Q. Does my Medicare cover Home Health care services?

A. Home Health Care is skilled nursing care and certain other health care services you receive in your home for the treatment of an illness or injury. Medicare covers some home health care if:

  • Your doctor decides you need medical care in your home, and makes a plan for your care at home.
  • You need at least one of the following: intermittent (and not full time) skilled nursing care, physical therapy, speech language pathology services, or a continued need for occupational therapy.
  • You are homebound. This means you are normally unable to leave home and that leaving home is a major effort. When you leave home, it must be infrequent, for a short time. You may attend religious services. You may leave the house to get medical treatment, including therapeutic or psychosocial care. You can also get care in an adult day-care program that is licensed or certified by a state or accredited to furnish adult day care services in a state.
  • The home health agency caring for you must be approved by the Medicare program.

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Q. How much do I need to pay out of pocket?

A. You pay $0 for all covered home health visits. For more information, you may call 1-800-MEDICARE 1-800-633-4227.

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Q. What is the main benefit I can get from home care?

A. With home care services, you are given the privilege to stay at home and receive prescribed health treatments. If eligible, your insurance will also cover for the expenses.

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Q. Do I need to ask my physician for a prescription to be eligible for home care?

A. Generally, there are guidelines for eligibility. You can read more about it HERE. However, we highly encourage that you consult your physician on the care programs and services that can be delivered straight to your home.

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Q. Who will provide me with home care/health services?

A. We have staff who specialize in nursing, physical therapy, occupational therapy, speech therapy and social service specialists who can administer treatment or support services in your home.

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Q. Will I be able to choose my caregiver?

A. Yes, we highly encourage that you meet your caregiver prior to officially receiving care services in your home. If you are not comfortable with the first caregiver we match for your case, you can simply call our office and we will find another care professional who is more attuned to your preferences.

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Q. Who determines my care schedule?

A. Basically, we consult your physician regarding this because schedule of treatment is a main part of your care plan. However, because our services are flexible, we can provide care on an hourly, daily, weekly or long-term basis.

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Q. What’s the Medicare ” Homebound ” requirement for home health ?

A. Medicare considers the individual homebound if:

He/She has a condition due to an illness or injury that restricts his or her ability to leave their place of residence except the aid of supportive devices such as crutches, canes, wheelchairs, and walkers; the use of special transportation; or the assistance of another person; OR if leaving home is medically contraindicated.

AND

The individual does not have to be bedridden to be considered “confined to the home”. However, the condition of the patient should be such that there exists a normal inability to leave home AND consequently, leaving home would require a considerable taxing effort

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For more information on homecare services, or to find out if you are a candidate for home healthcare, call Sphinx Home Health Care toll free 1-877-774-4694.