Home health care is skilled nursing care, physical, speech, or occupational therapy provided in a patient's home rather than in an inpatient or outpatient facility. Home health care is a Medicare benefit, and the Medicare regulations related to home health care qualifications are considered standard in the industry. Private insurance companies may also offer home health benefits, which may differ slightly from Medicare's benefits. Most home health agencies operate under Medicare guidelines because Medicare is the most common payor source for individuals receiving home health benefits.
Homebound Requirement
The most common con to home health care benefits is the requirement that the patient be home-bound. In order for Medicare and most other insurance providers to pay for home health care, the patient must be unable to leave the home to visit a treatment facility or for any other purpose. If leaving the home requires significant assistance, such as the use of hands-on assistance by another person, is extremely taxing for the patient, or is infrequent and for medical treatment only, the patient may also be considered home-bound.
Short-Term Treatment
Home health care is generally considered to be a short term treatment, typically lasting approximately six weeks. There is no regulation specifying the length of time a patient can receive home care, however, the home health agency must continue to prove that the patient has a need for skilled care. Home health care is also usually part time, lasting less than 28 hours per week, so it's not an all inclusive solution for patients who require round the clock care.
Costs
There may be co-payments associated with home health care, which are a portion of the costs of care to be paid for by the patient. This varies from state to state, and can vary depending on the payor source. Durable medical equipment, such as wheelchairs and oxygen concentrators, and medications are only partially paid for by the home health agency, with a usual co-payment of 20 percent for the patient. However, this cost can be significantly less than if a patient were paying the total cost out of pocket.
The Home Component
Home health care is convenient for patients for whom it is difficult to leave the home. Home health care benefits allow patients to received necessary skilled care without leaving the home, including more advanced maintenance, such as changing catheters and intravenous therapy. It's possible for patients to return home from the hospital sooner and receive home health care in lieu of extended hospital stays, in some circumstances.
Private Pay Options
If an individual requires round-the-clock care, or caregiver services at different times throughout the day, it's possible for the family to hire a non-medical in-home care provider. These services must be paid for privately. Non-medical home care agencies provide a range of services, including housekeeping, personal care, transportation, meal preparation, and more, although the services can be quite expensive.
Fraud
The home health industry is subject to frequent scrutiny, being suspect of falsifying documentation in order to qualify individuals for care or bill for services not provided. This practice drives up the cost of home health care, and contributes to skyrocketing health care costs in general. Choose a well-known provider and monitor your bills closely.
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