Medicare and Continuing Care
Home Health Care
What Is Home Health Care?
Home health care is short-term skilled care at home after hospitalization or for the treatment of an illness or injury. Home health agencies provide home care services, including skilled nursing care, physical therapy, occupational therapy, speech therapy, medical social work, and care by home health aides.
Home health services may also include durable medical equipment, such as wheelchairs, hospital beds, oxygen, and walkers, and medical supplies for use at home.
Who Is Eligible?
If a patient has Medicare, he or she can use the home health benefit if all of the following conditions are met.
- The doctor must decide that the patient needs medical care at home, and makes a plan for this care.
- The patient must need one or more of the following services.
- intermittent skilled nursing care
- physical therapy
- speech-language pathology
- continued occupational therapy
- The home health agency selected must be approved by the Medicare Program (Medicare-certified).
- The patient must be homebound or normally unable to leave home unassisted. To be homebound means that leaving home takes considerable effort. Patients may leave home for medical treatment or short, infrequent absences for non-medical reasons, such as a trip to attend religious services. A patient can still get home health care if he or she attends adult day care.
To find out if a patient is eligible for Medicare's home health care services, call the Regional Home Health Intermediary (RHHI). A RHHI is a private company that contracts with Medicare to pay bills and check on the quality of home health care. To contact a RHHI, call 1-800-Medicare (1-800-633-4227) or visit http://www.medicare.gov. TTY users should call 1-877-486-2048.
Choosing a Home Health Care Agency
If the doctor decides the patient needs home health care, you can choose an agency from the participating Medicare-certified home health agencies that serve the area. To find an agency, ask the doctor or hospital discharge planner, use a senior community referral service or agency, or look in the telephone directory in the Yellow Pages under "home care" or "home health care."
Home health agencies are certified to make sure they meet certain Federal health and safety requirements. The choice of a home health agency should be honored by the patient's doctor, hospital discharge planner, or other referring agency.
Questions to Consider
Here are questions to ask when considering a home health agency.
- Is the agency Medicare-approved?
- How long has the agency served the community?
- Does this agency provide the services my relative or friend needs?
- How are emergencies handled?
- Is the staff on duty around the clock?
- How much do services and supplies cost?
- Will agency staff be in regular contact with the doctor?
You can use Medicare's "Home Health Compare" tool to compare home health agencies in your area. Visit http://www.medicare.gov. Under "Search Tools," select "Compare Home Health Agencies in Your Area."
Community Based Services
There are times when a person's needs extend beyond the intermittent skilled care provided through Medicare. Community-based services across the country support independent living and are designed to promote the health, well being, and independence of older adults. These services can also supplement the supportive activities of family caregivers.
Often, community-based senior citizens' services offer companionship visits, help around the house, meal programs, caregiver respite, adult day care services, transportation, and more. These support services may be funded by state and county programs or offered by church or volunteer groups.
