Follow
Share

I just read from an answer (Tattoo Chick) that Medicare will pay for in home care, even if it's only a few hours a week, Is this true?

This question has been closed for answers. Ask a New Question.
Find Care & Housing
Maybe it depends on the state, but not in Utah. In home aides are paid for privately or with a LTC policy. Check your state's coverage plans. The company I called charged between $22-28 per hour.
Helpful Answer (0)
Report

It depends on the situation, but as far as I know, Medicare will cover in-home nursing care ONLY if medically necessary, and then only for as long as needed. Once the home care nurse indicates that nursing-level care is no longer needed, Medicare cuts it off.

If you are talking about an in-home caregiver, as far as I know, Medicare will *not* cover that. In Michigan, there is a Medicaid waiver program that will help pay for in-home care that keeps the recipient out of a nursing home, because it saves the state money in the long run not to have them in a nursing home. However, there are restrictions and the application process is a little tedious. I don't know if other states have this program. The one thing I found was a drawback of even the waiver program, which covers more than medicaid, was that even the waiver program would not cover a night-time aide or caregiver so that I could sleep. (Mom was a bad sleeper and was up all hours of the night, at high risk for a fall because of her 24/7 oxygen use and the hose for the O2 trailing behind her all the time.)
Helpful Answer (3)
Report

This is a bit of a controversial subject on this website. I think people have had different experiences. I've had people tell me Medicare wasn't paying for the service when I was looking at the statement from Medicare showing their payments. So experiences vary and there is a lot of information that seems to conflict with my personal experience.
Start with whether you have traditional Medicare or one of the "advantage" plans?
My experience has been with traditional Medicare. I'm sure if you asked the advantage folks they would say they have HH too but I think the services offered are different. You would need to ask specific questions. My friend on an advantage plan did not get the same services I was familiar with.
If I were you I would go on Medicare.gov and look up the home health care agencies in your moms zip code. They are rated and you can choose a couple, call and discuss with them your situation and they will tell you what they do and how you can access their services. Be sure to call more than one.
A doctors order is required. When I look for a new primary I always request that the new doctor be willing to work with HH. The only time I've had an issue is when my mothers cardiologist requested I go through a primary. He helped me find a primary for her that worked with him. Problem solved. Some drs work with a few HH agencies already and may suggest one or two. I chose my first one based on a specific nurse that I knew personally.
About the "hours" part.
No, it's only for a few minutes each visit. About the same length of time as at a drs office face to face. They take the patients vitals. Check their meds and sort them, reorder them if you want that service. Discuss bowels, appetite etc check for edema, order pt and/or ot evaluations as needed.
Can do blood work.UTI tests. Treat wounds. 
The aid will change linens. Give a bath. Shampoo. Heat a meal. They are efficient and usually only there a few minutes, usually less than half an hour unless need to be there longer for some reason. The nurse generally comes once a week unless there is a reason to come more often. The aid did come three times a week but now only twice a week. I love home health. The right aid is usually the first to notice a rash or a burn or bump.
I always take the nurses log with me to drs visits because a running log of their bp, pulse, weight, condition, is easy to notice trends and I've never had a dr who didn't want to copy it for the file. So if your mom has elevated bp that day, the dr can see it's white coat syndrom and not normal for her, etc.
Or that she's had edema the last few weeks.
So do some research in your area and see what you can find out.
I also think it's a good idea to work with a HH that offers hospice. I think they are interested in building long term relationships. Once you get to know the office staff, it's easier to work through issues that naturally occur as conditions and nurses change. They do require your oversight and you may not always like a particular nurse as much as you did the last one but overall it's a great resource.
I also think some HH know how to manage gov rules better than others. Some may just want patients recently released from rehab. So I would check with a couple. I have added private pay aids to my aunts list of caregivers and I got a little push back on continuing the bathing aid. I had to make sure they understood the aids I hired weren't there for bathing. I still find HH a layer of care I'm not willing to let go of.
Oh yes, some HH will fax the orders over for the dr to sign. I just leave a message for dr to be on the lookout. " we think aunt might have a UTI, HH will send over request for test ".
HH helps the dr and the family to take good care of the patient but some drs are not educated as to the benefit so it's important to make sure your primary is willing to work with HH. They get paid to do so by Medicare.
I hope this helps give you some ideas on how to check for yourself whether this is a good resource for you.
I've been working with the same agency about 10 years now.
Helpful Answer (1)
Report

I have heard that Medicaid, not Medicare has programs for in home care.
Helpful Answer (2)
Report

Hi, I do not know about your state, but there is help available, I am in Florida
Florida Department of Elder Affairs
The Department of Elder Affairs offers a variety of programs for seniors. To learn more about the programs listed below and other programs call the toll-free number (800) 963-5337 or visit the Department of Elder Affairs.
Older Americans Act (OAA) - Provides homemaking services, home-delivered meals, medical transportation, home health aide, adult day care, and other services. The OAA is for people 60 years or older, especially those in economic or social need.
Community Care for the Elderly - Provides homemaking, home-delivered meals, and personal care services to frail elders, age 60 and older. Eligibility is based, in part, on a person’s inability to perform certain daily tasks needed for independent living, such as meal preparation, bathing, or grooming.
Home Care for the Elderly - Provides some financial help so relatives can keep a low-income elder in their own home or in the home of a caregiver. A participant must be at risk of nursing home placement and be 60 years or older.
CARES (Comprehensive Assessment and Review for Long-Term Care Services) – Provides evaluation of seniors or people with a disability who need long term care services, to see what level of care they need. It also provides help in getting in-home and community services to avoid nursing home care. Call the toll-free number (800) 963-5337 or view the CARES website at the Department of Elder Affairs.
SHINE Program – Serves seniors and people with a disability and provides counseling on health insurance, Medicare, Medicaid, long-term care insurance, prescription assistance programs, and other health insurance needs. Call the toll-free number (800) 963-5337 or view the Florida Shine website at the Department of Elder Affairs.
Helpful Answer (0)
Report

I also know that Medicare will help with Social Services to help you find solutions. I used that service for my mom to help get her and myself help in finding help. It had to be ordered by the doctor.
Helpful Answer (0)
Report

This is what MediCARE will or will not pay regarding home services.

https://www.medicare.gov/coverage/home-health-services.html

[Note: If you get services from a home health agency in Florida, Illinois, Massachusetts, Michigan, or Texas, you may be affected by a Medicare demonstration program. Under this demonstration, your home health agency, or you, may submit a request for pre-claim review of coverage for home health services to Medicare. This helps you and the home health agency know earlier in the process if Medicare is likely to cover the services. Medicare will review the information and cover the services if the services are medically necessary and meet Medicare requirements.]
Helpful Answer (1)
Report

This question has been closed for answers. Ask a New Question.
Ask a Question
Subscribe to
Our Newsletter