New York Estate Planning & Elder Law Blog
The Center for Medicare Advocacy recently published a document answering various questions about Medicare’s home health benefits. In addition to a document answering frequently asked questions, the Center also published recordings of two webinars, “Medicare Coverage of Home Health Services”, which reviews the eligibility basics for Medicare coverage of home health services.
What Do Home Health Agencies Do?
Medicare’s home health benefits are known as the Mediacertified home health agencies. These benefits have been approved by Medicare to provide the home health services that Medicare covers. The agency has agreed to receive payment from Medicare. Additionally, Medicare only pays for home health services administered by home health agencies that are Medicare-certified.
What Should You Expect from Home Health Care?
Doctor’s orders are necessary to begin care. After a medical provider refers you for home health services, the home health agency will arrange an appointment and come to your residence to discuss your needs. The home health agency workers will also speak with your talk about the type of care you receive and your doctor will be updated about your progress. Some of the specific actions that you should expect home health workers to take include:
- Inspecting whether you are drinking and eating
- Check your vital signs
- Inspect whether you are appropriately taking prescriptions
- Determine if you’re in pain
- Assess the safety of your home
- Inform you about how you can best care for yourself
How Can Medicare-Certified Home Health Agencies Be Found?
A person can determine what home health agencies are Medicare-certified by going to the Care Compare website. Under the provider Type on the website, a person can choose Home Health Services to determine what Medicare-certified home health agencies function in your area.
The medical professional ordering home health services can also provide suggestions for home health agencies. Discharge planners from nursing facilities as well as hospitals can also sometimes help.
If you’re part of an HMO, PPO, or other types of Medicare advantage plan or another Medicare health plan including a Program of All-Inclusive care for the elderly, you might be required to utilize home health agencies that are in your network.
It often proves helpful to contact several different home health agencies that provide services in your area. There is often a substantial difference in what services are offered.
Does Medicare Compensate Individuals for Home Health Services?
Medicare only covers home health services that Medicare-certified home health agencies provide directly or Medicare is “under arrangement” with another provider that furnishes the services then inspects the primary home health agency for compensation.
Primary health agencies must bill Medicare for all covered services. Payment must be made only to the agency. Unlike many Medicaid or state-sponsored programs in which beneficiaries can retain family members as personal care attendants, Medicare does not cover home health services in such a manner.