Frequently Asked QuestionsHome Health & Hospice
Common Questions about Home Health & Hospice
Who is eligible for home health?
All Medicare beneficiaries can receive home health care benefits. Some insurance companies also cover home health care benefits, depending on your plan. You must meet all four conditions outlined below for Medicare to cover home health care.
- Your doctor must decide that you need medical care in your home, and make a plan for your care at home; and
- You must need at least one of the following: intermittent (and not full time) skilled nursing care, or physical therapy or speech language pathology services; and
- You must be homebound. This means that you are normally unable to leave home. Being homebound means that leaving home is a major effort. When you leave home, it must be infrequent, for a short time, or to get medical care; and
- The home health agency caring for you must be approved by the Center for Medicare & Medicaid Services.
Who is eligible for Medicare coverage of home health?
Most Americans older than 65 are eligible for the federal Medicare program. To qualify for Medicare Home Health Care, you must meet the following requirements:
- A physician must determine (order) that you need a skilled home health service.
- A physician must develop and sign a plan of care.
- You must be homebound. This means you have an inability to leave home and, therefore, leaving home requires a considerable and taxing effort. Occasional absences from the home are permitted as long as they are of short duration. For example, doctor appointments, family reunions, funerals, religious services, graduations will not disqualify you from home health services as long as they do not indicate you have the ability to obtain services in a setting other than your home.
- You must need one of the following services intermittently (part time): skilled nursing / physical therapy / occupational therapy or speech therapy.
What does the original Medicare Plan cover?
If you meet all of the conditions outlined for home health care, Medicare will cover:
- Part – Time or Intermittent Skilled Nursing Care
- Part – Time or Intermittent Home Health Aide Services
- Physical and Occupational Therapy
- Speech Language Pathology Services
- Medical Social Services
- Medical Supplies
- Durable Medical Equipment
The following explains some of the items notated above:
- Skilled nursing care on a part-time or intermittent basis. Skilled nursing care includes services and care that can only be performed safely and correctly by a licensed nurse.
- Home health aide services on a part- time or intermittent basis. A home health aide does not have a nursing license. The aide provides services under the direction of the nurse, and can include helping with personal care, such as bathing, using the toilet, or dressing. The Home Health Aide Services must be part of the home care for your illness or injury. Companion services, assistance with homemaking, housekeeping and errands are not covered by Medicare.
- Medical social services to help you with social and emotional concerns you have related to your illness. This might include counseling or help in finding resources in your community.
- Certain medical supplies, like wound dressings, but not drugs or prescriptions.
- Medicare usually pays 80 percent of the approved amount for certain pieces of durable medical equipment, such as a wheelchair or walker.
Are home health workers insured while coming to my home?
Yes. All care providers are fully insured. Additionally, all receive a full background check during the application process.
What services does the Healthy Living Network provide?
The Healthy Living Network consists of independently owned and operated agencies that are state licensed and Medicare certified. The Healthy Living Network‘s mission is to provide exceptional clinical care and services to the aging population, in their homes, with the intent of not just helping individuals get well, but also fostering a healthier state of being.
The Healthy Living Network provides:
- Licensed Nurses
- Physical Therapists
- Speech Language Pathologists
- Occupational Therapists
- Dietary Consultants
- Medical Social Workers
- Home Health Aides
How do home health services work and are Healthy Living Network services covered by health insurance?
Healthy Living Network offers services provided by on-call nurses 7 days a week, 24 hours a day. Once a Healthy Living Network agency receives an order from your doctor, a Healthy Living Network professional will contact you to schedule a home visit. On the initial visit a nurse or a physical therapist will provide an evaluation to determine your current medical and functional status, which will help the professionals develop your personalized plan of care.
Medicare generally covers Healthy Living Network‘s services 100%. Healthy Living Network generally accepts some HMO and PPO insurance plans. Healthy Living Network professionals will verify your benefits and arrange coverage.
Who needs home health?
The Healthy Living Network’s services are tailored specifically to help geriatric patients recover after injury or illness. Patients qualify for home health services if leaving home takes a considerable and taxing effort. Therefore, Healthy Living Network agencies often see patients recovering after surgery, trying to heal a wound, taking new medications, or those who are at risk of falling.
In what areas are Healthy Living Network services available?
I noticed that Healthy Living Network agencies are accredited by the Joint Commission. What does that mean?
Joint Commission accreditation is challenging, but well worth the effort. The Joint Commission’s Gold Seal of Approval®, is a mark of quality. Accreditation requires a thorough evaluation of each agency and sets clinical care standards in line with those of the best healthcare providers in the nation.
Does the Healthy Living Network offer any specialized programs?
Yes, the Healthy Living Network strives to provide exceptional care. The Healthy Living Network offer cardiac rehabilitation programs, joint rehabilitation programs, and behavioral health programs.
Do you provide care in healthcare facilities or just in-home?
The Healthy Living Network can provide care in assisted living, independent living, and board and care facilities in addition to private residences.