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What Is A Home Health Aide

Medicare & You: Nursing Home / Long-Term Care

A home health aide is a professional who provides assistance to patients with special needs, including those who are disabled, chronically ill, or cognitively impaired. They may also provide services for seniors who require assistance in the home.

A home health aide may provide services including checking vital signs, assisting with personal hygiene, administering medication, and employing other elements of a physician-prescribed plan of care.

Home Health Aide vs. Personal Care Aide

The duties of a home health aide and a personal care aide overlap at times, but the key difference is that home health aides typically work for agencies instead of being directly employed by their clients. Home health aides play an important role in the continuity of care, coordinating among caregivers and medical professionals, and tracking the condition and progress of their clients.

While home health aides and personal care aides provide services to the same type of patient, a personal care aide’s duties are typically limited to non-medical services. This may include dressing, bathing, cooking, cleaning, running errands, doing laundry, and providing companionship for their clients.

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  • Locations in 39 states

  • Variety of programs to enhance skilled nursing, including skilled therapy, balance and fall prevention, and orthopedics

  • Not all locations offer hospice

  • Website offers Spanish translation, but only portions of the site are available in Spanish

We chose Encompass Health for its easy-to-use technology that makes a customers online experience simple, with comprehensive information quickly available. Its online software streamlines each step, from referral processing to scheduling to management of physician orders, in order to optimize patient care and attention. This connection between patients, doctors, and in-home care providers makes processes easier and more transparent.

In addition, Encompass web portal provides one-stop access to manage diagnoses, patient history, medications, and plan of care. Encompass is also able to deliver better care for patients through predictive analysis, to identify potential risks. According to LexisNexis Risk Solutions, Encompass was also the nations fourth largest provider of Medicare-certified skilled home health services in 2019.

What Certified Nursing Aides Do

Also known as: CNA, home health aide or certified nursing assistant

A certified nurse aide is a caregiver who will come to your home to provide medical care. Home health aides and CNAs may also help with other day-to-day care needs, such as bathing, dressing, light housekeeping, or meal preparation.

Generally, home health aides and certified nurse aides have undergone formal training and certification. They can administer medications, and many have received special training to change simple dressings, give massages, and assist with braces and mobility devices.

Some are also trained to operate and troubleshoot medical equipment, such as home oxygen or ventilators. Training and certification requirements for this type of caregiver vary by state, so be sure to ask about each caregivers unique qualifications. You should expect any home health worker to be supervised by a nurse and to provide care as outlined in your loved ones home healthcare plan.

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When Is Physical Occupational Or Speech Therapy Covered By Medicare

Physical therapy will be covered by Medicare when it will help the patient regain strength or movement after an illness or injury. The same holds true for occupational therapy where the goal is to restore functionality, and for speech therapy to help patients relearn how to communicate.

The services will only be covered if they are expected to result in an improvement within a predictable period of time. Additionally, the frequency, duration, and number of services must be reasonable and provided by a qualified therapist. To be eligible for the services your condition must either:

  • Be expected to improve,
  • Require a maintenance program from a skilled therapist, or
  • Require a skilled therapist for maintenance.

Professional therapists will restore or improve your ability to perform routine everyday tasks, speak or even walk following an illness or injury. They may also help prevent a condition from worsening and will only be covered if the services specifically, safely and effectively treat your condition.

What Are Medical Social Services

Medicare Part A and ER visits: Coverage and costs

These are medically prescribed services to help the patient cope emotionally in the aftermath of an illness or disease. Examples of medical social services that Medicare covers include in-home counseling by a licensed therapist or social worker. Keep in mind that these services are only covered by Medicare if you are receiving skilled nursing care at home. They can also help you find community resources if you need them.

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How Can I Help My Elderly Parent Stay At Home

Many people find it challenging to adjust to changes and losses that occur as they grow older. In addition, a large number of people aged 65 and older experience impaired health or injuries that severely affect their day-to-day life and habits. So, caring for your aging parent may be overwhelming at times.

If you and your elderly parent dont find moving to a skilled nursing facility appealing, home health care may be the best option as it allows your aging parent to stay at home and still receive all the assistance needed.

Consider your parents needs and the level of assistance needed, so you understand how much help your parent needs to stay safe in their own home.

What Medicare Will Not Cover

Medicare will not pay for a number of services sometimes provided as part of home health care, including:

  • drugs and biologicals administered at home
  • personal care by part-time home health aides if this is the only care you need
  • meals delivered to your home
  • housekeeping services, or
  • full-time nursing care.

If you require durable medical equipment, such as a special bed or wheelchair, as part of your home care, Medicare will pay only 80% of the costs.

For more information on Medicare coverage of home health care, read Medicare’s online publication Medicare and Home Health Care at .

