Key Information About Home Health Care and Medicare

Senior woman wiping her eyes, home health care Home health care is in-home care given for an illness or injury. When injuries or illness interrupt our lives, worries compound. Probably at the top of our worry list is money because healthcare is costly, but home health care is less expensive and the goals of care are the same as a skilled nursing facility.

Goals of care can include getting better, regaining independence, and improving self-sufficiency. Utilizing home health care, these goals become reachable because health professionals monitor eating and drinking, blood pressure, temperature, heart rate, breathing medications, prescriptions, pain, and safety in the home. Toward the goal of self-sufficiency, at the appropriate time they begin to teach the patient how to care for themselves. They coordinate care by keeping the lines of communication open between health professionals, the patients, and anyone else who is caring for the patient.

Medicare-covered Home Health Benefits

Stethoscope - home health careTo begin Medicare-covered care, doctor’s orders are needed. Next, the physician provides a list of community agencies that provide home care. By law, the referring physician is required to disclose if their organization has a financial interest in any agency listed.  Once an agency has been selected by the patient, they will schedule an appointment in the home to discuss needs and goals of care.

Examples of what Medicare covers include the following:

  • Patient and caregiver education
  • Wound care for pressure sores or a surgical wound
  • Intravenous or nutrition therapy
  • Injections
  • Monitoring serious illness and unstable health status
Selecting a Home Health Care Agency

Home health care worker with patientHome health is convenient but with the ‘best fit’, the patient is more likely to receive optimal care and improve sooner. As a consumer of health care, how can the patient optimize their experience? As it goes when selecting a consumer good or service, word of mouth is always best, but in this case that might not be possible. If such is the case, interview at least two agencies. Listed below are examples of interview questions for the agency and for the home caregiver.

Questions for the agency – 

  • What types of insurance do you accept?
  • Are you approved to receive payment from Medicare, etc.?
  • How long has your agency been a provider?
  • How do you handle billing and payment?
  • What is included in your service?
  • What separates you from your competitors?
  • How do you handle nights and weekends?
  • What is your back-up plan if a caregiver is unable to work their shift?
  • If I select your agency, who will be providing the services for me?
  • What qualities made you decide to hire this person?  I will want to interview them. Does your agency permit this?

Questions for the home health professional –

  • Are you comfortable working with ____________ (name condition, illness, situation) ?
  • Why did you choose this profession?
  • What makes you good at your job?
Home healing has many benefits! To learn more about the home health care process through Medicare, visit: https://www.medicare.gov/what-medicare-covers/home-health-care/home-health-care-what-is-it-what-to-expect.html