To qualify for Home Health Benefits
- You need to be classified as Homebound status
- You need skilled services
- Your doctor certifies your need for home care
- You receive your care from a certified home health agency
Who can determine my Homebound Status?
- Your Doctor
- A Skilled Clinician
- A Home Health Agency
- YOU!
What is Homebound Status?
- Leaving the home requires a considerable and taxing effort.
- Taxing effort can mean that you need help from another person.
- Taxing effort can mean that you need crutches, walker or wheelchair.
- Taxing effort can mean that you are fatigued after going out and need considerable time to rest.
What does the doctor “certify?”
Once the home health agency does their assessment and determines that the homebound status is appropriate, they will do the appropriate evaluations. A plan of care is formulated based upon your needs and sent to the doctor for approval for the certification period.
What is a certification period?
Home health recipients are certified to receive benefits for 60 day periods. Upon the completion of a 60 day period, the home health agency and the doctor will determine if it is appropriate to recertify your plan of care.
How much does Home Health Cost Me?
Nothing! It is covered 100% by traditional Medicare Part A. There are no co-pays or limits provided you qualify for home health.
PPO’s and HMO’s have separate payment schedules and you need to check with their guidelines.
Can I use my home health benefit more than once a year?
Yes, Medicare Part A covers services as long as you need skilled services and are homebound as often as you need it.
- To continue you need to be showing progress towards goals set in the plan of care
- Medicare Part A will only cover therapy if your condition can improve or if your condition will deteriorate without therapy