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Learn How To Schedule In

    Everyone needs a little extra help sometimes. Thats especially true if youre dealing with a serious medical condition or recovering from a procedure. For example, maybe youre finding it hard to manage your medications or personal care. Or perhaps standing for long periods of time to cook a healthy meal or take care of necessities around the house is simply too much right now.

    If that sounds familiar, an extra set of hands might be just what the doctor ordered and thats where a home health aide can help. A home health aide is someone who can help you with non-skilled care in the comfort of your own home. In other words, they can help you with day-to-day living activities. But not with services a health care worker like a nurse or physical therapist offers.

    Best of all, a home health aide may be covered by your plan, provided you have a doctor or hospital order and plan of care. Heres what you need to know.

    Whos eligible for a home health aide

    You may be able to get a temporary home health aide if you meet all the following qualifications:1

    Home health aides through Medicare are approved for only up to 21 days. If you need longer-term care, then you may be eligible for a home health aide through your state via a Medicaid waiver, says Nicole Wolf, RN, manager of Clinical Health Services at Aetna®. Your hospital, doctor or insurance case manager can help you find out if you qualify.

    What to expect during your in-home visits

    • Give you medications.

    How Can I Get Help Paying For A Caregiver

    Medicare and your CalPERS Health Benefits

    If you or your loved one have exhausted your financial resources paying for in-home caregivers, you may be eligible for both Medicare and Medicaid.

    Every state has at least one home- and community-based health services waiver program. If you meet the eligibility guidelines, this type of waiver program could help you pay for things like:

    • adult day care
    • help with daily personal care
    • modifications to your home
    • help with housekeeping

    If you think you or someone in your family might need custodial care, you may want to consider a long-term care insurance policy to help you cover the cost.

    A Medicare supplement plan may also help you pay some of the costs that Medicare wont cover.

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    Range Of Home Health Benefits

    Either element of original Medicare Part A hospital insurance and/or Part B doctor visits and outpatient treatment might cover home care. Services include these:

    Medicare does not cover:

    • 24-hour care at home
    • Custodial or personal care when this is the only home care you need.
    • Household services such as shopping, cleaning and laundry when they are not related to your care plan.
    • Meal delivery to your home

    Medicares website has a search and comparison tool to help you find certified home health agencies in your area. If you have original Medicare, Parts A and B, you can choose any approved agency.

    If you have a Medicare Advantage plan from a private insurance company, you may have to use an agency that the plan works with. Before you start receiving care, the agency should let you know, verbally and in writing, whether some of the services they provide are not covered by Medicare and what you would pay for them.

    Editor’s note: This article was originally published on Jan. 1, 2014. It has been updated with the latest information regarding Medicare coverage in 2020.

    Does Medicare Cover Podiatry

    Medicare Part B may cover podiatry. Visits to a foot doctor may be covered, but not for routine foot care. Generally, Medicare Part B covers podiatry when:

    Find affordable Medicare plans in your area

    Your doctor determines that this care is medically necessary for example, you have a foot injury or deformity, or a heel spur or hammer toe

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    How Much Does Home Healthcare Cost And What Are The Payment Options

    In most cases, home health care agencies are not set up to provide fee-for-service they offer services that are reimbursed by Medicare or other insurance. If they do charge fee-for-service, Home healthcare costs range from $15 to $75 per hour, depending on the training and expertise of the specific healthcare worker who comes to your home. Nurses and physical therapists are more expensive home health aides charge less.

    When your loved one is recovering from surgery, accident, or illness and home healthcare is prescribed by a doctor, its generally covered by Medicare. Heres the tricky part: Medicare provides coverage for a specific ailment. Once recovery from that ailment is complete, Medicare coverage ends. And Medicare coverage also ends if your loved one ceases to make progress in recovery efforts.

    When home healthcare is not covered by Medicare, you can explore additional options, such as veterans benefits, Medigap, Medicaid, long-term care insurance, or private pay.

    Note that home healthcare is different from long-term in-home care assistance that doesnt involve medical care. In-home nonmedical care to help someone with things like bathing, toileting, and other activities of daily living or for companionship, security, or household tasks involves different costs and coverage possibilities.

    There are many options to pay for your loved ones home healthcare. What follows are some of the most common payment options.

    Home Repair And Maintenance Services

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    As a general rule most personal care agencies provide only aides to help with personal needs in the home. Very few offer such things as deep housecleaning, home repairs, remodeling or yard maintenance. There is now a growing trend for companies to specialize in providing these additional services for the elderly. And as with personal care agencies many of these belong to national franchises.

    It is evident that there is a growing national need to provide services to allow people to remain in their homes as long as possible. The growth of companies providing these services is evidence that this is a preference for the elderly needing care in the community.

