Home Health Frequently Asked Questions
Most often, patients use Home Care services when they are recovering from a surgery or managing a chronic illness. Most plans follow the Medicare guidelines when considering coverage. The Medicare guidelines include the following criteria:
- The services must be ordered by a physician.
- There must be a skilled need. Skilled nursing or therapy services (such as physical, occupational, and/or speech) are needed on an intermittent basis.
- A patient must be homebound. The patient’s ability to leave their home requires abnormally taxing effort. This is considered the ‘Homebound Status’, and it needs to be confirmed and certified by the patient’s doctor.
If you have:
- Medicare or Medicaid Insurance – Click the link to view more detailed requirements: The Center for Medicare and Medicaid Services guide, “Medicare and Home Health Care (PDF).”
- Private Insurance – Contact the insurance company to determine Home Care eligibility.
Of course, we are always available to speak with you about your options. Please feel free to contact us.
The goal of Home Care is to serve patients who have an illness or health concern that makes it difficult for them to leave their home, it is important to determine each individual’s Homebound Status.
To find out if a patient meets the Homebound criteria, please take a moment to complete the Homebound Checklist.
We provide Home Care any place that is considered a permanent residence. This can be:
- A house or condo
- An apartment
- A relative’s home
- An assisted living facility or home for the elderly
During the first Home Care visit, one of our nurses or therapists will meet with the patient to perform an initial evaluation. The nurse or therapist will answer a series of questions and develop a coordinated plan for future Home Care visits. Most importantly, they’ll work closely with the patient to establish goals and start the process of achieving them.
Patients can continue to see their person doctors, but they must meet the homebound criteria. Our Home Care team works closely with the patient’s doctor when the plan of care is created. If the patient’s doctor makes home visits, they can continue to make visits as needed.
We work closely with the patient’s doctor to determine the type of care that is needed. The amount of visits performed varies by patient. Different patients have different needs. We create a plan so the appropriate health care professionals will visit at the frequency that is best for the patient.
As long as the patient meets Home Care eligibility requirements, Home Care services are covered by Medicare, and in many cases covered by Medicaid and private insurance.
- Medicare – If eligibility requirements for Home Care are met, and the patient’s doctor has certified their Homebound Status, Medicare may cover Home Care services for a 60-day period. Click the link to learn more about how Medicare pays for these services: The Center for Medicare and Medicaid Services guide, “Medicare and Home Health Care (PDF).”
- Medicaid – Medicaid payment options depend on each state’s Medicaid policy. In many cases, Medicaid covers Home Care services. The best way to find out how your plan works with Premier Home Health is to contact your state’s Medicaid office. You can find additional contact information for your state’s Medicaid program by searching the CMS.gov Contacts Database.
- Private Insurance – Most private insurance plans cover Home Care services. To find out if your insurance plan includes Home Care coverage or if Premier Home Health is an in-network provider, please contact the insurance company directly. You can also give us a call — we’d be happy to guide you through the options.
The decision to receive Home Care services begins with a patient’s doctor, and the patient should contact them to make an appointment.
- If the doctor decides that Home Care is the right choice, the patient communicates they would like to receive care from Premier.
- The doctor will work with the patient to determine the best type of care.
- The doctor will contact us to discuss the Home Health plan of Care.
- Premier Home Health will contact the patient to schedule the first evaluation.