I have been told that in order to receive home health care, I have to be homebound, what does that mean?

 

In order to receive home health care under Medicare benefits and most private insurance policies, both the home health agency and the patient’s physician must certify that the patient is homebound.

Homebound does not mean that the individual has to be confined to a bed or wheelchair, or even to his house, but rather, the patient must either require assistance to leave his home (human and/or a device), or leaving poses a taxing effort to the patient. The taxing effort must be documented.

For example: The patient was short of breath from the 3 minutes it took to walk from the front door to the bedroom, a distance of 35 feet, and it took 10 minutes of rest to recover.

 

Homebound status allows for some specific flexibility. A patient may leave home for medical treatments, doctors’ appointments – infrequent outings to the hair salon, church, or special occasions. However, again, assistance is required and the effort must be taxing to qualify for home health care. A nurse or physician can help make that determination.

Who pays for Home Health Care?

 

Medicare – Pays 100%

Commercial Insurance

VA

Medicaid (depending on circumstances)

Individuals

Worker’s Comp

Personal Injury Settlements

 

How can a person get on home health?

 

Referrals are welcomed from prospective patients, family members, friends, hospital personnel, and others. However, home health services must be authorized and coordinated by a physician. Anyone may contact our offices and we can start the process immediately.

 

Who decides what home health agency provides service to a patient?

 

It is always the patient’s choice as to which home health agency he/she wants. Oftentimes, a patient will be misinformed about whose choice it is or will be directed toward a preferred agency, however, no matter what the service is, in healthcare, it is always patient’s choice.

 

What qualifies a person for home health service?

  • If you have difficulty leaving home
  • You are calling or making frequent trips to your doctor
  • You have recently been discharged from the hospital
  • You have wounds that are not healing
  • You need periodic blood work
  • You are an unstable diabetic
  • You have been prescribed new medications
  • Your blood pressure fluctuates
  • You are coming home from a nursing home – Medicare will pay for continued therapy in home
  • You have had surgery
  • You are about to have surgery