The Complete Guide to Home Health Care

WHAT IS HOME HEALTH CARE?

Home health care includes a wide range of healthcare services that can be provided in your home. It is often used to help people recover from surgery, injury or an acute illness. Home health providers like Amedisys also help people manage chronic illnesses such as diabetes, COPD or heart disease at home.

You have to meet certain eligibility requirements to get coverage for home health, including your physician certifying that you are “homebound.” This means it’s difficult for you to leave home without help. You also will need to be under the care of a physician, who certifies that you have a skilled need. Home health care is typically covered by Medicare as well as Medicaid and some private insurance plans for eligible patients.

Home health care is typically delivered by a home health agency like Amedisys. So, what is a home health agency?

Here’s a simple definition of home health agency: an appropriately licensed organization that provides skilled nursing care and therapy services in eligible patients’ homes, in accordance with applicable federal, state and local requirements. Care is delivered by a team of healthcare workers and supervised by the patient’s doctor and a home health nurse.

Home health care can include nursing, occupational, speech and physical therapy and other services to help you stay safe at home. The type of care you receive is based on your needs and your doctor’s orders. With Amedisys, your team will work with you, your family and your doctor to:

• Monitor your health
• Ensure your doctor and caregiver are up-to-date on your progress
• Provide high-quality care that helps you manage your illness or recover in the comfort of home

Who is on the home health team? Depending on your needs and doctor’s orders, you may work with a:

• Nurse
• Physical therapist
• Occupational therapist
• Speech therapist
• Home health aide
• Medical social worker

WHAT ARE THE GOALS OF HOME HEALTH CARE?

Your home health providers will work with you to set goals that are specific to you and your situation. In general, some of the goals of home health care include:

• Helping you feel better and recover after an injury or illness
• Keeping you independent at home as long as possible
• Delaying or preventing the need for a nursing home or other facility
• Maintaining your highest possible level of health and ability while living with a chronic illness
• Teaching you and your caregiver how to manage your health at home
• Preventing unnecessary and potentially costly trips to the hospital

Examples of Home Health Services

What’s included as part of in-home health services?

There are a variety of home health care services that can be included in your care plan. Every patient has different needs. Your doctor will decide which services are right for you.

In-home health services with Amedisys may include:

IS HOME HEALTH CARE ONLY FOR SENIORS AND ELDERLY ADULTS?

Adults of any age may receive home health care if they meet the eligibility requirements. Younger adults may need home health after a surgery, injury or acute illness in order to recover. Studies show older adults are more likely to use at-home health care than young people because of higher rates of chronic illness and disability.   

WHAT ARE THE SIGNS YOU MIGHT NEED HOME HEALTH CARE?

Home health is for anyone who meets eligibility requirements, with a doctor’s order, and needs help at home. You may need home health care if you have difficulty leaving home and:

• You recently got discharged from a skilled nursing facility or hospital after an illness, injury or surgery
• You visit your doctor or the emergency room often
• You’re managing one or more chronic health conditions
• You take several medications and need help taking them as directed
• You recently had a medication change and need help monitoring side effects and making sure they’re working properly
• Daily activities like bathing and dressing are difficult for you

WHO QUALIFIES FOR HOME HEALTH CARE SERVICES?

Home health is typically covered by insurance if you meet eligibility requirements. For example, you’ll need to meet all of these requirements:

• Be “homebound” (unable to leave home without help); and
• Require intermittent/part-time skilled nursing care, speech therapy or physical therapy, or continue to need occupational therapy; and
• Be under the care of a doctor who orders home health for you; and
• Receive care from a Medicare-certified home health agency

The best way to get home health care is to ask your doctor about it. They’ll determine your eligibility and can place an order for home health care with Amedisys.

Another option is to contact your preferred home health agency. At Amedisys, we’ll coordinate with your doctor to find out if you’re eligible.

WHAT IS THE COST OF HOME HEALTH CARE?

