Phoenix Walks Beside You for the Full Home Health Journey
When a doctor recommends care at home, families often assume that Medicare will pay for whatever help is needed. However, it is important to understand that Medicare covers a specific kind of home care called home health.
Home health is a specific benefit for people who meet certain eligibility requirements and need skilled care on an intermittent basis. Examples of skilled care may include nursing after a hospitalization, physical therapy during recovery, or treatment for a wound or serious condition. Medicare does not generally cover ongoing caregiving for meal preparation, housekeeping, companionship, or personal care when those are the primary services someone needs.
Phoenix Home Care & Hospice provides home health care services through a Medicare-certified home health care agency for people who qualify. We also provide other forms of care when someone needs more day-to-day assistance than Medicare home health is designed to provide. Knowing where Medicare coverage ends makes it easier to plan for the care your family may need next.
Ask questions, get answers, and request care today by contacting your local Phoenix office.
When Does Medicare Cover Home Health Services?
Medicare Part A and/or Part B can cover qualifying home health when several requirements are met at the same time.
You must need intermittent skilled nursing or qualifying therapy, meet Medicare’s definition of homebound, be under the care of a doctor or another allowed healthcare provider, and receive care from a Medicare-certified home health agency.
Medicare also requires a visit with a doctor or allowed provider related to the need for home health, and that provider must certify the need for care. To get all rules in detail, review Medicare’s current eligibility requirements for home health care services.
Remember that a diagnosis alone does not guarantee coverage. One person may need nursing and therapy after a hospitalization, while another with the same diagnosis mainly needs help with meals, bathing, or supervision during the day. Medicare looks at the type of care that has been ordered and whether the patient meets the program’s requirements.
If your provider has recommended skilled care at home, contact your local Phoenix office. You get to choose your home health care agency, and we’re ready to serve.
What Does “Homebound” Mean for Medicare Home Health Services?
A person may be considered homebound when an illness or injury makes leaving home medically inadvisable, or when leaving requires another person’s assistance, special transportation, or an assistive device such as a walker or wheelchair. Medicare also considers whether leaving home normally takes considerable effort.
This doesn’t mean that you can never leave your home. You may still go to medical appointments and remain eligible. A person recovering from surgery, for example, may attend a follow-up appointment with help while still meeting Medicare’s homebound requirement because getting out of the house remains difficult.
What Does “Intermittent” Home Health Care Mean?
Medicare home health is generally delivered through scheduled visits for a skilled purpose. It is not the same as having a caregiver remain in the home for most of the day.
In most cases, Medicare defines part-time or intermittent skilled nursing and home health aide care as up to eight hours a day combined, for a maximum of 28 hours a week. In certain circumstances, care may temporarily increase to as much as 35 hours a week. You can read Medicare’s explanation of part-time or intermittent home health care for the complete rule.
Which Home Health Services Can Medicare Cover?
When eligibility requirements are met, Medicare may cover skilled nursing, physical therapy, speech-language pathology services, occupational therapy, and medical social work.
Phoenix’s home health services include skilled nursing and therapy delivered in the patient’s home. Request care from Phoenix today.
What Doesn’t Medicare Cover Through Home Health Care Services?
Medicare does not pay for 24-hour care at home through its home health benefit. It also does not cover home meal delivery, shopping or cleaning unrelated to the home health plan, or personal care when that is the only care you need.
A person may finish physical therapy because the skilled rehabilitation goal has been met and still need help preparing dinner or getting ready for bed. Those needs are still important, but they simply fall outside what Medicare’s skilled home health benefit was created for.
When Does Private Duty Care Make More Sense Than Home Health Care Services?
Private duty care is designed for those who need ongoing assistance with everyday life, from personal hygiene and meal preparation to transportation, companionship, and extended respite care so family caregivers can take a break.
Phoenix Home Care & Hospice offers private duty schedules ranging from two-hour shifts to 24 hours, and a doctor’s order is not required. Explore Phoenix private duty care today or request care here.
Private duty is separate from Medicare’s home health benefit. Phoenix states that it may be paid for out of pocket, through long-term care insurance, or with authorized VA benefits. Phoenix also offers Medicaid-authorized in-home programs. Find your local Phoenix office to see what we offer in your community.
Looking for a Home Health Care Agency? Ask for Phoenix Home Care & Hospice by Name
If you qualify for Medicare home health, you have a say in which Medicare-certified agency provides care. Phoenix Home Care & Hospice is Medicare- and Medicaid-certified for qualifying home health care services. If a physician or another healthcare provider recommends home health, you can ask whether Phoenix is available for your care.
You don’t need to learn every Medicare rule before you make a call. Tell Team Phoenix what your provider has recommended, share your questions, and we’ll guide you through the entire process of receiving care from our professionals. From there, you can get a clearer picture of whether Medicare-covered home health services fit the situation or if another type of care, like private duty care, is a better fit.
Call (855) 881-7442 to talk with Team Phoenix about home health eligibility, coverage, and next steps.
