Home Health
Home Health FAQ
What does "homebound" mean?
For Medicare beneficiaries and for certain insurance plans, patients must be homebound to qualify for home care services. This means that because of a physical condition or limitation, the patient cannot leave home without extreme difficulty or hardship. Homebound status is not affected by absences from home for doctor's visits or medical treatment such as dialysis or chemotherapy. If the person is able to drive or is frequently transported by others for various activities, then the person is not considered homebound. The absence of transportation does not render a patient homebound.
What are the requirements to receive Home Health care?
A patient
must be under the care of a physician and must require the services of
a skilled nurse or physical therapist. The physician writes the orders
for the provision of home health services. Home health service is designed
to meet the goals determined by the team on the treatment plan within a
defined time period. Home health service is not “round-the-clock” care,
but is a specialized treatment plan of skilled care visits by a team that
teaches, gives treatments and helps a patient and family through an illness
episode toward optimal independence.
Who pays for Home Health?
Most medical insurance policies
cover home health services. This includes Medicare and Medicaid,
which cover 100% of the cost of services, provided the patient meets the requirements for home care. Some private policies require a co-pay fee for visits or a deductible
to be met. Patients not covered by medical insurance can arrange for private
pay or seek special arrangements with the agency. The agency handles the filing
of all insurance claims.
HomeCare visits for Medicare beneficiaries are covered under the following conditions:
- They have a need for skilled care.
- They are confined to the home, considered homebound.
- They have an order from a physician.
For those with a private insurance policy or a managed care plan, HomeCare visits are covered under the following conditions:
- They meet the plan’s conditions of participation.
- They have an order from a physician.
What plans support Home Health?
CHRISTUS HomeCare has
contracts with many private insurance and managed care plans.
