By: Breque Bonner
If you find yourself in the midst of providing care for a loved one who is hospitalized or recovering in a rehabilitation facility and will soon be discharged home, you may have more questions than answers about what type of care will be needed once your loved one has returned home and how to get it set up. After reading this article you should have a clear understanding about the types of aftercare that can be provided in the home and how they can be paid for.
What is home healthcare?
Home healthcare encompasses a wide range of medical and non-medical services offered to patients in their own home. There are a variety of services offered such as: assistance with activities of daily living, highly skilled IV infusion therapy, and even physical therapy.
If your loved one is in need of a nurse or therapist, you will be referred to a Medicare certified home health agency. After being referred to a Medicare certified agency each patient is then assigned to a nurse, therapist or social worker. This private team designs a plan of care for the patient and oversees their care. Medicare or the patient’s insurance company will provide funds for a period of time based on the patient’s diagnosis. A nurse or therapist will visit the patient’s home anywhere from a few times a day to once per week, depending on the diagnosis. In order to receive home health from a Medicare certified agency you must have a referral from a doctor.
Medicare certified home health agencies, are there to provide skilled care. They do not provide ongoing assistance with activities of daily living. If your loved one is in need of daily or weekly help with hygiene, personal care or medication management, a private-duty agency can provide these services. Private-Duty home healthcare is also called non-medical home healthcare. Sometimes it is helpful to hire a private-duty agency in conjunction with a Medicare agency. This ensures that your loved one is receiving the daily care they need as well as the physical or occupational therapy necessary to help them fully recover.
How do I get home healthcare?
When your loved one is preparing to be discharged from the Hospital or rehabilitation facility a case manager will look at your loved ones need’s and determine a care plan for his or her return home. This care plan may include a recommendation for Medicare home health (physical and occupational therapy), Private-Duty home care (for help with daily living in the home) or a recommendation for an Assisted Living Facility.
Sometimes it is difficult for a case manager to know all of the details of each patient’s needs, so it is necessary for you as the loved one to pick up where the case manager has left off. At times a case manager will make a recommendation for Medicare home health but you may find that private-duty home care is also needed. For instance, you may have noticed that it is difficult for your loved one to dress and bathe alone, or you may feel uncomfortable with him/her being at home alone. Upon request, your case manager can provide you with a list of companies that offer services such as: help with hygiene, personal care and meal preparation. Or you may do your own research on the internet or in the phone book. A doctor’s order is not needed for private-duty home care. You can arrange this service yourself at any time by calling the agency of your choice.
Who pays for home healthcare?
Home healthcare services can be paid for in one of three ways, depending on the care required, type of insurance the patient has, and the patient’s financial circumstances.
Some funding is available through public third- party payers such as: Medicaid, Medicare, Veterans Administration, and Social Services grant programs. Some local community organizations also provide funding to help pay for home healthcare services.
Assistance is also available through private third-party payers which include: health insurance companies, long-term care insurance, managed care organizations, and workers’ compensation.
As a rule of thumb it is safe to assume that skilled home healthcare (nursing and therapy) can be paid for through insurance. Private-Duty home healthcare on the other hand is usually only paid for through long-term care insurance or directly out of pocket.
If you are interested in learning more about private-duty home care visit www.bayshorehomecare.com or call 1-800-335-2150.