What is Home Health Care?

Home Health is a fast growing setting for health care due in part from the fact that patients are being discharged earlier from the hospitals then ever before. Doctors are recognizing that a less intrusive environment such as the home is more cost-effective, convenient, and sets the stage for better outcomes. Home Health care offers a broad range of professional services which include Skilled Nursing, Physical Therapy, Occupational Therapy, Speech Therapy, Social Workers, and Home Health Aides. 

When is Home Health Care appropriate?

• For an illness or injury that does not require hospitalization
• After a hospital stay
• While recovering from surgery, accidents, stroke, or heart attack
• If the patient suffers from urinary incontinence
• Diabetes management
• Pain management
• Wound care management
• To care for an elderly family member

Who is eligible for Home Health?

• The service must be ordered by a physician
• The patient must be homebound
• The services must be reasonable and necessary for the treatment of the illness or injury

What does “Homebound” mean?

• Normal inability to leave home without a considerable taxing effort
• Patient with psychiatric conditions which would put them at risk to leave the home unattended.
• Homebound status is not affected by absences from the home due to medical services that cannot be provided in the home.
• Homebound status is not affected by brief and infrequent absences from the home for non medical reasons

Homebound status is not met when:

• Patient is able to safely drive a car
• Patient has frequent absences from the home due to social reasons

Does Medicare cover Home Health Care?

Yes, Medicare covers skilled nursing, physical therapy, speech-language therapy, occupational therapy, medical social services and home health aide services in the home if the patient meets certain criteria. The care must be provided on a part-time intermittent basis, be reasonable and necessary to treat the illness or injury. The patient must be under the care of a physician. The patient must be homebound. Currently there is no co-pay for Medicare Home Health and Medicare Home Health is exempt from a deductible

Does Medicaid cover Home Health Care?

Yes, Medicaid is a state covered program and coverage will vary from state to state. Medicaid will pay for nursing and home health services as well as medical supplies but certain coverage requirements must be met and there may be a limitation on the number of visits you will receive.

How would I get Home Health started?

Consult your physician regarding a request for a home health evaluation, then choose a home health agency. It would be wise to compare and check the outcomes of several home health agencies before you sign up. You can do that at www.medicare.gov.