Nowadays, people want insurance for almost anything, but not as much as an assurance of a complete health care. In the United States, there is a social insurance program, known as Medicare, being administered by its government. Medicare was made to provide health insurances for people who are 65 years old and above, people under 65 but have a congenital physical disability or are permanently physically disabled, and for those who qualify for other special criteria. This program sounds great and assuring, but people find more comfort from home health care services. However, will Medicare pay for home health care services?
Home Health Care
Home health care is a range of health care services that are provided by healthcare professionals within the comforts of one’s home. This service makes it possible for people to stay at home rather than having residential or long-term treatments in hospitals and the likes. Home health care services include professional home health care services as well as home health aide services. Its main goal is to treat an injury or illness in order to help a patient get better and be as independent and self-sufficient as possible.
Professional home health care services provide monitoring for serious illness and unstable health, pain management, physical therapy, speech therapy, occupational therapy, wound care, and patient and caregiver education. As for home health aide services, these include aid in daily tasks such as getting in and out of bed, bathing, dressing, eating, using the bathroom, housekeeping, doing the laundry and errands, giving medication reminders and/or companionship.
In order to have home health care services, health insurance plans such as Medicare have a list of requirements to check on a patient’s qualification. A patient’s eligibility for a Medicare program is based on the amount of services needed. Eligible patients must be under the care of a doctor who has certified that intermittent skilled nursing care, physical therapy, speech-language pathology services, and/or continued occupational therapy is/are needed by the patient. Also, the home health agency that is caring for the patient must be approved by Medicare. A patient must also be homebound; meaning that leaving home isn’t recommended or it takes a considerable effort and help because of one’s condition.
If all the conditions are met, Medicare will pay the patient’s Medicare-certified home health agency the covered services during an episode of care (60-day period). The home health benefit provided by Medicare only pays for the services rendered by the home health agency. The following services are covered and could be paid for by Medicare home health care:
• Skilled Nursing Care – This includes the kind of assistance that can only be provided by a licensed nurse (a registered nurse or a licensed practical nurse).
• Physical Therapy – This covers exercises done to regain movement and strength to certain parts of the body.
• Occupational Therapy – This therapy aids a patient in becoming independent and able when it comes to daily activities of an individual.
• Speech-language Therapy – This is an exercise designed to help a patient speak more clearly and easily.
• Medical Social Services – These are services that help with the social and emotional concerns of the patient.
• Medical Supplies and Equipments – These may be wound dressings, walker, or a wheelchair (prescription drugs are not included).
All these benefits are provided for by Medicare as long as the patient passes all the conditions and requirements set by Medicare. It should also be noted that Medicare does not pay for prescription drugs, meals, or even a 24-hour-a-day home care.