Home Health Care Payment Options

Home health care is a great option for seniors who require special assistance while recovering from illness, injury or medical procedures. It is provided in the home, and can afford most all of the medical care a hospital or rehab center may provide.

Paying for Home Health Care

The cost of services will vary depending on the type of provider and medical services required. Services can be paid for directly by the patient from private funds, or through many different public sources. Public sources for home health care funding include Medicare, Medicaid, Medigap, Managed Care, the Older Americans Act, the Veterans’ Administration (VA), and private long term care insurance.

Medicare

Medicare is the most commonly used funding source of home health care services. It covers a wide range of services such as:

• Skilled nursing care on an intermittent or part time basis provided by or under the supervision of an RN
• Home health aides if necessary
• Up to 35 hours per week combined nursing and home health aide services
• Physical and occupational therapy
• Speech language pathology
• Medical social services to assess the social and emotional factors related to your condition
• Prescribed medical supplies
• Durable medical equipment such as wheelchairs, walkers, oxygen tanks (covered at 80% of the Medicare-approved amount)

• The Medicare program will pay for home health care if the following conditions are met:
• Medicaid will cover most skilled nursing care at home, including any medical equipment deemed necessary by a physician, under the condition that the total cost is less than living in a nursing home (skilled nursing facility).

• Medical care at home must be prescribed by a doctor in accordance with a plan of treatment
• Care required must include intermittent or part-time (not full time) skilled nursing care, physical therapy or speech pathology services
• Patient must be homebound
• Home health agency hired must be approved by the Medicare program

Medicaid

Medigap

Medigap policies D, G, I and J have a benefit that covers home health care. The coverage varies according to the policy you choose. These benefits may include assistance with Activities of Daily Living (ADLs) such as personal hygiene, meal preparation, housekeeping and more.

In order to be eligible to receive Medigap benefits, an individual must currently be receiving Medicare-covered skilled home health care.

Veterans’ Benefits

The Veterans’ Administration provides home health care to veterans with chronic health conditions. Home health caregivers are provided directly by the VA or at times through contract home health care agencies. Services provided include:

• Skilled nursing care
• Physical and occupational therapy
• Speech language pathology
• Social services

The VA will pay for home health care if the following conditions are met:

• Patient meets certain benefit eligibility criteria as set by the VA
• Patient must be homebound
• Patient demonstrates need for home health care

Source:  www. myseniorcare.com