The most common general home health care question Care Mountain gets asked from families in the Dallas, Texas area is about the types of home health care available and how they are paid for. The easiest way found to explain the different types of home health is by their source of payment.
Home health care that is paid through Medicare will need to be prescribed through a doctor’s order. This will include standard home health care or hospice care. Standard home health care covers a lot of different activity, but most commonly physical therapy, occupational therapy, nursing aide for bathing, and general oversight by a skilled nurse. The activity of these home health care professionals is limited to short in and out visits (averaging less than 2 hours) and the duration of coverage is limited to an episodic illness of time usually less than seven weeks. Medicare has clearer guidelines on this.
Hospice care that is covered under Medicare through a doctor’s order can last much longer than seven weeks. Care Mountain provides home care that works with hospice companies, and has worked with a client under hospice care coverage for as long as four years.. Hospice care is directed at palliative or comfort care for a patient. While this too can cover a variety of home health care activity, the most common visits are by a nursing aide, registered nurse and hospice Chaplin. Depending upon one’s stage in hospice care, the visits by a nursing aide can range from one up to 24 hours of care. Clear guidelines can be found on the Medicare website.
Under standard home health care and hospice care coverage certain types of medical equipment will also be covered. The Medicare website also has clear guidelines on this too. The most common types of home health care medical equipment we see being used/needed include a bedside commode chair, wheelchair, hospital bed, pressure relief cushions to minimize the chance of bedsores, seat riser with grab bars to set over your toilet, a mechanical lift for transfers and a hospital bed.
For those that qualify for Medicaid, home health care coverage is available for an extended period of time. Each state sets up their own programs to determine how these Medicaid home health care dollars are spent. Currently in Texas this is set up though the Texas Health and Human Services Department. Once you receive an approved amount of covered weekly home health care hours, then you will need to find a home health care agency that accepts the program that you are on. Finding a good quality provider usually takes some time.
Veterans and survivors who are eligible for a VA pension and require the aid and attendance of another person, or are housebound, may be eligible for additional monetary payment. These benefits are paid in addition to monthly pension, and they are not paid without eligibility to Pension. This program offered through the Veterans Administration is called the Aid & Attendance Program.
Long term care insurance polices are another source of payment for home health care. Care Mountain is a long term care insurance preferred home health care provider for all the major insurance companies. After working through your grace, or out of pocket period, your policy will typically cover a fixed daily dollar amount for home health care. This can include the activity of a wide range of home health care professionals, but mainly involves a nursing aide. The nursing aide is there under your direction and duration, and any time used above your allotted insurance policy coverage will typically be paid out of pocket.
The most common source of payment for home health care requiring more than short in and out visits, or for a time duration outside of Medicare coverage, is going to be through private pay or out of pocket. During my 30+ years helping families with home health care, I have found that not more than 20% of those served had a long term care policy. So, don’t feel bad if you need a private pay caregiver for home health care as this is the case with almost everyone else here in the Dallas, Texas area.
If you end up having to get a private pay caregiver, the good thing is for most all of us it will not be for one above the nursing aide level. Paying for a caregiver above this level can get very costly. If you need a caregiver above the nursing level, there is a good change your insurance policy will cover all or most of it. So, don’t worry.
When you are paying privately or out of pocket for you caregiver, then you obviously will have much more latitude as to the direction of services received. Care Mountain home health care provides caregivers that are accepted under all the major long term care insurance policies, and available for private duty care. Care Mountain has be recognized as one of the best home health care companies in the Dallas, Texas area due to a ZERO State complaint history since inception in 2004, always maintained a BBB A+ Rating with the North Central Texas & Dallas Better Business Bureau and due to receiving from the Greater Dallas Chapter of the Alzheimer’s Association SIX highly competitive high quality achievement awards for outstanding care at home for someone with Alzheimer’s or other dementia.CLICK HERE FOR FAQ
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