Home health care is affordable. Medicare, Medicaid and many private insurance plans typically cover home health services for eligible patients when prescribed by a physician. If you’d like to receive home health care but you don’t meet eligibility requirements, private pay for home health may also be an option.

In addition to covering standard home health services, many insurance providers cover durable medical equipment (e.g., walker or wheelchair) and certain medical supplies, if required. These may incur an out-of-pocket cost (around 20%), depending on your insurance plan. A home health company like Amedisys can help you understand your coverage and any out-of-pocket costs.

HOME HEALTH CARE INSURANCE OPTIONS

Who pays for home health care? Does Medicare cover home health care? Does Medicaid pay for home health care?

Home health care is often covered by Medicare as well as Medicaid and some private insurance plans if you meet the eligibility requirements. Here are a few of the most common ways to pay for home health care:

Medicare

If you’re over 65 and meet the home health eligibility requirements, Medicare typically covers home health services. In fact, Medicare is the largest payer of home health care. Medicare may also cover part-time or intermittent help with bathing, dressing and other daily tasks from a home health aide. However, an aide is only covered if a doctor orders those services in addition to skilled care to care for your injury or illness.

Medicare does not cover non-skilled personal home care services if that is the only type of care you need. Medicare Advantage plans might offer different coverage, so check with your plan provider.

Medicaid

Medicaid typically pays for home health care for those who are eligible. It covers the same services as Medicare. Medicaid may also cover cleaning, meal preparation, transportation, personal care and other help that Medicare does not cover. Check your state rules to find out the details of your Medicaid home health care coverage.

Private Insurance

If you don’t qualify for home health or would rather use private insurance, many insurers cover home health services. Most plans cover short-term skilled care, but not long-term care or personal home care services like housekeeping or errands. Coverage varies significantly from plan to plan. Review your policy to see what type of home health coverage your plan offers.

The most common home health care setting is a patient’s private home. That could be a house, an apartment or a relative’s home. Being able to recover or manage an illness at home is convenient, affordable and comfortable.

A private home isn’t the only place people can receive home health care. Senior living communities and group homes are also considered a patient’s “home” for purposes of receiving home health care.

There are many options for seniors looking for help at home – so many options that it can be confusing trying to figure out what type of care you need. You might be wondering, “What’s the difference between home care and home health? Would I do best in a facility, or can I manage my condition at home?” Every type of care serves an important purpose. The key is finding the right care for your needs, at the right time.

We’ll explore several senior care options that may be available to you. Call us or talk with your doctor to find out if your preferred type of care would be appropriate for your needs.

HOW DOES HOME HEALTH CARE WORK?

The process of starting home health usually goes something like this:

HOW OFTEN DO HOME HEALTH PROFESSIONALS VISIT?

It depends on your needs and your doctor’s orders. You may only need one weekly visit from a nurse, for example. Or you might have several visits per week from a few different team members. For example, you might have a nurse visit one day, a physical therapist later in the week, and a home health aide once a week. Some patients could require daily visits for a period of time, depending on their needs.

Millions of people receive home health care each year. For those who are eligible, home health is often a first choice because it allows them to live independently in the comfort of home. Thanks to advances in technology, many of the treatments you used to get in a hospital can now be provided at home. Some of the other benefits of home health care with Amedisys are:

• Home health care is cost-effective, especially compared to nursing homes and other facilities.
• Home health services can make daily life easier.
• Home health can help you feel better, recover from illness or injury, and/or slow decline.
• Home health care may delay or prevent the need for nursing home or facility care.
• Monitoring and regular visits from home health professionals may help you stay out of the hospital.

The Centers for Medicare & Medicaid Services describes home health care as “less expensive, more convenient, and just as effective as care you get in a hospital or skilled nursing facility (SNF).”

There are more than 12,000 home health agencies in the U.S. So, how do you choose a home health care provider that you can trust? Here are a few important questions to ask home health care agencies:

Do you provide high-quality home health? What are your patient satisfaction and quality scores?

