Is Home Health Care the Same as Home Care?

No, home health care and home care are quite different, despite sounding similar. Home health care, also known as home health, is provided by licensed medical professionals and includes services such as physical therapy, post-operative care, and treatment for conditions like Alzheimer’s, dementia, and chronic illnesses. In contrast, home care focuses on non-medical support, such as assistance with daily activities and personal care, to help individuals remain safe and comfortable in their homes.

Related Link: Do you or a loved one have early warning signs of dementia?

What Does "Homebound" Mean?

Home health care is available to any patient in need, but for Medicare to cover it, the patient must be deemed “homebound.”

Being homebound means that the patient’s condition prevents them from safely leaving their home without assistance from others or the use of assistive devices (e.g., canes, walkers, crutches, or wheelchairs)1.Patients can still be considered homebound even if they leave home for necessary medical treatments that cannot be provided in-home. Brief and occasional non-medical outings, such as attending church, visiting the beauty shop, or participating in special family events, are also permitted2.

The primary benefit of home health care for the elderly is that it can be delivered directly to the patient’s residence, whether it be a private home, adult foster home, assisted living facility, memory care facility, or long-term nursing home. This approach helps avoid expensive hospital bills.

Family members are encouraged to actively participate in the planning process, working with home health care professionals to set and achieve goals for the patient’s benefit.

Additional benefits of home health care for seniors include:

Home care services may have limitations based on the patient’s needs and the availability of resources

How Does Home Health Care Work?

The first step in receiving home health care is to obtain a physician’s orders and collaborate with a home health care company to create a detailed care plan. This process begins with an initial consultation, where the patient’s needs are assessed, and a treatment plan is developed. Family members and other caregivers are encouraged to participate in this planning to ensure consistent and comprehensive care.

Once services commence, home health care staff will implement the care plan, adhering to all physician orders, and keep the physician updated on the patient’s progress. The frequency and type of home health visits will vary based on the patient’s needs. Some patients may require daily care, while others might need only a short visit once or twice a week.

All services are tailored to the patient's needs.

What Does Home Health Care Do for Patients?

What Services Does Home Health Care Provide?

Home health care offers medically necessary, skilled services prescribed by a physician to treat illnesses, injuries, or medical conditions.

These services are tailored to the patient’s individual needs and may include:

• Infusion therapy
• Medication management
• Nursing care
• Nutrition services
• Pain management
• Psychiatric services
• Social work
• Therapy (physical, occupational, speech)

Home health care professionals perform tasks such as checking vital signs, assessing pain, monitoring food intake, managing medications, assisting with basic hygiene, and ensuring safety in the home.

What Services Does Home Health Care Not Provide?

Home health care focuses solely on medically necessary services prescribed by a physician. It does not cover unskilled services or daily necessities such as cooking, cleaning, bathing, and transportation. These tasks fall under personal home care assistance, which some home health care services may offer at an additional cost. Coverage for these additional services varies and may not be included under insurance or Medicare.

What Is a Medical House Call?

A medical house call is a visit by a physician to a patient’s home. These visits are primarily for homebound adults who have limited or no access to regular medical care.

What Is a House Call Doctor?

A house call doctor, or house call physician, is a medical professional who provides care to patients in their homes. These doctors can either be employed by an agency or run their own practice.

What Are the Benefits of Physician House Calls?

Physician house calls offer numerous advantages, providing patients with high-quality care from qualified physicians in the comfort and convenience of their own homes. Here are some key benefits:

• Accessibility: House calls ensure regular medical care for patients with limited options, such as homebound adults or those living in rural areas.
• Preventive and Chronic Care: They help monitor and treat both preventable and chronic conditions, reducing the need for emergency room visits and hospitalizations.
• Convenience: By bringing the doctor directly to the patient’s home, house calls encourage patients to maintain regular medical visits.
• Cost and Time Efficiency: Patients save time and money by avoiding travel to the doctor’s office.

While there are many benefits, it’s important to note some challenges. House calls are not suitable for emergency medical situations, and the availability of physicians and scheduling options may be limited in certain areas.

How Often Do House Call Doctors Visit?

House call visits can be tailored to the patient’s needs, but on average, patients are seen monthly. Typically, visits are scheduled on weekdays, though physicians may be available by phone on weekends or after hours.

Patients can receive house call visits in various settings, including their own homes, adult foster homes, assisted living or residential care facilities, memory care facilities, or long-term nursing homes.

What Is Home Care Nursing?

Home care nursing involves skilled professionals, primarily nurses and physical therapists, who provide medical care in a patient’s home. These nurses are licensed medical professionals trained to follow a physician’s plan of care. While they often work with elderly patients, they also care for children with mental or developmental issues and patients with disabilities.

