Medicare Home Care Benefits

What is Medicare Home Health Care?

medicare_card-300x203Home Health Care is skilled nursing care and certain other health care services that you get in your home for the treatment of an illness or injury.

One of the services offered to senior citizens by Medicare is Home Health Services. Medicare recipients must qualify for services, and they must be recommended by the individual’s primary care physician or specialty care physician.

Medicare beneficiaries who feel they may need Medicare home care should always look into whether they can actually qualify for Medicare home health services. It is not a general personal care or chore-worker service. Rather, Medicare home care covers limited, specifically defined at-home care related to diagnosed medical conditions, and sometimes includes personal care services.

These Medicare home health services must be prescribed by a physician, and provided through a licensed home health agency. The beneficiary must have a medical condition, or combination of conditions, that require periodic services from a skilled nurse or therapist. A plan of care will be developed that describes the specific services covered. Eligibility and coverage are evaluated strictly so the beneficiary’s conditions and care needs must be aired fully.

If you or a loved one are in need of information related to your Medicare Home Health Benefits, Contact Us today or call 561-989-0441 for your free consultation.

How Do I know if I Qualify for Medicare Home Health Care?

It is common for an elderly person to need assistance upon discharge from a hospital or in-patient rehabilitation stay. That individual’s physician, sometimes in concert with family members and the patient him/herself, would determine the in-home health care need and complete paperwork that refers the patient to home health care.

Other common situations include the slow physical decline elderly people experience; when that decline includes inability to care for oneself on a daily basis—but nursing home care is not yet required—the physician may recommend home health care for just those tasks the senior is unable to perform.

These four conditions must be met before home health services can be prescribed and covered by Medicare:

1. Your doctor must decide that you need medical care in your home, and make a plan for your care at home; and

2. You must need at least one of the following: intermittent (and not full time) skilled nursing care, or physical therapy or speech-language pathology services or continue to need occupational therapy; and

3. You must be homebound or normally unable to leave home & leaving home takes a considerable and taxing effort. A person may leave home for medical treatment or short, infrequent absences for non-medical reasons; and

4. The home health agency caring for you must be approved (“certified”) by the Medicare program. If you or a loved one are in need of information related to your Medicare Home Health Benefits, Contact Us today or call 561-989-0441 for your free consultation.

What Does Medicare Home Health Care Include?

Medicare home health care includes skilled nursing care as well as other skilled care services, such as:

Nursing Care

Physical Therapy

Occupational Therapy

Speech Therapy (and swallowing)

Medical Social Worker Home Health Aide

Medicare covers these services as long as you are eligible and your doctor says you need them. Please note: skilled nursing and home health aide are covered on a part time (intermittent) basis. Therapy services don’t have to be intermittent. Your Medicare Home Health benefit will also cover: durable medical equipment, some medical supplies (wound care) but not prescription medications. Certain FDA approved injectable osteoporosis drugs may be covered.

These services are provided by a variety of home health care agency professionals. The home health care nursing staff provides and helps coordinate the care and/or therapy your doctor orders. In support of your doctor’s orders, the home health agencies nursing staff develops a care plan, which is a written plan for your care. It tells what services you will get to reach and keep your best physical, mental, and social well being.

You have a right to participate in planning your care and treatment. The home health care nursing staff keeps your doctor up-to-date on how you are doing and updates your care plan as needed.

Home health care agencies cannot make changes to the care your doctor orders for you without your doctor’s knowledge and permission. Since more treatments can now be done at home instead of in a hospital or nursing home and most people prefer being at home to heal, Medicare home health care makes sense and is cost effective.

If you or a loved one are in need of information related to your Medicare Home Health Benefits, Contact Us today or call 561-989-0441 for your free consultation.

What is a Medicare Home Health Doctor Care Plan?

The doctor’s plan of care tells the Medicare home health nursing agency which services you need in order for your health condition to improve. Together the doctor and the Medicare home health nursing agency decide:

• The services you require

• Which type of skilled professional will work with you

• How often you will receive these services

• The types of equipment needed • Any special foods

• The outcomes expected from these treatments

You can feel confident knowing that both your doctor and the Medicare skilled nursing agency professionals will be working with you. They will continue to communicate regularly to review your plan of care; & your doctor will make changes as needed to enable your recovery.

If you or a loved one are in need of information related to your Medicare Home Health Benefits, Contact Us today or call 561-989-0441 for your free consultation.

What Rights Do I have In Choosing My Home Health Provider?

Your doctor decides on the type(s) medical care you need at home and makes a care plan. Although the doctor writes the order, you, the patient has the right to choose the Medicare certified home health nusring agency you want to manage your care plan. This is known as patient choice.

Medicare will pay for one home health care agency at a time. To change Medicare home nursing agencies you must get a new referral from your doctor, notify the agency you are leaving and the new agency that you are making a new choice.

If you or a loved one are in need of information related to your Medicare Home Health Benefits, Contact Us today or call 561-989-0441 for your free consultation.

What Does Medicare Home Health NOT Cover?

• Round the clock care at home

• Prescription medication

• Home delivered meals

• Homemaker services- shopping, cooking, cleaning etc.

• Personal care by an aide (bathing) when it is the only care needed

• Medical services or supplies that Medicare doesn’t pay for

• 20% of the Medicare-approved cost for Medicare-covered equipment For more information visit: Medicare.gov

If you or a loved one are in need of information related to your Medicare Home Health Benefits, Contact Us today or call 561-989-0441 for your free consultation.