Frequently Asked Questions (FAQ)

What Is A "Home Health Care"?

Home health care — frequently referred to simply as "home health" — is a medical/skilled care provided directly in a patient's residence (which may be in a private home or adult foster home), or wherever they may reside, including assisted living facility, long-term nursing facility, memory care facility and retirement communities.  This type of care is provided by licensed medical professionals including nurses, therapists, and aides for the purpose of treating or managing an illness, injury, or medical condition.

Services that may be covered include:

• Medical Services such as Skilled Nursing, Physical Therapy, Occupational Therapy, and Speech Therapy
• Non-Medical Services such as social services or assistance with daily living.

What Does Home Health Do For Patients?

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

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

How To Get Home Health Care?

There are several ways to apply for home health care, but the first step is to have your Physician evaluate your condition and draw up a home health Care Plan. Once you have a physician-prescribed plan, you can contact your health insurance company or work directly with an agency to establish service.

Before applying for home health care, make sure you meet all eligibility requirements.

What Does "Homebound" Mean?

The patient is considered “homebound” status under Medicare if the patient's condition requires assistance when leaving the residence and that when they do, it requires a considerable physical effort.  Most patients have an injury or illness that makes it difficult to leave home thus will need assistance from a family or relative or requires the aid of supportive devices (wheelchair, walker, cane or crutches).

What Is A "Home Health Aide"?

A Home Health Aide is a professional who provides continuity of care and tracks the condition and progress of their patients. 

Services they can provide:

• Assistance to patients with special needs, including those who are disabled, chronically ill, or cognitively impaired.
• Services for seniors who require assistance in their residence.
• Services including checking vital signs, assisting with personal hygiene, performing medical reminders, and employing other elements of a physician-prescribed plan of care.

Who Qualifies for Home Health Care?

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.

In order to be eligible, you must meet these requirements:

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

— The services must be under a Care Plan created and reviewed regularly by the Physician.

• Meet the definition of "homebound" and a Physician must certify it
• Require skilled nursing or therapy services on an intermittent basis (Part-time or intermittent nursing care is skilled nursing care you need or get less than 7 days each week or less than 8 hours each day over a period of 21 days (or less) with some exceptions in special circumstances.)

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.

How Does This Work?

The first step toward receiving home health care is to 1) obtain a Physician's orders and work with a home health care company to develop a detailed Care Plan.

From there, 2) 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, 3) home health care staff will implement the Care 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.

How Are Payments Made?

Patients and their families can save considerably by choosing home health care over long-term hospitalization or a skilled nursing facility. Still, medical care is expensive.

When it comes to paying for home health care, there are several options:

• Self-pay - is home health care paid out-of-pocket
• Medicare - conditions should be met
• Private Insurance Plan 

Medicare Doesn't Pay For:

• 24-hour-a-day care at your home
• Meals delivered to your home
• Homemaker services (like cooking, cleaning, transportation, shopping and laundry) that aren’t related to your Care Plan
• Custodial or personal care that helps you with daily living activities (like bathing, dressing, or using the bathroom), when this is the only care you need