Know your options.
Transparency is key when it comes to feeling comfortable in your skilled home health service decision-making. Here are just a few of the most common questions we receive from patients regarding Prosperous Home Health’s services.
From long-term illnesses, to injuries, to day-to-day care, skilled home health services are often less expensive, equally effective and more convenient, because they’re administered in the comfort of your own home.
They can include a wide variety of services – for example, wound care, post-surgery care, patient and caregiver education, intravenous and nutrition therapy, injections and illness monitoring.
If your doctor or referring healthcare provider decides you need home healthcare, he or she will provide you a list of agencies in your area. (NOTE: Your doctor must tell you if he or she has a financial interest in any organization suggested.)
Orders from a doctor are needed for care to begin. Once your doctor refers you for home health services, the home health agency will schedule an appointment to talk to you about your needs and your health. The agency will also be in contact with your doctor to discuss your care, the frequency of visits suggested and your progress.
These visits will typically include:
- Checking what you’re eating and drinking
- Checking your blood pressure, temperature, heart rate and breathing
- Confirming you’re taking your prescriptions and administering treatments correctly
- Asking about any pain you’re experiencing
- Checking the safety of your home
- Empowering you to administer self-care as needed
Before you begin your services, Prosperous Home Health will determine how much Medicare and Medicare supplement insurance (Medigap) will pay. We will also tell you if any planned or prescribed items or services aren’t covered and how much out-of-pocket cost you’ll incur.
(NOTE: You will receive this information both in-person and in writing. We will provide a Home Health Advance Beneficiary Notice (HHABN) prior to providing any services and supplies that Medicare doesn't cover.)
|Medicare-covered home health services||$0|
|Medicare-approved amount for durable medical equipment||20%|
|Other insurance options||Accepted|
Medicare Part A (hospital insurance) and/or Medicare Part B (medical insurance) cover eligible home health services, such as intermittent skilled nursing care, physical therapy, speech-language pathology services, continued occupational services and others.
Services Medicare doesn't pay for include:
- 24/7 in-home care
- Meals delivered to your home
- Homemaker services
- Personal care
If you receive Medicare Part A and/or Medicare Part B, you are eligible if you meet the following requirements:
- You are under the care of a doctor, and you receive services under a plan of care established and reviewed regularly by a doctor
- You need one or more of the following services, as certified by a doctor:
- Intermittent skilled nursing care (beyond simple blood draws)
- Physical therapy
- Speech-language pathology
- Continuing occupational therapy services
- Your needed services must be reasonable and require a qualified therapist to perform them safely and effectively
- Your condition must either be expected to improve in a reasonable and generally predictable period of time or must require a skilled therapist to safely and effectively exact a maintenance plan or must require a skilled therapist to safely and effectively exact a maintenance therapy plan
- Your home health agency of choice must be Medicare-certified
- You must be homebound, and a doctor must certify that you're homebound
- You must not need more than part-time or intermittent skilled nursing care
You may leave home for medical treatment or short, infrequent absences for non-medical reasons, like attending religious services. You can still receive home healthcare if you attend adult daycare.
Improving the safety of the home can reduce a senior's risk for falls and other accidents contributing to health hazards that result in severe injuries. According to the National Institute of Health, six out of 10 falls happen at home. It's where people, especially older adults, spend much of their time. Falls can be prevented by making simple changes in living areas, as well as through personal and lifestyle changes.
Prosperous Home Health offers a free, comprehensive assessment of your home and advises of potential fall-risk hazards.