Medicare and Home Care ������������������������������������������

Choosing Home Care

Use these questions to interview providers:

How long has this provider been serving the community? How does this provider select and train its employees? Does it protect its workers with written personnel policies, benefits packages and malpractice insurance? Do they consult the patient’s physicians and family members? How does the agency follow up on and resolve problems? Does this provider include the patient and his or her family members in developing the plan of care? Are nurses or therapists required to evaluate the patient’s home care needs? If so, what does this entail? Are patients involved in making care plan changes? Does this provider supply literature explaining its services, eligibility requirements, fees and funding sources? Many providers furnish patients with a detailed “Bill of Rights” that outlines the rights and responsibilities of the providers, patients and caregivers. Is the patient’s course of treatment documented, detailing the specific tasks to be carried out by each professional caregiver? Does this provider take time to educate family members on the care being administered to the patient? Does this provider assign supervisors to oversee the quality of care patients are receiving in their homes? If so, how often do these individuals make visits? Who can the patient and his or her family members call with questions or complaints? What are the financial procedures of this provider? Does the provider furnish written statements explaining all of the costs and payment plan options associated with home care? What procedures does this provider have in place to handle emergencies? Are its caregivers available 24 hours a day, seven days a week?

Medicare and Home Care

Know the coverage options

When it comes to understanding Medicare coverage, many individuals can find themselves confused by a complex web of information. This especially applies to those who want to know if they are eligible for Medicare coverage when entering a nursing home or receiving home health care. Below is some helpful information on whether you can use your home health care benefits if you have Medicare and what services and products it will cover.

First, you can use your home health care benefits if all of the following applies to your situation. Your doctor must prescribe that you need medical care at home and create a care plan. The care you need has to be intermittent and in the form of skilled nursing care, physical therapy, occupational therapy or speech therapy. The home health agency must be Medicare-certified and you must be homebound, or unable to leave the home unassisted.

Once you have established those requirements, it is important to understand what Medicare will actually cover, which includes the following: • Home health aide services on a part-time or intermittent basis, as long as there is a skilled need • Medical social services • Certain medical supplies • Durable medical equipment (wheelchair, walker, bedside commode, etc.)

Given the services and products that Medicare does cover, it is also valuable to take note of what is not covered. Care that is required 24 hours a day will not be covered. Other services not covered include personal care provided by home health aides such as bathing and dressing, along with homemaker services like cleaning and laundry. Also not included are homedelivered meals.

If you require care that goes beyond intermittent visits for a limited amount of time, or if your needs are not covered by Medicare, an important option to consider is private duty home care. For more information on Medicare coverage, visit medicare.gov.

Your doctor must prescribe that you need medical care at home and create a care plan.