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Most elderly persons prefer to remain at home, in familiar surroundings. To do so, they often need assistance with the tasks of daily living – like food preparation, mobility, and personal hygiene – or they need medical assistance. Family members cannot always provide these services. The ability of an elderly person to remain at home depends on what public benefits and home health-care agencies are available in your area.
Home Health Care May Be Covered Under Medicare
To qualify for home health care under Medicare, you must be under a doctor’s care and require at least some skilled care such as physical therapy, skilled nursing (for example, administering IV drugs or shots), or speech therapy. Your doctor must also certify that you are homebound, which means that you cannot leave your home without considerable effort, you require assistance to leave your home, or your condition requires you to stay home. Medicare will only pay for home health-care services provided by an approved agency.
Compare Patient Experiences with Home Health Care Agencies
You can select a Medicare-approved home health care agency in your area with Medicare’s online “Home Health Compare” tool. Based on your zip code and other information, the locator generates a list of home health care agencies in your vicinity. You can also use this tool to compare the services provided by each agency view the ratings made by by previous patients. Alternatively, you can contact the U.S. Administration on Aging for information on services available to elderly persons in your area.
Home Health Care Agencies Must Comply with Licensing Requirements
Nearly every state requires that a home health care agency be licensed or certified before it can provide services to patients. Most states also require that the agency be Medicare-approved before it can receive a license. You should contact your state’s department of health to verify that any home health care agency you are considering is properly licensed and in full compliance with state law.
You Can Appeal a Termination of Home Health Care Service
At some point, Medicare may no longer approve payment for some or all of the home health care services you are receiving. When this happens, the agency will no longer provide services, unless you agree to pay for them yourself. If Medicare denies payment for any medical service, device, or prescription, you have the right to appeal. This should be done promptly upon notice of denial.
An Elder Law Attorney Can Help
The law surrounding home health care for elderly patients can be complicated. Plus, the facts of each case are unique. This article provides a brief, general introduction to the topic. For more detailed, specific information, please contact an elder law attorney.