Home Health FAQWhat is home health?
Home health is a physician-ordered service designed to enable patients to maximize their ability to function safely at home by teaching patients and their caregivers how to provide effective, appropriate care. Symptom management, medication management, mobility and home safety issues are among the many needs covered.
How do I get this service? Can I call in my own referral?
We are happy to answer any questions you may have about the many services we provide. However, we must have a physician’s order to provide care. Talk to your doctor about your need for home-based services.
When are services appropriate?
Home health is specifically designed to deal with acute medical changes in a patient’s condition. These changes can relate to a worsening of a long standing diagnosis or a new diagnosis. They can be physical or mental in origin.
How do I qualify for home health?
Your physician must determine your need for home-based care and write an order for the care. Medicare, Medicaid and most private insurance companies have homebound and skilled needs requirements.
Is this 24-hour continuous care?
No. All care is intermittent, with the frequency of visits determined by the physician and home health clinician. Typically, visits are about 30 to 45 minutes long, two to three times a week. Appointment times are approximate.
Where is care provided?
Care can be provided in your home, whether that is your house or a family member’s, an adult family home, assisted living or retirement home. Home health cannot be provided in a hospital or nursing home (although hospice services can).
Once services have begun, how long will they continue? Weeks? Months?
Home Health services continue as long as medically necessary, based on the assessment of the nursing or therapy case manager, your physician and your progress.
What is paid for by Medicare and Medicaid?
Medicare pays for home health services under Part A or Part B benefits at 100 percent when the patient is eligible for service and meets the criteria for admission. Medicaid coverage of Home Health Services is subject to the limitations of the medical program identified on your Medical ID card. We will verify this program before our first visit.
What about private insurance or DSHS coupons?
Private insurance coverage differs from contract to contract. You will know what the cost will be before service begins.
I've read that in order for in-home services to be covered by Medicare, Medicaid or even private insurance, the patient must be "homebound." What does this mean?
You may be considered "homebound" if you have difficulty leaving home by yourself, require assistance to leave home, and do not leave home frequently, due to your medical condition. The nurse or therapist will determine your homebound status as part of the initial assessment visit.
I've heard that Medicare will pay for "skilled care." What is skilled care?
Medicare regulations define skilled care as services that must be performed by a professional clinician that are reasonable and necessary for the treatment of your illness or injury. For example, after a hip replacement, the skills of a Physical Therapist will be necessary to help promote your recovery. Our team will determine with you and your doctor the kind of skilled care you will need.
Will Medicare pay for someone to assist me with my personal care and recovery at home?
If you are receiving skilled services from a nurse or therapist, Medicare will allow a Home Health Aide to assist with your personal care and recovery needs on an intermittent basis.
Will Medicare pay for someone to stay with a patient several hours a day if they cannot be safely at home?
That type of care is considered non-skilled or custodial care and is not covered by Medicare, although sometimes it is covered by private insurance or Medicaid. Our staff is available to help you research the availability of private insurance or Medicaid coverage for those services.
What about Medicare Supplements?
Senior Health Insurance Benefits Advisors (SHIBA) is the best resource to ask about Medicare supplemental insurance. This is a statewide network of trained volunteers who educate, assist, and serve people who have Medicare. SHIBA can be contacted at 1-800-397-4422.