Medicare Home-based Services

Do you want to learn about the new Medicare benefits for home-based services?

Home-based services are replacing nursing homes as the number one option for aging in place.
Check out the list of potential services your medical insurance policy may cover today or in the future.

Home Health Care

Home health care helps seniors live independently for as long as possible, given the limits of their medical condition. It covers a wide range of services and can often delay the need for long-term nursing home care.

More specifically, home health care may include occupational and physical therapy, speech therapy, and even skilled nursing. It may involve helping the elderly with activities of daily living such as bathing, dressing, and eating. Or it may include assistance with cooking, cleaning, other housekeeping jobs, and monitoring one’s daily regimen of prescription and over-the-counter medications.

At this point, it is important to understand the difference between home health care and home care services. Although they sound the same (and home health care may include some home care services), home health care is more medically oriented. While home care typically includes chore and housecleaning services, home health care usually involves helping seniors recover from an illness or injury. That is why the people who provide home health care are often licensed practical nurses, therapists, or home health aides. Most work for home health agencies, hospitals, or public health departments that are licensed by the state.

Interview Questions to Ask Potential Home Health Care Providers

  • How long has the agency been serving this community?
  • Does the agency have any printed material describing the services it offers and its pricing?
  • Is the agency an approved Medicare provider?
  • Is the quality of care certified by a national accrediting body such as the Joint Commission for the Accreditation of Healthcare Organizations?
  • Does the agency have a current license to practice (if required in the state where you live)?
  • Does the agency offer seniors a “Patients’ Bill of Rights” that describes the rights and responsibilities of both the agency and the senior being cared for?
  • Does the agency write a plan of care for the patient (with input from the patient, his or her doctor, and family), and update the plan as necessary?
  • How closely do supervisors oversee care to ensure quality?
  • Are agency staff members available around the clock, seven days a week, if necessary?
  • Does the agency have a nursing supervisor available to provide on-call assistance 24 hours a day?
  • How does the agency ensure patient confidentiality?
  • How are agency caregivers hired and trained?
  • What is the procedure for resolving problems when they occur, and who can I call with questions or complaints?
  • Is there a sliding fee schedule based on the ability to pay, and is financial assistance available to pay for services?
  • Will the agency provide a list of references for its caregivers?
  • Who does the agency call if the home health care worker cannot come when scheduled?
  • What type of employee screening is done?

Help with Activities of Daily Living

Whether you arrange for home health care through an agency or hire an independent home health care aide on an individual basis, it helps to spend some time preparing for the person who will be doing the work. Ideally, you could spend a day with him or her, before the job formally begins, to discuss what will be involved in the daily routine.

If nothing else, tell the home health care provider (both verbally and in writing) the following things that he or she should know about the senior:

  • Illnesses/injuries, and signs of an emergency medical situation
  • Likes and dislikes
  • Medications, and how and when they should be taken
  • Need for dentures, eyeglasses, canes, walkers, etc.
  • Possible behavior problems and how best to deal with them
  • Problems getting around (in or out of a wheelchair, or trouble walking for example)
  • Exercise routine
  • Special diets or nutritional needs

The expansion of home-based services is changing where and how medical services are provided under Medicare. You can learn more about these services in your health insurance handbook.