Resources

• Patients with a new diagnosis
• Homebound patients
• Patients with recent hospital/rehab discharges
• People with chronic medical conditions – Congestive Heart Failure, Diabetes, COPD, etc.
• Patients with a recent fall or mobility issue

Homebound means that you have an inability to leave your home or that it takes a considerable and taxing effort to leave home. Absences from the home must be infrequent or for a very short period of time, for example, leaving your home for medical care. Time away from home should not last longer than one to two hours or occur more often than one to two times per week, such as attending a place of worship once a week. In general, you are homebound if you have an illness or injury, which restricts your ability to leave home unless you have help.

Examples would be if you need special transportation or help from another person to leave your home.
If you leave your home and if the absences are long and frequent, such as frequent shopping trips or visits to friends, you are not deemed homebound. When you are able to leave your home on a regular basis, Medicare expects that any medical care you require will be provided in an outpatient setting.

Home health services are fully covered by Medicare and by most commercial insurance plans. Our reimbursement specialists can help you determine patients’ coverage.

To find out if you are eligible for Medicare home health care services, read the free publication Medicare and Home Health Care (Publication No. CMS-10969), available at http://www.medicare.gov/Publications/Pubs/pdf/10969.pdf.

Medicare and most commercial insurances will initially certify home health services for a period of up to sixty days. Should the patient require additional or new services after the initial sixty day certification, a new order or recertification will be submitted.

Home care generally refers to non-medical caregivers who assist with activities of daily living such as cooking, cleaning, and bathing. Home health refers to skilled nursing and home rehabilitation.

Talk to your primary care physician about whether home health care is the best option for you. If your doctor determines that you are eligible and in need, they will write, order, and coordinate care with the agency of your choice.