Home care involves administration of healthcare management at a person’s house instead of in hospital or a doctor’s office. This type of medical assistance can be equally effective than procedures provided in a medical facility or nursing facility. For most patients and their loved ones, it is a more convenient option than arranging hospital or doctor’s visits. Home healthcare services are particularly helpful for those who require wound care, pulmonary monitoring needs, injectables, IV care, catheter care, and rehabilitation that involves speech, occupational and physical therapy. Medicare covers home-based medical care, under Part A or Part B, however only when a patient meets specific criteria. The services must be deemed necessary as part of a patient’s treatment. Here are some examples.
The Patient Is Homebound
For a patient who is homebound, the doctor must certify that it is indeed the case. Patients that are homebound usually find leaving their homes to be a substantial effort. This means the person has trouble leaving their home without assistance. This could include the use of a wheelchair, walker, crutches, a cane, or the assistance of another person. If leaving their house is detrimental to their health condition, a person is considered to be homebound. However, those who are able to leave their house for infrequent and brief visits can also be considered homebound and qualify for home care services. Say the person is able to attend a funeral, graduation, or adult day-care, they can still be homebound. If you have a parent or loved one that is homebound and requires full-time home care, you can visit https://homecareassistance.com/caregiving-services/24-hour to learn more.
A Patient Is Under The Care Of A Physician
The patient must be receiving treatment and receive doctor’s care under a time-honored healthcare plan. The doctor must assess the healthcare plan where necessary. He must consult the patient in-person to certify that the patient is eligible for home care services.
The Patient Requires Skilled Services
The patient’s physician has to certify that he or she requires one or more of these medical treatments:
- Physical therapy, continuous occupational therapy, or speech-language pathology. Such services are viewed as necessary home treatments if they are effective and specific for a patient’s treatment and if they are significant enough to be carried out by or under the supervision of a skilled therapist.
- Intermittent qualified nursing care. Intermittent refers to less than seven days per week and less than eight hours per day, for up to twenty-one days. Medicare might exceed the twenty-one limit, however only under extraordinary circumstances and only if a doctor can foresee when the need for qualified nursing care would end.
- Qualified nursing care is carried out by a registered nurse or licensed practical nurse.
The Patient Is Getting Home-Based Care From An Agency Who Is Medicare-Approved
Medicare only covers home healthcare if the patient is receiving therapy/treatment from a Medicare-approved company. The patient and his family can choose their own Hello Home Doctor Service; however, it must be Medicare certified.
Which Home-Based Services Are Not Covered?
Medicare will not pay for prolonged care or custodial care. They also will not cover 24-hour care, assistance with activities or daily living, homemaker services, meal delivery, or personal care unless it is included in a physician-ordered home healthcare plan.
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