In most cases, part-time or intermittent means that you can receive specialized nursing care services and home health aides up to 8 hours a day (combined), for example. In most cases, part-time or intermittent means that you can receive specialized nursing care services and home health aides for up to 8 hours a day (combined), for up to 28 hours per week. You may be able to get more frequent care for a short period of time (less than 8 hours a day and no more than 35 hours a week) if your provider determines that it's necessary. If you're wondering: “Is home health care covered by Medicare Part A or B? , the answer is yes, it is covered by both. Under Medicare Part B, you are eligible for home health care if you are homebound and need specialized care even if you haven't been hospitalized before.
In certain cases, such as after a hospital stay or after spending time in a skilled nursing facility, you can receive home health care coverage under Medicare Part A. What exactly is home health care? This type of care is intended to provide health services and equipment to people while they are recovering at home. Home health care includes a wide range of health and social services provided at home to treat illnesses or injuries. What home health care does Medicare cover? The services covered by the Medicare home health care benefit include intermittent skilled nursing care, specialized therapy services, and care provided by a home health assistant. In particular, people living with long-term, debilitating illnesses face significant access problems.
For example, patients have been told that Medicare will only cover one to five hours a week of home health care services, or only one bathroom a week, or that they are not confined to their home (because they are wandering down the street due to dementia) or that they must first refuse treatment before they can start (or resume it). As a result, these individuals and their families struggle with inattention or a total absence of attention. The team found that Medicare Advantage patients had a shorter home health care stay, fewer visits from nursing and therapy doctors and home health aides, lower rates of improvement in self-care function and mobility, and higher rates of being discharged to the community for home health reasons. To determine if the patient has the general capacity to leave home and does so only infrequently or for short periods, it is necessary (as is the case to determine if skilled nursing services are intermittent) to analyze the patient's condition for a period of time and not for short periods during the health stay at home.
You won't be eligible for the home health care benefit if you need more than part-time or intermittent specialized care. You are generally not eligible for Medicare home health care benefits if you need full-time skilled nursing care for an extended period of time. Your Medicare home health care benefits will not change, and your access to home health care services should not be delayed due to the pre-application review process. For many years, beneficiaries who attended adult day care programs were routinely denied home health care services.
The agency must also tell you (both verbally and in writing) if Medicare won't pay for the items or services it provides and how much you'll have to pay for them. Based on this demonstration, your home health agency can submit to Medicare a request for a pre-claim review of coverage for home health services. If you receive your Medicare benefits through a Medicare Advantage (Part C) plan or another Medicare health plan, check with your plan for more information about your home health benefits. Not only does this provide money to health insurance companies, but it makes care outcomes potentially worse for patients.
In addition, partnering with a trusted home care provider like Firefly Home Care can make it much easier to manage these limitations. Home care is a wide range of health care services that you can receive at home in the event of an illness or injury. Problems with access to home health care have come and gone over the years, depending on current payment mechanisms, systemic pressures, and misinformation about Medicare home health coverage.
