Given the huge amount of written information about home care services, I am still amazed at the frequency with which specialized medical care at home is combined with non-medical care at home, as if they were similar concepts. Some writers even use the names for each other. Nothing could be more out of place. In this article, I would like to clarify some of the key distinctions between these two types of home care.
Specialized home health care services are almost always provided by Medicare certified agencies and are covered by Medicare and commercial health insurance companies. The services consist of intermittent visits by qualified professionals, usually a nurse and / or a professional rehabilitation therapy, physical therapy, speech therapy or occupational therapy. Visits are held periodically for a limited period of no more than a few weeks, usually begun after discharge from a hospital or nursing home. Along with specialized services, In-Home Care in Worcester may visit once or twice a week for a short visit to provide personalized help at home, such as bathing.
Medicare covers specialized home health care under the following conditions (commercial insurers generally adopt the same criteria): 1) Services must be prescribed by a physician; 2) They must be provided by a Medicare Certified Home Health Agency; 3) The patient must be at home, a requirement that is freely defined; 4) The patient must be in need of care by one or more of the above professionals as certified by a physician.
Now, the eligibility criteria and home insurance coverage have certain consequences for consumers, which are not always explained. First, the patient and family rarely play a role in choosing the agency they prefer. This decision is in the hands of the physician along with the hospital or nursing home. Of course, a patient may express a preference for a particular provider if he or she has had prior experience with home health services, but this is unusual in practice. Fortunately, Medicare has begun providing comparative information available on the Internet through the Home Health Compare database. This can help restore some control to the consumer over time as it allows patients and their families to get quick information within the limited time allowed by print scheduling.
The second implication for consumers is that the frequency of home visits and the duration of home health services are also beyond the control of patients and their families. It is the home health agency that is governed by physician orders and Medicare eligibility requirements that make these decisions. And just to make sure that home health agencies can't make unreasonable profits from more and more services, Medicare generally pays them for the episode of care, not for the amount of services they provide.
Non-medical home care is a completely different animal. Companies that provide such home care services employ unqualified staff, also called certified nursing assistants, home nurses, home helpers, home companions, and other designations. The care services they provide include personal care assistance such as bathing, going to the bathroom, dressing up and mobility assistance, as well as general company, security supervision and various household tasks. Generally, each visit lasts several hours and many recipients of highly disabled care require permanent or permanent attention. Conceptually, non-medical home care can be considered "assisted living at home." The recipient of the care is generally referred to as a client who reflects the consumer-driven nature of non-medical home care. Unless the client meets the low-income criteria to qualify for Medicaid, this type of home care is almost always paid out of pocket or with long-term care insurance. Customers choose the company that gives attention and can fire the business if they are not satisfied.
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