Home Health Care is offered by a registered professional caregiver either in the patient’s home or other personal care given by a trained caregiver within the patient’s home. As opposed to primary care given in nursing homes or clinics, home healthcare is often referred to as domiciliary healthcare, personal care or domiciliary care. These services are offered in most areas of the United States. Many people who require assistance with daily living activities, such as getting up and going to the bathroom, may receive these services at home. However, there are also services that are provided to people who may need specialized medical care for conditions that affect their ability to get around or perform simple tasks.
Home Health Care is primarily intended to provide health care to the elderly. A home health care plan was first introduced in Medicare Parts B and C in 1965. At that time, there was no Medicare supplement for home health care plans. The Medicare coverage of home health care at that time included “personal care services”, which consisted of the nursing of a patient, support activities like help getting dressed or bathing, and activities of daily living (ADL). “Personal care services” do not include routine medical care such as seeing a doctor or dentist, but does cover the usual medical and non-medical care that a patient would receive in a hospital environment.
Because home health care services were not available through Medicare at that time, most people had to rely on Medicaid or private health insurance to meet their needs. Medicaid was a Federal program for individuals, families and children that have financial difficulties and are certified to qualify for the assistance they require to meet their particular needs. Home Health Agencies was responsible for contacting and selecting the appropriate Medicaid provider to coordinate and provide the services the patient needed. When a Medicaid family member or friend became ill or became too ill to qualify for Medicaid, the home health agency would contact the doctor’s office and make arrangements for the care to be continued by the doctor or through other means.
In order to be eligible for Medicaid and receive Home Health Care, you must meet certain requirements. First, you must meet the Medicaid guidelines for income and resources. Second, you must meet the Medicare guidelines for income and resources as determined under the terms of your Medicare Part A and Part B. You must meet the Medicare guidelines for both in-home doctor visits and services other than in home care services.
If you do not meet one of the following conditions, you can apply for Medicaid or find a suitable independent payer to provide the in home care services you need. Medicaid is jointly run by federal and state governments. Each state has a different set of guidelines for how much Medicaid spending a person or family can be expected to cover, including: the difference between in home doctor visits and in home care; any additional benefits provided to the patient, such as prescription drugs and nursing home care; and costs related to nursing home care. Medicare is a federal plan that is available to anyone who earns a Medicare age within the coverage range. There are no restrictions on who can qualify for Medicare.
The Medicare Shared Savings program offers some additional benefits to help recipients of Medicare who are not otherwise qualified for Medicaid or Medicare supplement insurance afford quality in home health care services. If you fall within one of the following categories, you may qualify for additional benefits. You must meet the Medicare eligibility guidelines, be 65 or older, be in fair health, and not be receiving Medicaid. If you fall within one of the other categories, you will want to discuss your additional benefits with your in home health care professionals and/or physician.
Many Medicare and Medicaid patients are not comfortable with their in home health care providers and are forced to choose between their doctors and their nursing care. There are some options available to those patients who want to have more control over their care. For example, Medicaid covers some inpatient nursing care, but not all. There are also agencies that help select home health care professionals that are registered nurses. These agencies also provide additional benefits to the qualified nurse in order to ensure the patient gets excellent care by experienced and qualified practitioners.
Some patients may qualify for in home health care services that are more expensive than others. Age and medical condition often affects what additional benefits one is eligible for. The type of care received is often highly dependent on location, cost of the facility, and other factors. Medicare beneficiaries should always contact their local Medicare representative before choosing a skilled nursing facility. This will give them an opportunity to compare prices, options, and other important Medicare related information with other potential candidates.