Who Qualifies For Home Health Care Services?
Who Qualifies For Home Health Care Services?

Who Qualifies For Home Health Care Services?

Millions of older adults could benefit from home health care services, yet don’t receive them due to not understanding what home health care entails or not believing they qualify. Home health care may actually be more cost-effective and convenient than long-term care options and just as effective; many Medicare plans and private policies cover it; the key is understanding qualifications which vary slightly based on state and plan.

Home health requires you to be considered “homebound.” In other words, leaving your house requires significant effort or support from devices (like canes, walkers and wheelchairs) or another person due to your illness or injury and could pose potential danger. Your doctor must believe that leaving could only worsen your condition further, though occasional brief absences from home such as attending church services or family gatherings may be approved by him/her.

Home health benefits typically fall under Medicare Part B; however, you may also qualify under Part A if you’ve spent at least three days as a hospital inpatient or had a Medicare-covered stay in a skilled nursing facility (SNF). Your physician must first approve an initial plan of care prior to commencing home health services.

Home health visits typically consist of visits from nurses and physical therapists. Nurses can help manage medication, wound care and other health needs; physical therapists offer exercises and therapies designed to strengthen strength, balance and mobility; speech-language pathologists assess and treat communication disorders; while speech pathologists assess and treat communication problems. Other home health professionals such as dietitians or social workers may be required depending on your individual situation.

An initial evaluation by a home health professional will assess your needs and eligibility for services, working closely with both you and your doctor to create a personalized care plan that is regularly evaluated as your treatment progresses.

As part of your home health care provider discussions about costs, be sure to ask for details regarding Medicare payments as well as any items or services not covered by them – these must also include any additional charges such as copayments and deductibles that might apply.

Medicaid in most states covers certain home care services, such as personal or attendant care (often referred to as home health aide services). This may include personal assistance services provided by home health agencies or community-based settings like senior centers and adult day care programs, or residential facilities like assisted living and memory care facilities.

Some states offer Medicaid programs that enable individuals to select their own caregivers – usually family members – as homecare providers. New York refers to this option as Consumer Direction of Personal Care Services and should you wish to explore it, contact your local Medicaid office immediately.