Home health care constitutes a variety of social and health services that are offered to patients in the comfort of their homes. Medicare covers some of these services. This paper aims to examine the use of Medicare in covering home health care services.
Medicare Portion Covering Home Health Care Benefits
Home health care benefits are covered by Medicare Part A, which constitutes hospital insurance and/or Medicare Part B that constitutes medical insurance (CMS, 2017).
Criteria for Social Security Eligibility
For an individual to be eligible for social security in the U.S., the individual has to have worked for not less than 10 years (for those born in 1929 or later) and paid social security taxes (Social Security Administration, 2019).
Criteria for Providing Home Health Services to a Medicare Recipient
The following are the requirements for providing home health benefits to a Medicare recipient (CMS, 2017):
- The recipient has to be under the care of a doctor and should be receiving services falling within the established plan of care that is evaluated regularly.
- The medical practitioner (MD) should certify that the recipient requires speech-language pathology services, part-time skilled nursing care, physical or continued occupational therapy.
- The home health care agency selected should be Medicare-certified.
- A certification from the MD indicates that the participant is homebound.
- A doctor or an ancillary health professional should document that they had a face-to-face meeting with the participant within the specified timeframes and the encounter should serve the purpose of attending to the home health need.
Definition of “Homebound” and “Skilled Need”
Homebound is used to describe an individual who has great difficulty leaving home without help (CMS, 2017). On the other hand, a skilled need means that the patient requires skilled nursing care which is offered by either a registered nurse or licensed practical nurse.
Although Medicare is a distinct benefit offered by the federal government, it is linked to social security retirement benefits which act as a financial safety net for retirees. In instances, of home health care especially among the elderly, Medicare serves as an essential medical insurance cover.