what services do you need?

Home care services can enhance your health and quality of life by helping you maintain your independence. The type of home care service you may need depends on factors such as your mental and physical health, what kind of support you have from family and friends, and whether you live in your own home or in a facility that provides some types of assistance. Home care services can range from help with chores to professional health care and rehabilitation.

You may consider home care services if you need assistance caring for yourself because:

• You're less able to care for yourself as you get older
• You have a disability
• You're recovering from an illness, surgery or a hospital stay
• You're living with a chronic illness
• You have a terminal illness

how you can find the home care service

The first step to finding a home care service is to talk to your doctor or your physical or occupational therapist about what services you'll need. You may only require an occasional visit from a nurse to administer medication, or you may need more elaborate medical care or other types of support.

Your nurse, doctor, hospital social worker or hospital discharge planner may be able to recommend several reputable home health care agencies. Your friends or family also may be able to provide some insight into which home care services provide the best care. Or you can check the Yellow Pages, under the heading "Home Health Care Services" or "Nurses." Other sources include your state and county health department and Area Agencies on Aging and the national Eldercare Locator, a public service of the Administration on Aging. Once you know what types of services you need, evaluate the costs, credentials and services offered by each provider you are considering.

Finding the right home health care services requires communication with your doctor or other health professionals, and a little research. But qualified home care is an important treatment option that can improve the quality of life of both the person receiving care — and the family members.

common questions

medicare coverage

Medicare covers HH services when the following criteria are met:

• The patient to whom the services are furnished is an eligible Medicare beneficiary who is not enrolled in a Medicare Advantage Plan
• The HHA that furnishes the services has in effect a valid agreement to participate in the Medicare Program
• The patient qualifies for coverage of HHA services
• The services are covered Medicare benefit
• Medicare is the appropriate payer
• The services are not otherwise excluded from payment

To qualify for Medicare HH benefit, a patient must:

• Be confined to the home
• Be under the care of a physician
• Be receiving services under a plan of care established and periodically reviewed by a physician
• Be in need of skilled nursing care on an intermittent basis (furnished or needed on fewer than 7 days each week or less than 8 hours of each day for periods of 21 days or less, with extensions in exceptional circumstances when the need for additional care is finite and predictable), be in need of PT or SLP services, or have a continuing need for OT services

A patient’s residence is wherever he or she makes his or her home (e.g. own dwelling, apartment, relative’s home, home for the aged, other type of institution). Hospitals, Skilled Nursing Facilities, and most nursing facilities under the Medicaid Program are not considered a patient’s residence under the HH benefit if they meet the requirements under §§1861(e)(1) or 1819 (a)(1) of the Social Security Act.

paying for home health care

Home health services can be costly. You may need to pay for home care services directly, or costs may be covered through insurance or other public or private sources.

Medicare

Medicare may pay for medical home health care services through a certified home health care agency, if a physician orders these services. Services covered by Medicare include skilled nursing assistance, or physical, speech or occupational therapy. If your home health services are covered under Medicare, your doctor, care manager or discharge planner will probably make arrangements for a home health care agency.

Medicaid

Depending on your income and assets, if you are over 65 you may be eligible for Medicaid coverage.

Medicaid Waiver

Helps seniors and people with disabilities become active members of their communities instead of living in an institution.

Veterans Affairs

If you are a veteran and at least 50 percent disabled due to a service-related injury or illness, you may be eligible for medical services through Veterans Affairs hospital-based home care services. You may qualify for VA assistance.

Community organizations

Depending on your situation and finances, certain community organizations cover home care costs.

Insurance

Many insurance programs cover some home health care services for short-term medical needs. However, long-term coverage varies. Long term care policies are available through private insurance companies and the federal government.

The Indiana Chronic Disease Management Program

Helps some of the most vulnerable Medicaid recipients improve their health and manage chronic conditions such as heart disease, diabetes and asthma.

Private Pay

Private Pay clients may select how they would like to pay: weekly, bi-weekly, or monthly. You will receive an invoice for the services you received.

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