Who Qualifies for Home Health Care Services?


Are you considering home healthcare for you or your loved one? Did you know that in the U.S. alone there are 12,200 home health agencies?

Wondering who qualifies for home health care services? In this article, explore the answer to this question and more to understand all about home health care. Read on to see if you or your loved one will qualify, and what you’ll need to do.

What Is Home Health Care?

Home health care is all about convenience since it’s healthcare services that you or your loved one will receive right in the comfort of your home. It can be chosen by a doctor based on whether or not you need therapy or nursing at home, or if you’re recently discharged from a nursing home.

Home health care services are there to help you be as independent as possible. If you have health problems that are long-term, it’s to teach you to live with this disability or illness.

Who Qualifies for Home Health Services?

First, you’ll need your doctor to write an order to receive home care. You’ll need to qualify for these services by a therapist or nurse. This is either due to mental or physical reasons that you might receive these services.

Does Medicare Cover It?

Medicare might pay for different services such as medical social services or physical therapy. It doesn’t cover personal care needs such as bathing if that’s all you need, meals brought to you, or 24-hour care.

It’s not for those who will need more than intermittent or part-time care. If you need to leave your house for non-medical purposes such as religious services, you can still qualify for home care.

Medicare Doesn’t Cover

Medicare is not a long-term option and isn’t unlimited coverage. Medicare coverage is for part-time and skilled care.

For those who need more, you’ll need to combine private pay and medicare or Medicaid and Medicare. This might lead to poor communication between the providers when it’s combining 2 options.

Home Health Care vs Nursing Homes

Nursing homes are the best option for those who require more than basic care. They offer medical care and assistance around the clock.

This can include medical care, therapy, laundry, and cleaning. Many choose nursing centers since they offer different services to help your loved ones.

Many nursing centers will offer private and semi-private rooms. If you choose a private room, that’ll cost more than a semi-private option.

Nursing homes will have different activities for your loved ones such as fitness, games, and crafts. They also offer outings to entertainment and shopping.

Some facilities will have other services such as memory care for those with Alzheimer’s. If your loved one has serious injuries or mobility issues, a nursing home might be the right option for them.

Senior Care Payments

Keep in mind that Medicare has short-term benefits for those who are looking for home care services. It covers medical treatment only. If you have Medicare Advantage, it might cover expenses for a nursing home or state-licensed facility.

Medicaid is an option for those with a limited income. It has more options compared to Medicare.

In order to pay for senior care it can include:

  • Medicaid
  • Medicare
  • SSI/Disability
  • Leveraging a home
  • Private insurance
  • Long-term care insurance
  • Private grants
  • Veterans benefits

Home Health vs Home Care

Home care gives your loved one non-clinical help with daily life. Home health provides them with a good lifestyle and health management.

When Home Care Is Necessary

Home care can be used when your loved one needs transportation to get to different places or needs help with cooking. They might also need a companion if they’re home alone.

Whereas home health care is for those who need rehabilitation after a nursing facility or hospitalization. It’s also for those who receive a change to their medications, and need it to be monitored.

Other Senior Options

Your loved one might not fall under home care or home health and might need something slightly different. For example, there are assisted living facilities.

Assisted Living

This is where your loved one will have their own apartment within a building, and they’ll receive help with social activities, cleaning, they’ll receive meals and transportation.

Some assisted living facilities have health services. This is paid with a monthly fee for utilities and rent, and then extra fees for anything not included.

Hospice Care

Hospice care is normally for those who have 6 months or left to live. They offer counseling for the families are well.

It includes volunteers, social workers, counselors, home health aides, nurses, and doctors as part of the care team. They’ll also help your family cope with you or your loved one’s illness.

Senior Housing

Another option is what’s known as subsidized senior housing. This is for those who have a moderate income where state and federal programs help pay for housing.

You might also receive help with laundry, housekeeping, shopping, and meals. In this type of housing, you’ll normally have your own apartment within a complex. The payment is a percentage of your income.

Retirement Communities

Retirement communities have different levels of care for your loved ones. For example, you can start out in independent living and then switch to nursing care if you need it. These tend to cost more and can include a monthly maintenance fee, plus a large fee before moving in.

Was it worth reading? Let us know.