What Does a Home Health Nurse Do?

A home health nurse delivers skilled services according to a physician’s plan of care. These services include:

• Taking the patient’s vitals
• Administering pain medication
• Performing medical treatments
• Recording symptoms and observations

Beyond these tasks, home health nurses play a crucial role in facilitating communication between the patient’s physician and caregivers. They ensure continuity of care by teaching all involved parties how to manage the patient’s condition effectively.

What Do Home Health Nurses Do on Their Visits?

The primary role of a home health nurse is to follow the physician’s plan of care, providing necessary medical services to treat, prevent, or manage the patient’s condition. During each visit, the nurse will:

• Take the patient’s vitals
• Monitor symptoms and other health details
• Administer medications and treatments
• Maintain a detailed journal of the visit

This documentation helps ensure continuity of care and effective communication between the patient’s family, caregivers, and medical team.

What Is a Home Health Aide?

A home health aide is a professional who assists patients with special needs, including those who are disabled, chronically ill, or cognitively impaired. They also provide services for seniors who need help at home.

Home health aides perform various tasks, such as checking vital signs, assisting with personal hygiene, administering medication, and following a physician-prescribed care plan.

Home Health Aide vs. Personal Care Aide

While the duties of home health aides and personal care aides often overlap, there are key differences. Home health aides typically work for agencies and play a crucial role in coordinating care among caregivers and medical professionals, ensuring continuity of care. They track the condition and progress of their clients.

Personal care aides, on the other hand, focus on non-medical services like dressing, bathing, cooking, cleaning, running errands, doing laundry, and providing companionship.

How to Get Home Health Care

To apply for home health care, start by having your doctor evaluate your condition and create a care plan. With this plan, you can contact your health insurance company or work directly with an agency to set up services. Ensure you meet all eligibility requirements before applying.

Who Qualifies for Home Health Care?

To qualify for home health care, especially if you want it covered by insurance or Medicare, you need to meet certain criteria:

1. Physician’s Care: You must be under the care of a doctor who orders home health services for you.
2. Homebound Status: You need to meet the definition of being “homebound,” meaning you have difficulty leaving your home without assistance due to illness or injury.
3. Skilled Services Requirement: You must require skilled nursing or therapy services on an intermittent basis.

Additionally, specific home health agencies might have their own requirements, and your insurance plan may have additional qualifications. It’s important to familiarize yourself with these criteria before applying for home health care¹².

How to Pay for Home Health Care

Choosing home health care can be a cost-effective alternative to long-term hospitalization or skilled nursing facilities. However, medical care can still be expensive. Here are several ways to pay for home health care:

1. Self-Pay: This involves paying out-of-pocket for home health care services. Depending on your situation, you may be able to negotiate the cost of services or arrange a payment plan with the agency.
2. Public Third-Party Pay: Most Americans over the age of 65 are eligible for federal Medicare coverage, which can be used to pay for home health care services. To receive reimbursement from Medicare, the following conditions must be met:

2. • The patient is an eligible Medicare beneficiary.
   • A physician certifies the need for services and creates a plan of care.
   • The beneficiary meets the Medicare definition of “homebound.”
   • The care is delivered to the patient’s place of residence.
   • The patient requires intermittent skilled nursing or therapy services.
   • The services are provided by a Medicare-certified agency¹.
3. Private Third-Party Pay: If you don’t qualify for Medicare or choose not to use it, you might be able to get home health care covered by a private insurance plan. Many insurers offer cost-sharing provisions for professional in-home care for seniors².

At Well Care Home Health, we accept Medicare, private insurance plans, and self-pay options to help make home health care accessible and affordable.

Is Home Health Care Covered by Medicare?

Yes, Medicare covers home health care services, provided you meet specific eligibility requirements:

1. Homebound Status: You must be considered “homebound” according to Medicare’s definition, meaning you have difficulty leaving your home without assistance due to illness or injury.
2. Skilled Care Requirement: You need part-time or intermittent skilled care to improve, maintain, or slow the progression of an existing condition.
3. Physician’s Care: You must be under the care of a medical doctor who prescribes home health care. This requires documentation of an in-person visit with the doctor either three months before starting home health care or within one month of beginning the services¹².

Medicare typically covers skilled nursing care and rehabilitative services, such as physical therapy, occupational therapy, and speech therapy. Additional services like medical social services, durable medical equipment, medical supplies, and other in-home services may also be covered depending on your needs.

If you have Original Medicare, you may receive home health care at no cost, though you might pay up to 20% of the Medicare-approved cost for durable medical equipment. If you have a Medicare Advantage Plan, you may qualify for additional coverage.

However, Medicare does not cover non-skilled personal care services such as cooking, cleaning, transportation, and other elements of custodial care¹.