation at 1-800-479-4712.