Frequently Asked Health Care Questions

• What is home health care?

  Home health care is clinical medical care provided by a registered nurse, occupational therapist, physical therapist or other skilled medical professionals, and is often prescribed as part of a care plan following a hospitalization.

  Home healthcare can help you live independently in your home. We can assist with and provide comprehensive care for you, all delivered in your home environment under the direction of your personal physician. Services and programs are provided if you have a medical condition that can be:

  • Helped by the skill of a nurse, including: recovery from an illness, accident or surgery, wound care, help with medications and/or injections, physical, occupational and speech-language rehabilitation, therapy services, clinical management of a chronic disease and/or monitoring a serious illness
  • Patient and caregiver education

  Home healthcare requires a skilled need that a nurse or physical therapist can provide. Nursing care by UR Medicine Home Care is provided with a teamwork approach involving the patient first, physician, family, caregivers, and members of the healthcare team.
  Personal care (or private duty care) is usually provided by a home health aide and does not require a nurse, but is necessary when you need help at home with bathing, dressing, moving around or meal preparation.

• What are the requirements for home health care?

  The requirements to qualify for home health care include:

  • You must be considered home bound
  • You are under the care of a physician who manages and authorizes the need for services
  • You require some type of skilled nursing services or need therapy from a Physical, Occupational, and/or Speech Therapist

• What is the definition of “Home Bound”?

  Generally, you can be considered home bound if:

  • You have an illness or injury that restricts your ability to leave home unless you have help, or if it takes considerable and taxing effort to leave home (if you need a wheelchair, special transportation, or other assistance)
  • Absences from the home must be infrequent or for a short period of time, as in only leaving your home for medical care
  • Trips out cannot last longer than one to two hours or occur more often than one to two times per week for activities like grocery shopping, attending a worship service, or going to a hair appointment

  You are NOT considered home bound if:

  • You are able to drive
  • You leave your home for reasons other than receiving medical treatment
  • The absences are long and frequent, such as frequent shopping trips or visits to friends

• What do home health services include?

  Home health services include:

  • Therapy and skilled nursing services
  • Administration of medications, including injections
  • Medical tests
  • Monitoring of health status
  • Wound care

• When should home health care be used?

  Situations in which home health is prescribed include:

  • Following an inpatient hospitalization, rehabilitation, or a stay at a skilled nursing facility – to help the senior transition back to independence
  • When a senior has had a recent medication change, in order to monitor for side effects and assure a new medication is effective
  • When seniors experience an overall decline in functioning – in order to help them to regain independence through therapy or learning new skills to compensate for their deficit
  • If you need continued care that can’t easily or effectively be provided by family members, services are available with 24 hour on call nurses to assist seven days a week

• How is home health care paid for?

  Home healthcare can be covered through a variety of sources if your care is medically necessary and you meet certain coverage requirements:

  • Medicare – traditional Medicare pays 100% of the cost for home healthcare if you are 65 years of age or over or permanently disabled
  • Medicaid – Medicaid health insurance helps those with limited income who can’t afford medical care, and will pay for some or all of their medical bills
  • HMO’s (Health Maintenance Organizations) – companies have contracts with doctors and other healthcare providers and are directly involved in your medical treatment. HMO health insurance plans are generally the cheapest kind of coverage available, but also the most restrictive. Benefits vary per policy and verification of benefits is required
  • Workers Compensation Insurance – “Workers comp” covers you if you are injured on the job, whether hurt on the workplace or elsewhere, in an auto accident while on business, and covers work-related illnesses/medical and rehabilitation services
  • Private Pay – If an option for services not covered as outlined above; you may choose to pay out of pocket for services. When insurance does not cover a needed service, fees are adjusted based on your ability to pay.