Home health care allows those who cannot leave their homes or need assistance with daily tasks to receive both medical and non-medical assistance at home from home health aides, nurses or physical therapists. Home care may help recover from surgeries, illnesses or injuries as well as manage chronic diseases like heart disease or HIV/AIDS more independently – it may even be covered by Medicare or Medicaid depending on an individual’s needs and condition.
Who Qualifies for Home Health Care Eligibility requirements for home health care may differ depending on the system in place, but typically individuals meeting these criteria qualify.
Medicare’s home health services eligibility criteria require a doctor’s certification that the patient requires skilled nursing or therapy services at home. While this criteria is less stringent than its predecessor under Part A, only those with serious medical conditions should consider applying.
Doctors must certify that someone is “homebound.” This means leaving home would require significant effort (i.e. using wheelchair, walker or crutches) with assistance from another person, or that leaving might worsen your condition.
Medical home health care services are typically prescribed by a physician and may include wound care, physical, occupational and speech therapy; medication management; injections; nutrition counseling and patient/caregiver education. Non-medical home health care may include helping with daily activities like bathing, dressing, meal preparation, shopping and running errands as well as transporting patients to medical appointments or religious services.
Medicare and private insurers that cover home care tend to offer short-term or intermittent home health services as the purpose is usually teaching patients how to care for themselves at home and manage medical conditions themselves. Those needing long-term in-home care services may want to consider investing in long-term care insurance as this will cover more permanent care needs.
No matter whether an individual qualifies for home health care, finding an agency that best meets their needs can be challenging. Yount recommends starting by asking friends and family members for recommendations before researching what services and supplies their Medicare plan will cover, their responsibility to pay any outstanding amounts owed and any costs not covered by their plan – agencies are required to explain this both verbally and in writing for patients before receiving an ABN notice from Medicare which explains these fees and charges each time their plan renews – providing additional reminders as each renewal.
