Utilizing your Medicare A services
Courtesy Recover Health, Linn County LIVING WELL Magazine
Maximizing all levels of home care can help you stay independent and healthy, avoiding a hospitalization. Many people believe that you can only have Medicare home services if you have been discharged from the hospital or a rehabilitation center. This may be the most common use of this 100% covered benefit but any Medicare member (at times a caregiver) who can benefit from these services can ask their physician about home care and ask for an order to be written so an assessment can be made and a treatment plan begun.
Medicare has four qualifying conditions for home care:
1. Your doctor must decide that you need medical care in your home.
2. You must need at least one of the following: intermittent (and not full-time) skilled nursing care, physical therapy, speech-language pathology services or continue to need occupational therapy.
3. You must be homebound or normally unable to leave home & leaving home takes a considerable and taxing effort. A person may leave home for medical treatment or short, infrequent absences for non-medical reasons.
4. The home health agency caring for you must be approved (“certified”) by the Medicare program.
Situations in need of skilled home visits by a registered nurse for an evaluation:
- You’ve been diagnosed with a new disease or ailment.
- The doctor has changed your medications or ordered a new prescription.
- Your current health situation has worsened.
- You are post surgery or have had any type of incision or cut requiring “Wound Care.”
- A marked change in either cognitive ability or emotional response.
Why you would need a Physical or Occupational Therapist home visit?
- If you are experiencing chronic pain or limited mobility (getting up from a bed or a chair and walking)
- If you are physically weak, experiencing low levels of endurance or tolerating exercise.
- Having trouble managing personal care – bathing, dressing, and toileting.
- You have poor balance or are diagnosed with vertigo – basically at risk for falling or a history of falling.
A speech therapist would come to your home if you needed help regaling speech or are having trouble swallowing.
A medical social worker would come to your home to assess your environment, eligibility for other services, tell you about resources and discuss emotional difficulties like depression among other things.
Recover Health can assist you in putting together a plan to utilize Medicare, Medicaid, or private pay services to stay at home and independent. We’re here to help! Call us today at 319-373-6294.