Medicare covers home health care if you're under the care of a doctor, if you can't leave home, and you need specialized nursing care or intermittent physical, speech, or occupational therapy. Medicare may cover a percentage of the cost of ongoing health care, but it doesn't cover 24-hour home care, home delivery of meals, or home helpers who only help with activities of daily living (ADL), such as bathing, dressing, and preparing meals. For more information about Medicare and health care requirements, visit Medicare, gov or call 1-800-MEDICARE (1-800-633-422) if you have questions about benefits. To qualify for Medicare home health care, a doctor must certify that you need medical care specialized.
You should also be considered homebound. This means that it's a lot of effort for you to get out of your house. Understanding Medicare and the concept of home health care services is crucial when considering the requirements for Medicare coverage. This can include a variety of services, such as skilled nursing care, physical therapy, occupational therapy, and medical social services. The certification must indicate that the patient needs intermittent skilled nursing services, physical therapy, occupational therapy, or speech-language pathology.
It serves as a road map to be followed by the home health care agency and ensures that the patient's needs are effectively and efficiently met. You should do your own due diligence to ensure that the job or caregiver you choose is right for your needs and complies with applicable laws. It is important to update the care plan as the patient's condition changes to ensure that care remains adequate and effective. They also have the right to file a complaint about the quality of their home health care if they are not satisfied.
If the home health care agency has provided poor care or treated the patient inappropriately, contact your state's Quality Improvement Organization (BFCC-QIO) (site accessed September 24, 2016). These include having their property treated with respect; being told in advance what care you will receive and when your care plan will change; and being involved in planning your care and treatment. For example, patients have been told that Medicare will only cover one to five hours a week of home health care services, or only one bathroom a week, or that they are not confined to their home (because they are wandering down the street due to dementia) or that they must first refuse treatment before they can start (or resume it). To navigate the world of Medicare and understand the requirements for home health care services, it's important to have a clear understanding of Medicare itself and what home health care services entail. A patient is confined to their home if they cannot leave their home or must make a considerable effort to do so, or if leaving home is not recommended because of their medical condition.
To establish medical need, a health professional, usually a doctor, must certify that the person needs specialized nursing care, physical therapy, occupational therapy, or speech-language pathology services. Medicare home health care is designed to provide necessary medical care to beneficiaries in their homes.
