HOME HEALTH CARE COVERED BY MEDICARE
- Appropriate patient
- Reasonable and necessary "for the treatment of an illness and injury"
- Requires Skilled Services
- Home Bound
Who is an "Appropriate patient"?
- Consenting patients whose medical needs can be safely managed at home when the required time, financial, physical and emotional resources have been considered.
What "Skilled Services" are needed to qualify?
Any or all of the following 3:
- Registered Nurse
- Physical Therapist
- Speech Therapist
Other services may be added only if one of the 3 above skilled services are needed:
- Social Work
- Home Health Aide
What defines "Homebound"?
If the patients leaving home requires considerable and taxing effort
and Patient needs:
- supportive devices such as crutches, canes, wheelchairs and walkers
- the use of special transportation
- the assistance of another person
- if the condition is such that leaving the home is medically contraindicated
Note: the HOMEBOUND can leave home if:
- the absences from the home are infrequent*
- for periods of relatively short duration
- for the purpose of receiving medical treatment
*Infrequent is often interpreted as once a week for non-medical outings)
- Medical outings can be often as needed and does not affect homebound status e.g. dialysis can be 3 or more times per week
How much service will Medicare pay for?
Services that are:
- not "24/7" home care
- Interprofessional Education
- Medical Students
- Ambulatory Rotation Goals and Objectives
- Minimum Geriatric Competencies for Residents
Knowledge & Skills Checklist
- Geriatric Consult Clinic Presentation Sample
- Medicare Qualifiers
- House Officer’s Association Alliance (HOAA)
- Fellowship Information
- Educational Resources
- Research Awards
- Research Activities
- Patient Care
- Home Instead Center for Successful Aging