Frequently Asked Questions

Home health care is designed to help the patient rest, recover, and receive treatment in the comfort of their own home or residence. Services provided by home health care are offered with the goal of helping the patient regain independence to become as self-sufficient as possible while also managing their disease or condition.

Home health care can benefit both acute and chronic conditions, including but not limited to the following:

• Alzheimer's Disease

• Chronic kidney disease

• Chronic obstructive pulmonary disease (COPD)

• Diabetes

The primary benefit of home health care for the elderly is that it can be delivered directly to the patient's residence, whether it be a private home, adult foster home, assisted living or residential care facility, memory care facility, or long-term nursing home. By delivering care directly to the patient, expensive hospital bills can be avoided.

Family members are encouraged to be active participants in the planning process to help set and meet goals, working with home health care professionals for the benefit of the patient.

Additional benefits of home health care for seniors include:

• Faster recuperation and recovery from illness or injury

• Improved independence (over time)

• Maintaining or improving of current condition or level of function

• Regaining of self-sufficiency in the home

• Slowing of the decline of serious conditions

• Better symptom management

The first step toward receiving home health care is to obtain a physician's orders and work with a home health care company to develop a detailed care plan. From there, you will be asked to complete an initial consultation with the patient, during which they assess the patient's needs and develop a plan for treatment. Family members and other caregivers are encouraged to participate in this planning process to ensure consistent and comprehensive care. When services begin, home health care staff will implement the plan – following all physician orders – and keep the physician updated about the patient's progress. The frequency and type of home health visits will vary depending on the patient's needs. Some patients require daily care while others require only a short visit once or twice per week. All services are tailored to the patient's needs.

Home health care consists of medically necessary, skilled services prescribed by a physician for the treatment of an illness, injury, or medical condition.

Skilled services provided by home health care may include the following:

• Infusion therapy

• Medication management

• Nursing care

• Nutrition services

• Pain management

• Psychiatric services

• Social work

• Therapy (physical, occupational, speech)

Services provided by home health care professionals are tailored to the patient's individual needs. Examples include checking vital signs, assessing pain, monitoring food intake, managing medications, helping with basic hygiene, and ensuring safety in the home.

There are rules for how to qualify for home health care, especially if you want it to be covered by your insurance or Medicare plan. To be eligible, you must meet these requirements:

• Be under the care of a physician who orders home health services.

• Meet the definition of "homebound”.

• Require skilled nursing or therapy services on an intermittent basis.

Specific home health agencies may have additional requirements of their own, and you may also need to meet certain qualifications for your insurance plan. Be sure to familiarize yourself with these requirements before applying for home health care.

No, home health care (i.e. home health) is significantly different than home care. While the two services sound similar (both take place at a patient's home or residence), home health is administered by licensed medical professionals. Further, the type of care encompassed by home health care covers a myriad of ailments and diseases, including physical therapy, post-operative care, and treatment of Alzheimer's, dementia, and chronic health conditions.

Home health care is available to any patient who needs it, but in order for it to be covered by Medicare, the patient must be deemed "homebound." Homebound simply means that the patient's condition prevents them from being able to safely leave the home without assistance from others or assistive devices (e.g. canes, walkers, crutches, or wheelchairs). In most cases, patients are still considered homebound even if they leave the home as needed for medical treatments that cannot be provided in-home. Brief and occasional non-medical absences may also be allowed, such as going to church, the beauty shop, or special family events.

• Heart disease

• Recovery from illness or surgery

• Chronic conditions or injuries

In addition to providing medically necessary services for the treatment of the above conditions, home health care professionals act as a liaison between the patient, the patient's family, and the patient's doctor. Home health care professionals keep a log for each visit and provide updates on the patient's condition to the doctor as needed. This helps to ensure continuity of care.

Home health care only provides medically necessary services – skilled services prescribed or recommended by a medical doctor. It does not provide unskilled services or daily necessities such as cooking, cleaning, bathing, and transportation. These services are covered by personal home care assistance. Some home health care services offer personal home care assistance at an additional cost, which may or may not be covered by insurance or Medicare.

A home health nurse provides skilled services in keeping with a physician's plan of care for a home health care patient. These services may include the following:

• Taking the patient's vitals

• Administering pain medication

• Completing medical treatments

• Recording symptoms in a journal

In addition to these simple tasks, a home health nurse helps facilitate communication between the patient's physician and caregivers. Continuity of care is extremely important, and a home health nurse helps keep the lines of communication open, helping teach all involved parties how to effectively manage the patient's condition.

Home health care services are covered by Medicare as long as certain eligibility requirements are met. To be eligible for Medicare coverage for home health care, you must meet the following requirements:

• Be considered "homebound" according to the Medicare definition.

• Require part-time or intermittent skilled care to improve, maintain, prevent, or further slow the progression of an existing condition.

• Be under the care of a medical doctor who prescribes home health care (you must have documentation of an in-person visit with said doctor either three months before starting home health care or within one month of when home health care begins)

Medicare typically covers skilled nursing care and rehabilitative services, which may include physical therapy, occupational therapy, and speech therapy. Depending on your needs, additional services like medical social services, durable medical equipment, medical supplies, and other in-home services may also be covered.

If you have Original Medicare, you may be able to receive home health care at no cost (though you might pay up to 20% of the Medicare-approved cost for durable medical equipment). If you have a Medicare Advantage Plan, you may qualify for additional coverage.

Medicare does not cover non-skilled personal care services such as cooking, cleaning, transportation, and other elements of custodial care.