A high-quality home health agency treats you with respect, provides superior care and gives you the best chance of getting the results you want. The Centers for Medicare & Medicaid Services makes it easy to get quality home health. Visit its Care Compare website to get scores and compare providers. These scores are based on an objective assessment using large surveys.

Does your home health agency serve my area?

Most home health agencies provide care in a defined service area. Look for one that can come to your neighborhood.

There are several common myths about home health care. In addition to being inaccurate, these misconceptions can be dangerous if they keep people from getting the care they need. Here are a few home health care myths, along with the facts.

Myth: It’s risky to have home health professionals in my home.

FACT: Quality home health providers like Amedisys conduct thorough screenings and provide training to help ensure your safety. You can expect your home health team to quickly build rapport with you and get to know you. Many patients report feeling close bonds with their home health team within a couple of visits.

Myth: I already have a caregiver, so I don’t need home health care.

FACT: If you already have a caregiver, either a family member or a paid caregiver, you may be receiving help with housekeeping, cooking, transportation and related needs. Home health care offers a different type of support for homebound patients who have a need for skilled nursing or certain types of therapy. For example, nurses can provide wound care and other services. You can also receive speech, occupational or physical therapy. If you’re eligible for home health care, you can receive these services as ordered by your doctor in addition to having a caregiver.

Myth: Home health care isn’t affordable for most people.

FACT: Sometimes people confuse home health care with personal home care, which is often paid out-of-pocket. Home health care, by contrast, is typically covered by Medicare, Medicaid and most private insurance companies if you meet the eligibility requirements. This makes it a highly affordable option for in-home healthcare.

Myth: Patients must be bedbound to get home health care.

FACT: You do not have to be bedbound (unable to get out of bed) to qualify for home health care. You do have to be homebound, which means that you normally are unable to leave your home without assistance, and that, if you are able to leave for brief intervals, it requires a considerable and taxing effort.

HOW LONG CAN I RECEIVE HOME HEALTH CARE?

It depends on your needs. You can receive home health care as long as you qualify and your doctor says you need it.

WHEN MY DOCTOR ORDERS HOME HEALTH CARE FOR ME, CAN I ASK FOR A SPECIFIC HOME HEALTH AGENCY?

Yes, according to federal law, patients have the right to choose their healthcare provider. You can research home health companies on Medicare’s Care Compare website or ask for recommendations from friends, your church or senior center, or other people you trust.

Amedisys would be happy to answer questions and help you make the right choice for your needs. Similarly, if a hospital refers you to their hospital-owned home health program, you can choose that agency or a different one based on your research.

CAN I CHANGE HOME HEALTH AGENCIES?

Yes, you can stop receiving home health at one agency and choose another one. First, you need to tell both agencies that you’re planning to make the switch.

The greatest testament to the benefits of home health care are patients whose lives have been improved by their team of nurses, therapists, aides and social workers. We often receive letters and emails from patients thanking us for treating them like family, being there when they needed us, and helping them do the things they care about most. We also hear from caregivers who finally have peace of mind that their loved one is getting the care they need. Read our patient stories.

Want to know more about home health care? Here are a few reliable home health resources:

Medicare.gov – A reliable source of information about Medicare home health coverage, eligibility requirements and services

Home Health Compare – This website allows you to compare quality and patient satisfaction scores among Medicare-certified home health agencies, so you can choose a high-quality home health agency

Medicaid.gov – Read about Medicaid home health eligibility and learn about your state’s coverage for home health care

Medicare and Home Health Care – A guide from the Centers for Medicare & Medicaid Services (CMS) with detailed information about Medicare’s home health care coverage and frequently asked questions

Eldercare Locator – This nationwide government service of the Administration on Aging can help you find a home health agency near you as well as other local support resources

National Institute on Aging – Part of the National Institutes of Health, the NIA is a trusted source of information on healthy aging, caregiving and more

Centers for Disease Control & Prevention – Research and statistics about home health care from the CDC