Home Health Q&A
What is Good Home Health Care?
Home health care brings quality health services to individuals in the privacy of their home and helps them to remain in familiar surroundings. Services including skilled nursing care, speech, physical or occupational therapy, and personal care services can be provided to individuals of all ages. The professionals at the home health agency will work with the patient and his/her family and the physician to improve health in the quickest and safest way.
In order to offer home health services in Kentucky, home health agencies are required to obtain a certificate of need and be licensed to serve a given geographic area. Only licensed agencies may be certified to receive Medicaid or Medicare reimbursement for providing home health services.
A good home health agency will always provide:
- Evaluation of the patient's health needs by a registered nurse or therapist;
- Development of a plan of care by the nurse or therapist;
- An opportunity for the patient to ask questions, to be kept informed and to understand the services given, including information about charges for services and financial arrangements for payment;
- Assurance that all care is coordinated with the physician and other health care providers and is provided by qualified health care personnel;
- Instruction on how to care for one's health needs;
- Assurance that care is treated confidentially.
Is Home Health for You?
Would you rather stay at home than go to the hospital or a nursing home when you are sick? Perhaps you or a family member need some type of "special care" which neither you nor your relatives can handle alone? Home health care could be the answer!
Home health care brings health services to you in the privacy of your home and helps you remain in familiar surroundings. Services which include skilled nursing care, therapy, and personal care services can be provided to individuals of any age. For example:
- a cancer patient requiring chemotherapy
- a teenager recovering from a fracture
- a child with diabetes
- a grandparent recovering from surgery or an acute illness
- a businessman recuperating from a heart attack
- a pregnant woman with high blood pressure or diabetes
- a wife and mother with terminal illness
- a baby with breathing problems
- a stroke victim who requires physical, speech or occupational therapy
Highly trained, skilled professionals can care for you in your home when you are ill or disabled as an alternative to a longer hospital or nursing home placement.
Who Pays the Bill?
Charges for home health services vary and government health plans are subject to change. MHHA takes pride in having the lowest per visit charges in the area and providing a very cost effective treatment option. Potential home health clients should inquire about charges and coverage before accepting services. The fact that a patient's physician may order home health care does not guarantee that reimbursement sources will cover the care.
Medicare, Medicaid and private insurance may cover all or a portion of the cost of home health care. In Kentucky, only licensed home health agencies or hospices may be certified to receive Medicare and Medicaid reimbursement for providing home health. Some providers of related home care services or supplies may be reimbursed by these payors but not for providing hands-on home health care.
To be eligible to receive home health services under Medicare or Medicaid programs, individuals must be eligible for these programs and must have health care needs which can be met by care provided on an intermittent basis (less than full time). There must be a need for skilled care services, and the individual must be essentially home bound. There is no requirement for a prior hospital stay in order to receive home health benefits. A home health agency can be of assistance in determining if the patient's health care needs meet the criteria for Medicare of Medicaid reimbursement.
All private insurance carriers in Kentucky must offer home health benefits; however, full home health care coverage may be an optional benefit. Coverage varies widely. Insurance plans may cover expanded services beyond specific identified benefits if such services are cost effective and medically appropriate alternatives to institutional care. Each potential patient should check with his/her insurance company or with a home health agency to determine how much home health coverage may be available.