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    How Much Does Medicare Pay For Home Health Care

    The average hourly cost of home health care in Arizona is $23.25, and it is normally less expensive than the care you would receive in a hospital or skilled nursing facility. Statewide, the cost of non-medical home care ranges from $16 $28 per hour. Medicare covers 100% for skilled health-care services as long as you are homebound.

    However, Medicare wont cover for home aides that help with household services and personal care . Also, Medicare doesnt cover long-term care for conditions like Alzheimers or cancer.

    How Much Will Medicare Pay For Mental Health Services

    Medicare will cover the outpatient mental health services under Part B at 80% of the Medicare-approved amount. So, as long as you receive mental health services from a participating provider, you will pay a 20% coinsurance after you meet your Part B deductible.

    Mental health services that Medicare Part B may cover include:

    • Psychiatric evaluation

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    Does Private Health Insurance Pay For Home Health Care

    Private health insurance, such as employer-sponsored as well as individually-purchased insurance, managed care programs, and long-term care insurance, may cover some home care services . It may be an option for those who dont participate in a government insurance program or who desire more services than these programs cover.

    Plans sponsored by an employer , and those purchased by an individual often cover home health services for limited periods. Check with your plan administrator, benefits coordinator, or insurance representative to verify what your policy covers and whether home health services require an authorization.

    VNSNY accepts a wide variety of managed care programs and Medicare Advantage plans, including those offered by our subsidiary company, VNSNY CHOICE. Check with your managed care company to verify that VNSNY is a participating home health care company and whether home health services require an authorization. Learn more about the managed care plans offered by VNSNY CHOICE.

    Whether provided by an employer or purchased individually, LTC generally provides specific dollar payments for insured persons who require assistance with activities of daily living. Policies vary in terms of how much assistance is covered, and by benefit amounts. Be sure to check with your provider to verify that your plan covers what you think it does.

    Find Home Healthcare Agencies Near Me

    Medicare Care Compare Video Nursing Home (:15 Seconds)

    Home healthcare, or skilled care you receive at home, is a continuation of care your loved one might have received or needed in an inpatient care placement. This kind of care may be called senior home healthcare or elderly home healthcare.

    These services may be part of a doctors treatment plan for your loved one, so they can be at home and still receive rehabilitation, recovery or other clinical healthcare. The doctor may recommend occupational or physical therapy, speech therapy, wound care, staff to provide medications or injections, and staff to monitor recovery while remaining at home.

    This arrangement, as ordered by a doctor, is likely temporary as the patient may resume normal function and can handle household duties and functions after recovery. In some instances, caregivers decide to continue the skilled home healthcare after the physicians order has ended, with the understanding that coverage for that benefit may change at that point.

    You will have some ability to negotiate when care providers come to your home, depending on what kind of care the doctor has recommended. For example, a doctor may recommend that a physical therapist come to your home three times a week to work with your loved one. Your family will be able to work with the provider to find the times of day that work best for everyone. Since these services are part of a treatment plan, Medicare or insurance often covers the cost of home health care.

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    What Is A House Call Doctor

    A house call doctor, or house call physician, is simply a doctor who performs medical visits in the patient’s place of residence. House call doctors may be employed by an agency, or they may have their own practice.

    What Are the Benefits of Physician House Calls?

    The primary benefit of physician house calls is that patients receive quality care, from qualified physicians, in the comfort and convenience of their own home or place of residence. Additional benefits of physician house calls include the following:

    • It ensures regular medical care to patients who have few or no other options
    • It helps monitor and treat both preventable and chronic conditions to keep patients out of ERs and hospitals
    • It encourages patients to keep up with regular medical visits by bringing the doctor directly to the patient’s home
    • It saves the patient time and money traveling to the doctor’s office

    Though there are many benefits associated with medical house calls, there are also some challenges, namely that house calls are not ideal for emergency medical problems, and availability of physicians and scheduling options may be limited in some areas.

    How Often Do House Call Doctors Visit?

    House call visits can be scheduled as often as required by the patient, but on average patients are seen on a monthly basis. Visits are typically scheduled on weekdays, though the physician may be available by phone on weekends or after hours.

    How Does Home Health Care Work

    The first step toward receiving home health care is to obtain a physician’s orders and work with a home health care company to develop a detailed care plan. From there, you will be asked to complete an initial consultation with the patient, during which they assess the patient’s needs and develop a plan for treatment. Family members and other caregivers are encouraged to participate in this planning process to ensure consistent and comprehensive care.

    When services begin, home health care staff will implement the plan following all physician orders and keep the physician updated about the patient’s progress. The frequency and type of home health visits will vary depending on the patient’s needs. Some patients require daily care while others require only a short visit once or twice per week.

    All services are tailored to the patient’s needs.

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