Home health care is care provided in your home when you are confined there due to illness or injury and need "skilled care," such as dressing changes or physical therapy. This care is ordered and supervised by your doctor. A plan of care is developed by you, your doctor, and the home care staff. Any changes must be approved by your primary health care provider. The plan sets goals for your rehabilitation.
Home health care agencies provide the services of skilled professionals, such as nurses, medical social workers, and therapists (physical, occupational, speech, and respiratory). They also provide home health aides for personal care.
Nurses assess your condition, change dressings and give other treatments, provide intravenous therapy, family counseling, and health care teaching. They may show you how to handle equipment and give shots.
Physical and occupational therapists work with you to improve your strength and ability to do everyday tasks, such as bathing and dressing. Therapists also can look at your home and suggest easier ways to do things and recommend assistive devices that may be helpful.
Home health aides help you with personal care (bathing, shaving) and do light housekeeping.
Some home care agencies provide other services. They may rent durable medical equipment such as wheelchairs, walkers, portable commodes, and oxygen. Some agencies offer services not covered by insurance. Through them, you can hire helpers by the hour or by the day. The kinds of helpers may include nurses, aides, or homemakers (workers who do light housekeeping and some personal care).
You may have concerns about people you don't know coming into your home. Choose an agency that is accredited or Medicare-certified. Accreditation means that an impartial third party checked out the agency and that it met quality standards. All Medicare-certified agencies are reviewed by the state health department each year. They must meet federal and state guidelines.
Choose an agency that either provides all the services you need, or works closely with other providers. Interview the primary nurse that will be involved in your care. Home care staff come into your home, so there must be a good fit between you and the staff.
You have the right to choose which home health care agency you want to provide your care. There may be many agencies in your town. A hospital or health care provider cannot tell you which agency you use.
Many health care plans cover home health services. Each plan is different, so check with your health plan. Insurance does not cover nurses, aides, or therapists whose services are not medically needed. Insurance does not cover services when they are needed for personal care only.
Medicare pays for home health care when these four conditions are met:
A prior stay in the hospital is not required to receive home care benefits under Medicare. There is no deductible for home care services.
Medicare Part A (or Part B if you do not have Part A) pays for covered services for as long as they are medically necessary and reasonable. Medicare pays for part-time services provided by:
You may be able to get full-time nursing care if you pay for it yourself. The home health care benefit also pays for some medical supplies and 80% of the approved amount for durable medical equipment (DME). DME includes wheelchairs, walkers, hospital beds, and oxygen supplies.
For more information on the home health care agencies in your community, contact your hospital discharge planner or social worker or see the Yellow Pages under nursing.
For more information on Medicare coverage, call 1-800-MEDICARE.
Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.
HIA File AGI3017F.HTM Release 9.0/2006
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