Eligibility For Home Health Care
As per a survey, home health care services can be provided only in three conditions:
- When you are considered homebound
- When doctors advised you to get home health care
- When Medicare provides you the certificate
When You Are Homebound
In this condition, your doctors will analyze and observe whether it is difficult for you to leave home and visit a hospital or not. They will evaluate on the following terms:
- Whether you need the support of a wheelchair, walker or cane, etc., additionally, they will evaluate whether you need the support of someone else to walk and complete your tasks.
- Due to the COVID pandemic, the federal healthcare department has come up with a new policy that clearly states that homebound status would be applied to people over the age of 65+ as these people are at a huge risk of catching the COVID virus. Accordingly, people prone to infection and who require long-term health care facilities underlying critical medical conditions fall into this category.
When Doctors Advises Home Healthcare
For checking this eligibility criterion, your doctor will assess your existing condition. The diagnosis might include a new or change in the medication for which you visit hospitals more often than usual. To meet the requirements, they will consider the following factor:
- If you need skilled nursing, physical therapy, speech therapy, or occupational therapy. Besides, the doctors will consider whether you need a regular-term health care facility.
Medicare Certified Home Health Care
Home healthcare agencies that meet the federal terms and conditions can provide you with a certificate, and this certificate can help you qualify for home health care. You must look for an agency with a good quality score and compare it with others to get a certificate.
How Does Home Healthcare Services Help The Patients?
Let’s understand why it is essential to qualify for the federal government’s terms and conditions and how it can help you cover the expenses. Consequently, this will give you instances under which healthcare agencies provide financial aid and home healthcare services to the patients.
Home healthcare service agencies have four plans A, B, C, and D and cover different aspects of healthcare. You can enroll in any one or more plans. Altogether these parts cover the majority of services. People usually pay a monthly premium to get the services, depending on income.
Plan A of Medicare
Part A covers the costs of the patients. Agencies provide services when you are admitted to a hospital with a doctor’s recommendation. Their services include:
- some home healthcare services
- walkers and wheelchairs
- free hospice care
- some home healthcare services
- coinsurance for hospitalization
- all the cost of hospitalization days
- all costs of 101 days of approved skilled home healthcare
Additionally, they provide limited coverage for skilled nursing facilities. You can stay for three consecutive days if you have an inpatient hospital after getting a formal order from your doctor.
Plan B Of Medicare
Plan B covers your doctor’s services and clinical tests for healthcare. People often have plans A and B together to get the most benefits of the program. For instance, if you stay in a hospital, the expenses will come under Plan A, and the doctor’s services will come under Plan B.
The vast services mentioned in the plans include:
- diabetes supplies
- screening for cancer, depression, and diabetes
- medical equipment
- influenza and hepatitis vaccinations
- ambulance and emergency department services
If you seek any service that the federal healthcare department policy doesn’t cover, you will have to pay for it from your pocket. The rules apply the same to home healthcare.
Plan C is also considered the Advantage plan. It is a privately sold insurance option that covers mostly the provisions of plans A and B. In addition to that, you get extra benefits like drug plans, prescriptions for dental, hearing, vision, and more. You must be enrolled in the federal healthcare program to purchase the Advantage plan.
Usually, you have to take a premium plan and check doctors within your network; otherwise, repayments or other fees might apply. The cost of Plan C depends on the type of plan.
Plan D covers prescriptions, drugs, etc., that are not covered by Plan B. These types of medications are executed by a doctor, for instance, injection or infusion. The plan is optional, but still, numerous people select it as it covers their medications since medications altogether cost very expensive compared to other hospital expenses.
The cost for Part D varies on the kinds of medications you take and the pharmacy you shop from. You have to take a premium plan based on your income. Additionally, you might have to pay some extra costs and may make repayments. The person also has to pay a round sum refund in a few cases.
Based on the requirements and conditions of the patients, healthcare agencies provide the certification to qualify for home healthcare.
Requirements and Certification
Supposedly, you are eligible to receive home health care. Still, your doctors will ask for a signed certification by the agency. Additionally, they will review the need of getting regular care, skilled nursing, and medical social services. If you qualify for receiving the aforementioned facilities, you can get the services effortlessly. Even if you need help in daily activities and financial aid, medical supplies, etc., your healthcare agency will provide you with that. Some people who might require speech or occupational therapy can also benefit from the program, but they have to show up to the doctors for the same.
Home healthcare requires quality health staffing, so be careful while hiring a home healthcare nurse. Visit here to learn more about hiring a home healthcare nurse.
How Can I’Kare Consulting Firm Help You?
I’ Kare Consulting Firm guides and provides qualified patients with home healthcare services. It is a nurse staffing agency that caters to health care staffing solutions for hospitals and individuals. Choose us to get reliable and compassionate home health care nurses for yourself. To ask any queries regarding qualification criteria of the home healthcare services, visit I’ Kare Consulting Firm.