A doctor must ONLY prescribe home care for Medicare services provided by a Medicare certified agency. If you are looking for non-skilled services such as bathing, grooming, transportation, companionship and more, you can receive services from a Private-Duty home care agency.
Home care is skilled medical, and/or non-skilled home assistance services provided in the patient’s place of residence.
A person who is homebound requires considerable and taxing effort to leave home and cannot do so unassisted. A person is allowed to leave for medical treatment or short, infrequent trips for non-medical reasons, such as a trip to the beautician or religious services.
Medicare home care is covered by Medicare, Medicaid and most private insurance. If you do not meet the admitting criteria you are allowed to pay privately for services. Private-Duty home care is primarily paid for out-of-pocket or through the help of private insurance.
Most insurance plans cover the cost of Medicare home care services, and some cover or subsidize the cost of private-duty home care services. Please keep in mind that each plan may have certain criteria that must be met in order to qualify. Your insurance may also have a specific provider they require you to utilize. You should contact your insurance provider to see what home care coverage is included in your specific plan.
Private-Duty home care home health aides provide personal care services, including bathing and grooming. In order for Medicare home care services to include a bath or any other type of personal care, there must be a need for skilled services (a nurse or physical therapist).
Anyone can get home care from nearly any home health agency depending on the insurer. If you are unhappy with the care being provided, you should first voice your concerns to the current agency. If the agency is still unable to meet your needs, you can request to change agencies. If you have a complaint that is unresolved you should call your state’s Department of Health.