A doctor or other health care provider (such as a skilled nurse) must evaluate you face-to-face before certifying that you need home health services. A doctor or other health care provider must order your care, and a Medicare-certified home health agency must provide it to you. If you receive services from a home health agency in Florida, Illinois, Ohio, North Carolina, or Texas, you may be affected by a Medicare demonstration program. As part of this demonstration, your home health care agency can submit to Medicare a request for a review prior to the application for coverage of home health services.
This helps you and the home health agency to know early in the process if Medicare is likely to cover services. Medicare will review the information and cover services if the services are medically necessary and meet Medicare requirements.
Home health care services focus on
medicine and may include skilled nursing care, medication management, and rehabilitation therapy. These services are usually provided by nursing professionals as part of a home health plan prescribed by a doctor. Home health care may include occupational and physical therapy, speech therapy, and skilled nursing.It may involve helping older adults with activities of daily living, such as bathing, dressing and eating. It may also include help with cooking, cleaning, other household tasks, and monitoring the medication regimen. While these services are vital, regular human interaction can be the most transformative for elderly people. Home care services include household chores and household cleaning, while home health care generally involves helping someone recover from an illness or injury.
As with any major purchase, it's a good idea to talk to friends, neighbors, and the local Local Agency on Aging (AAA) to learn more about home health agencies in your community. These services are provided in the patient's home or place of residence, in a hospital or in a palliative care facility. Johns Hopkins Advantage MD offers comprehensive Medicare Advantage coverage for eligible Northern Virginia residents and Maryland. Talk to your health insurance plan to find out what type of home health care services your plan might cover.
If you have long-term care insurance or are thinking about buying this type of insurance, find out exactly what it covers, under what conditions you can receive coverage, any restrictions that may apply, and what you should do when you need it. If you receive your Medicare benefits through a Medicare Advantage (Part C) plan or another Medicare health plan, check with your plan for more information about your home health benefits. After the referral, the home health agency will schedule an appointment and come to your home to talk to you about your health needs and problems. Out-of-pocket costs for home health care and nursing homes are comparable because the services are specialized and provided by licensed medical professionals. Some aides have received specialized training to provide more specialized care under the supervision of a nurse.
If the agency certified Medicare, include in the letter the date you sent the 855 to your tax broker. If your provider decides that you need home health care, they should provide you with a list of the agencies that provide services in your area. Home health care is often less expensive, more convenient, and as effective as the care you receive at a hospital or skilled nursing facility (SNF). The agency must also tell you (both verbally and in writing) if Medicare won't pay for the items or services it provides and how much you'll have to pay for them.
