Lumaktaw sa pangunahing content

The Basics of Home Health

Home health care includes a wide range of health and social services delivered in your home to treat illness or injury. Services covered include intermittent skilled nursing care, therapy, and care provided by a home health aide. Home health care will still depend on the circumstances, thus, it will be covered by either Part A or Part B.









Medicare will cover your home health care if:
  • You are homebound, which means that it is extremely difficult for you to leave your home and you need help in doing so.
  • You need skilled nursing services and/or skilled therapy care on an intermittent basis. 
  • 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). 
  • And, you receive care from a Medicare-certified home health agency (HHA).

Definition of terms:
Intermittent means you need care at least once every 60 days and at most once a day for up to three weeks. This period can be longer if you need more care, but your care needs must be predictable and finite.
Medicare defines skilled care as care that must be performed by a skilled professional, or under their supervision. 
Skilled therapy services refer to physical, speech, and occupational therapy.
Note: 
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.
 Your doctor should review and certify your home health plan every 60 days. A face-to-face meeting is not required for recertification.
You cannot qualify for Medicare home health coverage if you only need occupational therapy. However, if you qualify for home health care on another basis, you can also get occupational therapy. When your other home health needs end, you can continue receiving Medicare-covered occupational therapy under the home health benefit if you need it.
If you meet all the requirements, Medicare will pay for skilled care in your home and/or home health aide services. 

If you have questions or experience billing issues, call 1-800-MEDICARE.
Mga etiketa:

Mga Komento

Mag-post ng isang Komento

Mga sikat na post sa blog na ito

NCOV -19 and MEDICARE 2020

Medicare Part B , which includes a variety of outpatient services cover medically necessary clinical diagnostic laboratory tests when a doctor or other practitioner orders them. Medically necessary clinical diagnostic laboratory tests are generally not subject to coinsurance or deductible. It will cover medically necessary imaging tests, such as computed tomography (CT) scans, as needed for treatment purposes for lung infections, however not for screening asymptomatic patients. For those imaging tests paid by Part B, beneficiary coinsurance and deductible would apply. If the Part B deductible ($198 in 2020) applies to the Part B services, beneficiaries must pay all costs - up to the approved amount of Medicare until the beneficiary meets the yearly Part B deductible. Once it is met, Medicare pays its share, and beneficiaries typically pay 20% of the approved amount of the service, except laboratory tests. There’s no yearly limit for what a beneficiary pays out-of-pocket tho
Mag-post ng isang Komento
Magbasa nang higit pa

Cardiovascular Disease Risk Reduction

Cardiovascular disease generally refers to conditions that can lead to a heart attack or stroke. Cardiovascular disease risk reduction visits can help detect and prevent this disease. How to know if I am Eligible? Medicare   Part B  covers an annual cardiovascular disease risk reduction visit with your primary care  provider . You do not need to show any signs or symptoms of cardiovascular disease to qualify for screening, but you must be considered competent and alert when counseling is provided.  During the screening, your provider may; Encourage aspirin use if the benefits outweigh the risks You are a man  of age 45-79 Or a woman of age 55-79 Screen for high blood pressure if you are age 18+ Provide behavioral counseling and tips to encourage a healthy diet Note: Men under 45 and women under 55 are not encouraged to use aspirin as a tool to reduce cardiovascular disease. How much will it cost? If you are eligible,  Original Medicare  will cover your cardiovascular disease risk red
Mag-post ng isang Komento
Magbasa nang higit pa

Lifetime Reserve Days

There are  90 days of  inpatient  hospital care coverage on Original Medicare for each  benefit period , In addition, you also have an additional 60 days of coverag e , called LIFETIME RESERVE DAYS .   These Lifetime Reserved Days  can be used only ONCE, and you will pay a  coinsurance  for each of it. To have a better understanding of it, let’s imagine an individual who had a 120-day  Medicare -covered inpatient stay, this means that they used 30 lifetime reserve days. After they have been out of the hospital for 60 days in a row, they will be eligible for another 90 days of hospital coverage because they will be in a new  benefit period . However, if they need  inpatient care  beyond the benefit period maximum, they will only have 30 of their 60 lifetime reserve days remaining. The above example illustrates that lifetime reserve days do not have to be applied to the same hospital stay. If you need to stay in the hospital twice for 120 days each time during different benefit
Mag-post ng isang Komento
Magbasa nang higit pa