In this section you will find frequent asked questions (FAQs) that can be found on http://www.medicare.gov. Please click here to view the complete list of questions on the website. Click on the arrows to view/hide the answers to the questions below.

What is home health care?

Home health care includes skilled nursing care , as well as other skilled care services, like physical and occupational therapy, speech-language pathology (therapy) services. Services may also include medical social services, and assistance from a home health aide (when needed by people also receiving skilled care).
These services are provided by a variety of health care professionals in your home. The home health staff provides and helps coordinate the care and/or therapy your doctor orders. In support of your doctor’s orders, home health staff develop a care plan, which is a written plan for your care. It tells what services you will get to reach and keep your best physical, mental, and social well being. You have a right to participate in planning your care and treatment. The home health staff keeps your doctor up-to-date on how you are doing and updates your care plan as needed. Home health agencies cannot make changes to the care your doctor orders for you without your doctor’s knowledge and permission.

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Why home health care?

The need for home health care has grown for many reasons. Medical science and technology have improved. Some care that was once provided only in a hospital can now be delivered at home. Also, home health care is usually less expensive and may be as effective as care in a hospital or skilled nursing facility. And just as important, most patients and their families prefer to stay at home rather than be in the hospital or a nursing home when their condition allows them to be cared for at home.

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What are my rights as a patient?

As a patient of a Medicare-approved home health agency, you have several rights and the home health agency must provide you with a written copy of them. They include the following:

  • The right to choose your home health agency, although for members of managed care plans, the choices will depend upon which home health agencies your plan works with.
  • The right to have your property treated with respect
  • The right to have your family or guardian act for you if you are unable
  • The right to complain to the agency or the State Survey Agency about your treatment or care if it not provided, or staff shows disrespect for you or your property
  • The right to be given a copy of your plan of care, so you can ask questions about the type of services and staff the home health agency plans to provide to you and how often you can expect those services
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What are the benefits my family will get from home health care?

Since home health care is part-time and usually temporary, patients (and their informal caregivers) need to learn how to identify and care for possible problems, like confusion or shortness of breath. While you get home health care, home health staff teach you (and those who help you) to continue any care you may need, including medication, wound care, therapy, and managing stress. Even if a patient's health condition (such as heart failure or diabetes) is not expected to get better, patients can improve how they manage and live with their illness.

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What should I expect from the home health staff when they see me in my home?

It is important that home health staff see you as often as the doctor ordered.

At each visit, the home health staff should

  • Check what you are eating and drinking
  • Check your blood pressure, temperature, heart rate, and breathing
  • Check that you are taking your medicines and treatments correctly
  • Check your safety in the home
  • Teach you about your care so you can take care of yourself
  • Coordinate your care. This means they must communicate regularly with you, your doctor, and anyone else who provides care to you.

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What are some examples of skilled home health services?

Examples of skilled home health services include:

  • wound care for pressure sores or a surgical wound
  • respiratory care, like oxygen or a nebulizer
  • physical and occupational therapy
  • speech-language therapy
  • patient and caregiver education
  • intravenous or nutrition therapy
  • injections
  • monitoring serious illness and unstable health status

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What are some examples of home aide services?

Examples of home health aide services include:

  • help with basic daily activities like getting in and out of bed, dressing, bathing, eating, and using the bathroom
  • help with light housekeeping, laundry, shopping, and cooking

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Do I have the freedom to choose a Home Health Agency?

If your doctor decides you need home health care, you have the freedom to choose among a list of participating Medicare-certified home health agencies that serve your geographic area to give you the care and services you need. Your choice should be honored by your doctor, hospital discharge planner, or other referring agency. Although you have a say in which agency you use, your choices may be limited by agency availability, or by your insurance coverage. (Managed care plans may require that you receive home health services from agencies they contract with.) The discharge plan should also identify any of the home health agencies in which the hospital has a financial interest. When selecting from several home health agencies, there are several factors to consider.

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Am I eligible to receive home health care?

If you have Medicare, you can use your home health care benefits if you meet all the following conditions.

1. Your doctor must decide that you need medical care at home, and make a plan for your care at home.

2. You must need at least one of the following: intermittent skilled nursing care, or physical therapy, or speech-language therapy, or continue to need occupational therapy.

3. The home health agency caring for you must be approved by the Medicare program (Medicare-certified).

4. You must be homebound, or normally unable to leave home unassisted. To be homebound means that leaving home takes considerable and taxing effort. A person may leave home for medical treatment or short, infrequent absences for non-medical reasons, such as a trip to the barber or to attend religious service. A need for adult day care doesn’t keep you from getting home health care.

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If I am eligible for home health care, what will Medicare cover?

  • Skilled nursing care on a part-time or intermittent basis. Skilled nursing care includes services and care that can only be performed safely and correctly by a licensed nurse (either a registered nurse or a licensed practical nurse).
  • Home health aide services on a part-time or intermittent basis. A home health aide does not have a nursing license. The aide provides services that support any services that the nurse provides. These services include help with personal care such as bathing, using the toilet, or dressing. These types of services do not need the skills of a licensed nurse. Medicare does not cover home health aide services unless you are also getting skilled care such as nursing care or other therapy. The home health aide services must be part of the home care for your illness or injury.
  • Physical therapy, speech-language pathology services, and occupational therapy for as long as your doctor says you need it. Medicare covers these types of therapy:

    • Physical therapy, which includes exercise to regain movement and strength to a body area, and training on how to use special equipment or do daily activities, like how to get in and out of a wheelchair or bathtub.
    • Speech-language pathology services, which includes exercise to regain and strengthen speech skills.
    • Occupational therapy, which helps you become able to do usual daily activities by yourself. You might learn new ways to eat, put on clothes, comb your hair, and new ways to do other usual daily activities. You may continue to receive occupational therapy even if you no longer need other skilled care.
  • Medical social services to help you with social and emotional concerns related to your illness. This might include counseling or help in finding resources in your community
  • Certain medical supplies, like wound dressings, that are ordered as part of your care.
  • Medical equipment when ordered and meets criteria for coverage; Medicare usually pays 80 percent of the approved amount for certain pieces of medical equipment, such as a wheelchair or walker.
  • Prescription drugs Medicare will provide the opportunity to receive subsidized prescription drug coverage to beneficiaries enrolled in a Medicare Advantage Prescription Drug Plan or a Prescription Drug Plan.

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It is the policy of Advocate Home Care to provide service to all persons without regard to race, color, national origin, handicap, age or religious preference.

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