Are you trying to stay independent at home, and out of the hospital as much as possible? Do you need help from a nurse, physical therapist, occupational therapist or speech therapist to be able to do that? If you find it difficult to leave your home, home health care may be the answer.
In this guide, you’ll learn all about home health care, including eligibility requirements, how to find the right home health care provider for your needs and more. We’ll answer frequently asked questions about home health care such as:
Download a PDF version of this Home Health Guide to reference this information and share with your loved one.
Home health care includes a wide range of healthcare services that can be provided in your home. It is often used to help people recover from surgery, injury or an acute illness. Home health providers like Amedisys also help people manage chronic illnesses such as diabetes, COPD or heart disease at home.
You have to meet certain eligibility requirements to get coverage for home health, including your physician certifying that you are “homebound.” This means it’s difficult for you to leave home without help. You also will need to be under the care of a physician, who certifies that you have a skilled need. Home health care is typically covered by Medicare as well as Medicaid and some private insurance plans for eligible patients.
What is home health care? Learn more about the home health care definition.
Home health care is typically delivered by a home health agency like Amedisys. So, what is a home health agency?
Here’s a simple definition of home health agency: an appropriately licensed organization that provides skilled nursing care and therapy services in eligible patients’ homes, in accordance with applicable federal, state and local requirements. Care is delivered by a team of healthcare workers and supervised by the patient’s doctor and a home health nurse.
Learn more about home health care. Complete our brief form to speak to a home health specialist.
*If you are a current Amedisys patient, please contact your Care Center directly.
Home health care can include nursing, occupational, speech and physical therapy and other services to help you stay safe at home. The type of care you receive is based on your needs and your doctor’s orders. With Amedisys, your team will work with you, your family and your doctor to:
Who is on the home health team? Depending on your needs and doctor’s orders, you may work with a:
Your home health providers will work with you to set goals that are specific to you and your situation. In general, some of the goals of home health care include:
There are a variety of home health care services that can be included in your care plan. Every patient has different needs. Your doctor will decide which services are right for you.
In-home health services with Amedisys may include:
Some home health companies have specialized clinical programs. For example, many Amedisys home health agencies offer a heart failure program, a diabetes program and a COPD program. If you have a condition that increases your risk of falling, our home health companies offer a fall reduction program. This program helps you make changes that reduce your fall risk and build your strength and balance.
Adults of any age may receive home health care if they meet the eligibility requirements. Younger adults may need home health after a surgery, injury or acute illness in order to recover. Studies show older adults are more likely to use at-home health care than young people because of higher rates of chronic illness and disability.
Home health is for anyone who meets eligibility requirements, with a doctor’s order, and needs help at home. You may need home health care if you have difficulty leaving home and:
Home health care can help homebound people with a variety of conditions. Some of the most common diagnoses for home health patients include:
How does home health help? Learn more about the ways home health care can help people with these conditions.
Home health is typically covered by insurance if you meet eligibility requirements. For example, you’ll need to meet all of these requirements:
The best way to get home health care is to ask your doctor about it. They’ll determine your eligibility and can place an order for home health care with Amedisys.
Another option is to contact your preferred home health agency. At Amedisys, we’ll coordinate with your doctor to find out if you’re eligible.
John fell in the bathroom and needed hip surgery. He spent five days in the hospital and is ready to be discharged, but he hasn’t fully healed. In his discharge paperwork, John’s doctor includes information about being homebound and orders short-term skilled care. His doctor lists the services and equipment John will need. John is eligible for home health care.
Martha visits her doctor for follow-up on a wound. Her doctor notes that she is homebound and orders daily wound care visits from a home health nurse for the week. The nurse will be at Martha’s house less than an hour per day. Martha’s care is “intermittent” and would likely be covered under Medicare.
Do you qualify for home health? Learn more about eligibility requirements and how to qualify for home health.
Home health care is affordable. Medicare, Medicaid and many private insurance plans typically cover home health services for eligible patients when prescribed by a physician. If you’d like to receive home health care but you don’t meet eligibility requirements, private pay for home health may also be an option.
In addition to covering standard home health services, many insurance providers cover durable medical equipment (e.g., walker or wheelchair) and certain medical supplies, if required. These may incur an out-of-pocket cost (around 20%), depending on your insurance plan. A home health company like Amedisys can help you understand your coverage and any out-of-pocket costs.
Home health care is often covered by Medicare as well as Medicaid and some private insurance plans if you meet the eligibility requirements. Here are a few of the most common ways to pay for home health care:
If you’re over 65 and meet the home health eligibility requirements, Medicare typically covers home health services. In fact, Medicare is the largest payer of home health care. Medicare may also cover part-time or intermittent help with bathing, dressing and other daily tasks from a home health aide. However, an aide is only covered if a doctor orders those services in addition to skilled care to care for your injury or illness.
