Many health emergencies, such as broken bones from a fall or even a stroke, are unexpected. While the recovery period from these and other conditions can vary, you might require the assistance of a home health care organization. 

On the surface, having someone come into your home to provide health-related services sounds costly. But, the good news is that many private insurance companies cover this as do Medicare and Medicaid. 

Steps for Getting Affordable Home Health Care

Home health care is designed to deliver equipment and health services to patients who are homebound. Hospital stays are expensive, so it’s often more cost-effective to deliver some services to a patient’s home rather than have them admitted to a facility. 

Unfortunately, Medicare doesn’t cover long-term care, or custodial care, for patients diagnosed with cancer, Alzheimer’s, and some other conditions. But there are some programs that can assist with those costs. Otherwise, here are some of the ways you can access affordable home health care. 

1. Understand the Criteria

To qualify for home health care coverage under Medicare and Medicaid, you must meet the following criteria:

  • You must be classified as “homebound” by the Centers for Medicare & Medicaid Services (CMS); 
  • You must be in need of skilled care on an intermittent or part-time basis to maintain, improve, further slow, or prevent a covered health condition;
  • You must be under the care of a physician, who documents a visit with you either within three months before or one month after the start of services; and
  • You must receive care from a Medicare-approved facility. 

2. Which Services Are Covered

If you have coverage for home health care services and meet the above criteria, you can receive a variety of services. These include durable medical equipment, physical therapy, occupational therapy, medical supplies, medical social services, speech-language pathology services, and some other services. 

3. What About Original Medicare?

Interestingly, if you have Original Medicare coverage, you won’t have to pay anything for home health services. The only exception is durable medical equipment, where you might be responsible for 20% of the Medicare-approved amount. If you are concerned about costs, home health care providers can give estimates of coverage before the delivery of services. 

4. Home Health Care vs. Home Care

There is a difference between home health care and home care, and this is a vital distinction when it comes to coverage. Home health care delivers medical services by trained personnel related to a condition. Home care refers to non-skilled personal care that most people are able to do on their own. 

Home care includes helping with activities of daily living (ADLs) such as eating, dressing, and bathing. Agencies offer these services, but Medicare doesn’t cover them. In some cases, Medicaid will cover the services, which eligible people can access through their state’s enrollment program. 

MedTrust is a leading provider of ambulance patient transportation services in South Carolina and parts of North Florida. A large portion (80%) of our services consists of transportation between hospitals, and 30% of our transports are ALS-based requests. Contact us to learn more about our services or find out how you can join our team of highly-dedicated EMTs and paramedics.