Using Medicare to Pay for Your Home Health Needs

North Carolinians who need home health care use a variety of means to pay for it, whether it’s out of pocket through savings, or through various forms of insurance like private health plans, Medicaid, or Medicare. Today, let’s talk about how people qualify for home health coverage under Medicare.

What Is Medicare?

Established in 1965 as part of amendments to the Social Security Act, Medicare is the federal government program that provides health care coverage (health insurance) if you are 65 or older, under 65 and receiving Social Security Disability Insurance (SSDI) for a certain amount of time, or under 65 and with End-Stage Renal Disease (ESRD).  Known by its “parts,” Medicare provides for inpatient and hospital coverage through Part A, while Part B pays for outpatient and medical coverage. Part D is the more recently enacted prescription drug benefit program.

Many people confuse Medicare and Medicaid. The easiest way to remember the difference is by knowing who benefits from each program.  Medicare is basically engineered to provide health care coverage for older Americans, while Medicaid targets its help to lower-income and poor Americans.

Medicare Coverage of Home Health Services
At HealthKeeperz, we offer a wide range of health services delivered in your home. Services covered by Medicare include intermittent skilled nursing care, therapy, and care provided by a home health aide. Depending on the circumstances, home health care may be covered by Part A or Part B.

Here’s a quick guide for qualifying for home health care under Medicare. Patients must meet the following requirements:

1. You are homebound, which means that it’s difficult for you to leave your home and you need help doing so.
2. You need skilled nursing services and/or skilled therapy care (physical, speech, or occupational) on an intermittent basis.
3. You have a face-to-face meeting with a doctor within the 90 days before you start home health care, or the 30 days after the first day you receive care. This can be an office visit, hospital visit, or in certain circumstances a face-to-face visit facilitated by technology (such as video conferencing).
4. Your doctor signs a home health certification confirming that you are homebound and need intermittent skilled care. The certification must also state that your doctor has approved a plan of care for you and that the face-to-face meeting requirement was met.
   1. Your doctor should review and certify your home health plan every 60 days. A face-to-face meeting is not required for recertification.
5. And, you receive care from a Medicare-certified home health agency (HHA), like HealthKeeperz.

If you or someone in your family needs home-based health care, and you meet the eligibility requirements above, contact us at HealthKeeperz today. Our customer service representatives can work with your family and your medical team to ensure you receive the very best in home health care with the peace of mind that comes from knowing your costs will be covered by Medicare. Call us today at 800-309-3784.
 
 
 
 

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