It may not be advisable for you to leave your home. And that’s not just according to you, but according to your doctor. You’ve got multiple criteria to meet before Medicare approves and covers your home health care, and the care itself has its own parameters.
Here, we’ll discuss
- How to get home health care
- What’s required of you, your condition, and your caretakers
- Services not covered
How to Get Home Health Care
Getting home health care isn’t a matter of filling out a form. Before anything can happen, you have to see a doctor in person, who then decides whether you need home health care.
When your doctor approves home health care, he or she creates and overlooks your home health treatment. That treatment must be conducted through a Medicare-covered and approved agency, and from there, you will get Medicare Parts A and B services.
You Must Meet These Criteria
Your doctor thoroughly assesses your condition(s) to make sure that your home is the most appropriate treatment setting. The doctor officially determines that you’re homebound. And if you don’t meet these criteria right now, still keep them in mind for future reference.
You MUST fit these descriptions:
- It is exceedingly difficult for you to leave home
- Someone has to help you leave home because of the effort it would take you to go out on your own
- Leaving home is inadvisable
And your condition has to fit at least one of these criteria:
- There’s a predetermined time window in which your condition is supposed to improve
- A skilled therapist has to do maintenance therapy for your condition
- A skilled therapist to design a maintenance program aimed at treating your condition
Treatments and Services
A healthcare professional has to give the following services intermittently. Here are a few examples of the treatments:
- Physical therapy
- Observing heart rate, temperature, breathing, and blood pressure and treating accordingly
- Speech-language pathology
- Occupational therapy
Medicare completely covers all of the above.
But it’s different for durable medical equipment, which includes blood glucose monitors, canes, oxygen equipment, and infusion pumps. For durable medical equipment, you’ve got to cover 20% of the Medicare-approved amount, plus the Medicare Part B deductible if you haven’t met it already.
The treatments must be medically necessary. However, there are additional requirements from the healthcare professionals, because while your condition is a priority, it doesn’t define you as a human being.
Your caretakers have to fulfill other responsibilities – asking if you’re in pain, making sure you don’t accidentally miss or exceed doses of your medication(s), and checking your diet to ensure you’re getting the nutrients you need. These serve a dual purpose because while they’re related to treating physical ailments, they also promote emotional wellbeing.
There Are Limits
Professional healthcare providers can’t be with you 24/7, because that’s not covered under any home health treatment plan. Medicare won’t cover the food delivered to you, either.
And these are services that won’t be covered if they are the only kinds of service you need:
- Personal care (also called custodial care). This involves assistance with daily activities like bathing, using the bathroom, and getting dressed
- Homemaker services, such as making your bed, for example
Our Efforts Have No Limits
We’re Trusted Senior Specialists, and we give you the opportunity to speak one-on-one with our top-notch professionals. You’ve made it this far – don’t let this opportunity pass you by. Call us today at (855) 952-1941 and you’ll be glad you did. Or if you’d rather chat with us via video call, you can schedule a video chat for free.