In the state of South Carolina, Medicare data tells us that MD order Home Health Care on only 3-14%patients that could benefit. Medicare pays for all PRESCRIBED skilled care. However, you need to ADVOCATE for your needs. Medicare is an insurance company and only pays for prescriptive care. So, start the conversation with your healthcare provider as soon as possible.
Key factors you need to ADVOCATE!
- Home health care is usually less expensive, more convenient than shorter inpatient care. The goal of home health care is to provide treatment for an illness or injury to help you get better, regain your independence, and become as self-sufficient as possible.
- Home health care may also help you maintain your current condition or level of function, or to slow decline.
- Medicare pays for you to get health care services in your home if you meet certain eligibility criteria and if the services are considered reasonable and necessary for the treatment of your illness or injury.
- You’re under the care of a doctor, and you’re getting services under a plan of care established and reviewed regularly by a doctor.
- You need, a doctor to certify that you need, one or more of these: ■ Intermittent skilled nursing care (other than drawing blood) ■ Physical therapy ■ Speech-language pathology services ■ Continued occupational therapy
- Make sure the home health care agency caring for you is approved by Medicare (Medicare-certified).
- You’re homebound, and a doctor certifies that you’re homebound, meaning you have trouble leaving your home without help (like using a cane, wheelchair, walker, or crutches; special transportation; or help from another person) because of an illness or injury, or leaving your home isn’t recommended because of your condition. You can still get home health care if you attend adult day care or religious services.
Here are some examples of what Medicare doesn’t pay for ■ 24-hour-a-day care at home ■ Meals delivered to your home ■ Homemaker services, like shopping, cleaning, and laundry ■ Custodial or personal care like bathing, dressing, and using the bathroom when this is the only care you need. This is all considered HOME CARE so be a good advocate and makes sure you ask for and get the services you require