Does Home Healthcare Qualify for Medicare or Medicaid?

November 26, 2013

Medicare and Medicaid patients dealing with illness or recovering from surgery or injury may be eligible to receive Visiting Nurse Association of Ohio’s home-based skilled nursing care. Under certain circumstances, Medicare pays for seniors and other qualifying beneficiaries to receive home healthcare services.

Home Healthcare under Medicare or Medicaid

Low-income and financially needy patients may be eligible for homecare services covered through Ohio’s Medicaid State Plan.

VNA of Ohio’s staff helps patients and their families understand these options and determine if they might qualify, said Claire Zangerle, president and chief executive officer of VNA of Ohio.

Qualifying for Medicare

Medicare, for example, covers home-based skilled nursing care for qualified recipients when:

1. The patient is homebound, either because his condition limits mobility or because leaving home could cause his condition to worsen.

2. A doctor issues an order indicating that the patient needs homecare as the result of an illness or injury. That physician must maintain oversight of the patient’s medical care and regularly review the care plan.

3. The prescribed home healthcare services can help the patient achieve an improved level of independence. (When a clinical assessment determines that the patient’s condition is no longer showing improvement under the care plan, coverage for the services is discontinued.)

Medicare Home Care Benefits

When the criteria are met, Medicare’s coverage of home healthcare is limited to part-time, temporary services including:

* Skilled nursing care performed by a registered nurse (RN) or a licensed practical nurse (LPN) overseen by a registered nurse. These services include wound care following surgery, administering shots or IV medications, changing wound dressing and teaching patients about their medical conditions and any prescription medications they will be taking.

* Physical therapy, occupational therapy, speech therapy and medical social services, such as counseling for emotional issues surrounding the patient’s condition.

* Part time or intermittent support services provided by a home health aide that could include help with bathing, eating and transfers. These tasks must be part of a skilled nursing care plan.

Call VNA of Ohio Today

Learn more about VNA of Ohio services or call us at 1-877-698-6264.

 

Posted in: Caregiver Resources, Home Healthcare

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