Home Health Care
How to Find Home Health Care That's Right for You
What Is Home Health Care?
If you are recovering from an illness, wound, surgery, stroke or other disabling event, your doctor may prescribe home health care. Home health care provides skilled nursing care, physical and occupational therapy, speech-language therapy, and medical social services in the comfort of home. Home health care is prescribed by your doctor and is provided by a variety of skilled health care professionals. Medicare covers home health care that is temporary and part-time.
Home Health Care: What Medicare Covers
Medicare will help cover home health care costs for people with Medicare who meet the following four conditions:
For information about these services and Medicare's coverage of home health care, read the free publication from the Centers for Medicare & Medicaid Services, Medicare and Home Health Care, available on the Web at www.medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227).
- Your doctor must decide you need medical care at home, and make a plan for your care at home.
- You must need at least one of the following: intermittent skilled nursing care, physical therapy, speech-language therapy, or continue to need occupational therapy.
- You must be homebound. This means that you are normally unable to leave home unassisted. Being homebound means that leaving home is a major effort. When you leave home, it must be to get medical care, or for short, infrequent nonmedical reasons such as a trip to get a haircut, to attend religious services, or adult day care.
- The Medicare program must approve the home health agency caring for you.
Things to Ask Home Health Agencies
Quality of care can differ among home health agencies. To make the best decision, talk to your family, health care provider, or discharge planner. Call agencies and ask questions about their services. Some services may not be covered by Medicare. Ask whether the agency:
- Offers the specific health care services you need, such as nursing or therapy
- Has staff available to provide the hours of care your doctor ordered, and can start when you need them
- Meets your special needs, such as language or cultural preference
- Offers the personal care services you need, such as help bathing and dressing
- Can help you arrange for additional services, such as Meals on Wheels
- Has staff available at night and on weekends for emergencies
- Is Medicare certified
- Will explain what your insurance covers, and what you must pay out-of-pocket
- Does staff background checks
- Has letters from satisfied patients, family members, and doctors
Compare Care: Medicare's Information About Quality
To help you make an informed decision, Medicare provides quality-of-care information for Medicare-certified home health agencies. You can compare how well agencies in your area help patients get better in the following measures:
For more information, visit the Home Health Agencies section of Medicare.gov. Or call 1-800-MEDICARE (1-800-633-4227).
- Dressing themselves
- Getting in and out of bed
- Taking oral medicines correctly
- Level of confusion
- Pain when moving around
- Admission rate to the hospital
- The need for urgent, unplanned care
- Improvement of surgical wounds