Frequently Asked Questions
WHAT IS HOME HEALTH CARE?
Home health care is designed to help the patient rest, recover, and receive treatment in the comfort of their own home or residence. Services provided by home health care are offered with the goal of helping the patient regain independence to become as self-sufficient as possible while also managing their disease or condition.
Home health care can benefit both acute and chronic conditions, including but not limited to the following:
- Alzheimer’s Disease
- Chronic kidney disease
- Chronic obstructive pulmonary disease (COPD)
- Diabetes
- Heart disease
- Recovery from illness or surgery
- Chronic conditions or injuries
WHO IS ELIGIBLE FOR HOME HEALTH CARE?
There are rules for how to qualify for home health care, especially if you want it to be covered by your insurance or Medicare plan. In order to be eligible, you must meet these requirements:
- Be under the care of a physician who orders home health services
- Meet the definition of “homebound”
- Require skilled nursing or therapy services on an intermittent basis
Specific home health agencies may have additional requirements of their own, and you may also need to meet certain qualifications for your insurance plan. Be sure to familiarize yourself with these requirements before applying for home health care.
WHAT CAN I EXPECT ON THE FIRST HOME HEALTH CARE VISIT?
On the first visit, a nurse or therapist will conduct a thorough interview and professional assessment. Our assessment identifies areas where you may benefit from education and tools to manage your health.
We partner with your doctor as well as family and caregivers to determine the best services for your needs. This team approach actively engages you and your caregivers in your health care and, if applicable, helps to make the transition from a hospital or nursing facility to your home much easier.
HOW OFTEN WILL MY HOME HEALTH CARE VISITS BE?
The frequency and type of home health visits are based on your personal plan of care. Your doctor may change your plan of care as necessary, increasing or decreasing the number of visits or services provided, in order to provide you with the best home health care for your needs.
MY DOCTOR IS ORDERING HOME HEALTH CARE FOR ME; CAN I REQUEST ROTEX HEALTHCARE BY NAME?
Absolutely, and we’d be honored to care for you or your loved one. Federal law gives patients the freedom to choose their health care provider.
IS HOSPITALIZATION A REQUIREMENT TO RECEIVE HOME HEALTH CARE?
No. Hospitalization is not a requirement to receive home health care. Many patients are referred by their doctor.
HOW DO ONE PAY FOR HOME HEALTH?
Patients and their families can save considerably by choosing home health care over long-term hospitalization or a skilled nursing facility. Still, medical care is expensive. When it comes to paying for home health care, there are several options:
- Self-pay
- Public third-party pay
- Private third-party pay
The first of these options, self-pay, is home health care paid out-of-pocket. You may be able to negotiate the cost of services or arrange for a payment plan with the agency depending on your situation.
Most Americans over the age of 65 are eligible to receive federal Medicare coverage, which may then be used to pay for home health care services. In order to receive reimbursement for services, Medicare requires that the following conditions be met:
- The patient is an eligible Medicare beneficiary
- The physician certifies the need for services and creates a plan of care
- The beneficiary meets the Medicare definition of “homebound”
- The care must be delivered to the patient’s place of residence
- The patient requires intermittent skilled nursing or therapy services
- The services are provided by a Medicare-certified agency
IS HOME HEALTH CARE COVERED BY MEDICAID?
Home health care services are covered by Medicare as long as certain eligibility requirements are met. In order to be eligible for Medicare coverage for home health care, you must meet the following requirements:
- Be considered “homebound” according to the Medicare definition
- Require part-time or intermittent skilled care to improve, maintain, prevent, or further slow the progression of an existing condition
- Be under the care of a medical doctor who prescribes home health care (you must have documentation of an in-person visit with said doctor either three months before starting home health care or within one month of when home health care begins)
Medicare typically covers skilled nursing care and rehabilitative services, which may include physical therapy, occupational therapy, and speech therapy. Depending on your needs, additional services like medical social services, durable medical equipment, medical supplies, and other in-home services may also be covered.
If you have Original Medicare, you may be able to receive home health care at no cost (though you might pay up to 20% of the Medicare-approved cost for durable medical equipment). If you have a Medicare Advantage Plan, you may qualify for additional coverage.
Medicare does not cover non-skilled personal care services such as cooking, cleaning, transportation, and other elements of custodial care.
WHAT SERVICES DO HOME HEALTH CARE PROVIDE?
Home health care consists of medically necessary, skilled services prescribed by a physician for the treatment of an illness, injury, or medical condition.
Skilled services provided by home health care may include the following:
- Infusion therapy
- Medication management
- Nursing care
- Nutrition services
- Pain management
- Psychiatric services
- Social work
- Therapy (physical, occupational, speech)
Services provided by home health care professionals are tailored to the patient’s individual needs. Examples include checking vital signs, assessing pain, monitoring food intake, managing medications, helping with basic hygiene, and ensuring safety in the home.
IS ROTEX HEALTH CARE A MEDICARE CERTIFIED HOME HEALTH AGENCY?
Yes. Our home health care centers are Medicare-certified. This is a requirement for Medicare to cover the cost of home health services.