Home Health Care Services offer a wide array of medical support within the comfort of your own home, catering to individuals recovering from illness or injury. This form of care is often a more affordable, convenient, and equally effective alternative to receiving treatment in a hospital or skilled nursing facility (SNF).
For those eligible, Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) can cover home health services. Coverage is available if you require part-time or intermittent skilled care and are considered “homebound.” Being homebound is defined as:
- Difficulty leaving home without assistance due to an illness or injury. This could involve needing aids such as a cane, wheelchair, walker, or crutches, requiring special transportation, or needing help from another person.
- A medical condition for which leaving home is not recommended.
- A general inability to leave home without considerable effort.
Medicare-covered home health services encompass a range of necessary treatments, including:
- Part-time or Intermittent Skilled Nursing Care: This may include essential services such as:
- Expert wound care for pressure sores or post-surgical wounds.
- Comprehensive education for patients and their caregivers on managing health conditions.
- Administration of intravenous or nutrition therapy.
- Delivery of necessary injections.
- Diligent monitoring of serious illnesses and unstable health conditions.
- Physical Therapy: To aid in recovery and improve mobility.
- Occupational Therapy: To help regain skills needed for daily living.
- Speech-Language Pathology Services: To address speech and swallowing difficulties.
- Medical Social Services: Providing support and resources to navigate health challenges.
- Part-Time or Intermittent Home Health Aide Care: This service is available when you are also receiving skilled nursing care or therapy services. Aide services can include:
- Assistance with walking and movement.
- Help with personal hygiene, such as bathing and grooming.
- Support with changing bed linens.
- Aid with feeding.
- Injectable Osteoporosis Drugs for Women: For managing osteoporosis.
- Durable Medical Equipment: Provision of necessary medical equipment for home use.
- Medical Supplies: Supplies required for home-based medical care.
- Disposable Negative Pressure Wound Therapy Devices: Advanced wound care solutions.
To initiate home health care, a physician or qualified health care provider, such as a nurse practitioner, must conduct a face-to-face assessment to certify the medical necessity of these services. A doctor’s order is required for your care, and the services must be delivered by a Medicare-certified home health agency.
Upon determining your need for home health care, your provider should offer a list of agencies in your area. It is also mandatory for them to disclose any financial interests they might have in the listed agencies.
“Part-time or intermittent” care generally allows for skilled nursing and home health aide services up to 8 hours per day combined, with a maximum of 28 hours per week. In certain situations, you might receive more frequent care, up to 35 hours per week and less than 8 hours daily, if deemed medically necessary by your provider.
However, it’s important to note what Medicare does not cover:
- 24-hour care at home.
- Home meal delivery services.
- Homemaker services like shopping and cleaning that are not directly related to your health care plan.
- Custodial or personal care, such as assistance with bathing, dressing, or using the bathroom, when this is the sole care required.
Eligibility for home health benefits is contingent on needing no more than part-time or “intermittent” skilled care. While receiving home health care, you are permitted to leave home for medical treatments or short, occasional non-medical outings, such as attending religious services or adult day care.