Medicare does not cover non-skilled personal home care services if that is the only type of care you need. Medicare Advantage plans might offer different coverage, so check with your plan provider.
Medicaid typically pays for home health care for those who are eligible. It covers the same services as Medicare. Medicaid may also cover cleaning, meal preparation, transportation, personal care and other help that Medicare does not cover. Check your state rules to find out the details of your Medicaid home health care coverage.
If you don’t qualify for home health or would rather use private insurance, many insurers cover home health services. Most plans cover short-term skilled care, but not long-term care or personal home care services like housekeeping or errands. Coverage varies significantly from plan to plan. Review your policy to see what type of home health coverage your plan offers.
Does your insurance cover home health care? Get a side-by-side comparison of these and other home health coverage options.
The most common home health care setting is a patient’s private home. That could be a house, an apartment or a relative’s home. Being able to recover or manage an illness at home is convenient, affordable and comfortable.
A private home isn’t the only place people can receive home health care. Senior living communities and group homes are also considered a patient’s “home” for purposes of receiving home health care.
Learn more about where you can (and can’t) get home health care services delivered.
There are many options for seniors looking for help at home – so many options that it can be confusing trying to figure out what type of care you need. You might be wondering, “What’s the difference between home care and home health? Would I do best in a facility, or can I manage my condition at home?” Every type of care serves an important purpose. The key is finding the right care for your needs, at the right time.
We’ll explore several senior care options that may be available to you. Call us or talk with your doctor to find out if your preferred type of care would be appropriate for your needs.
Some home health companies use the terms "home care" and "home health care" interchangeably. Check to make sure you’re looking at the right services for your needs.
With home care and home health, you don’t have to choose one or the other. Many older adults receive both at the same time. In fact, 80% of home health patients have a caregiver outside of the home health agency. This often is a spouse, child or other family member, but can also be a paid caregiver through home care.
Learn more about the differences between home health care and home care.
It is unusual to receive both hospice and home health at the same time. A person getting home health may have declining health and eventually transition into hospice care. On occasion, a person getting hospice may have an improvement in health and transition to home health.
What is the difference between hospice and home health care? Learn about eligibility criteria and other differences.
Often, people stay in a skilled nursing facility for a short time while they’re transitioning from a hospital to their personal home. They may have had surgery or an acute illness and need intensive support for the first few days or weeks. Then after those first few days or weeks, they can return home with regular check-ins, monitoring and care from home health professionals.
Home health is typically covered by Medicare and other insurance. Assisted living is not covered by Medicare, though Medicaid and long-term insurance may cover some costs, depending on your state’s rules. Many people pay for assisted living out-of-pocket.
Unless it’s also a skilled nursing facility, most nursing homes are defined as non-medical custodial care, which is not covered by Medicare. Most people pay with private insurance, Medicaid or out-of-pocket. Home health care is covered by Medicare, Medicaid and many insurance plans for eligible patients.
The process of starting home health usually goes something like this:
You visit your doctor, or you’re being discharged from a hospital or skilled nursing facility. You might ask about home health care, or your doctor may recognize a need for skilled care at home and determine you meet the eligibility requirements. Your doctor orders home health for you. They may recommend a particular home health care provider. Or they may provide a list of nearby programs, or encourage you to research on your own and find the best home health agency for your needs. You have the right to choose your home health company. It’s important to do your research and choose a high-quality provider like Amedisys.
You’ll hear from an Amedisys home health specialist to schedule the first visit. During this visit, they’ll ask questions about your health and learn more about your schedule and needs. They’re required by law to keep your information confidential.
The services you receive and the frequency of your home health visits are based on your doctor’s orders. Your team will set up a schedule and work to make the visits convenient for you.
Once you start care, a team of home health professionals visits your home. Depending on your doctor’s orders, your team could include skilled home health care providers like a nurse, physical therapist, occupational therapist or speech therapist. It could also include specialists like a social worker or home health aide. Home health visits can last anywhere from 30 minutes to a couple of hours, depending on your condition and the purpose of the visit. If an urgent need comes up, you can reach an Amedisys on-call home health specialist 24 hours a day, 7 days a week. Your home health team will update your caregiver(s) and doctor regularly. They may adjust your care plan as your needs change, if approved by your doctor.
It depends on your needs and your doctor’s orders. You may only need one weekly visit from a nurse, for example. Or you might have several visits per week from a few different team members. For example, you might have a nurse visit one day, a physical therapist later in the week, and a home health aide once a week. Some patients could require daily visits for a period of time, depending on their needs.
