How does home care service start?
Home care starts with a home health agency, nurse or physical therapist scheduling an initial consultation to complete a physical and ask questions like:
- What medications do you take? How many? How often?
- Do you take any other medications when you are feeling worse like aspirin or cough syrup?
- Were you or a family member given prescriptions to bring home from the hospital or nursing home? The nurse may want to call your doctor while he or she is there to make sure the medicines are the right ones in the right amount.
- The nurse may ask you to move around to make sure you're safe in your home (especially in the bathroom where many fall.) If she feels you need to get stronger, she may call your doctor to ask a physical therapist or occupational therapist come to your home to help you with exercises and make your home safe. Everyone’s job is to keep you out of the hospital.
When you receive private duty or personal care and support from a home care agency, a nurse or trained healthcare professional will come to evaluate your situation in your home. They may ask:
- Do you have any health conditions like heart disease, diabetes, trouble breathing, etc. that we should know about and affect your ability to do every day activities?
- Is there someone in your house or close by who knows you're not feeling well and may need help to see a doctor?
- Do you need help getting dressed, bathing, going to the toilet, shampooing your hair, shopping or preparing a meal?
- Can I look at your house to do a general safety check? He or she can let you know what you can do to make your home safer. See Hidden Hazards.
- What do you enjoy doing? Do you like watching a certain TV show? Reading? Sewing? Playing cards? Talking?
The evaluator will let you know what they think you need help with and work to create a service plan detailing how often/how long the company’s employee will be in your home. The employee will follow this plan for the duration of service.
Because this is your house, you should expect to set the rules on how the employee will get into the house, where they can eat, if they can talk on the phone, what bathroom they can use, etc.
What are the different types of home care services?
There are two main types of Home Care services:
- The first type is Medical Home Care prescribed by your doctor with instructions for your care. The treatment is provided by health care professionals including nurses, physical therapists, speech therapists, social workers and home health aides. This type of care is often paid for by Medicare, Medicaid or a commercial insurance company. A Medicare or Medicaid Certified Home Health Agency or a home care company approved by your insurance plan typically provides services.
- The second type involves a home health aide assisting clients with activities of daily living (ADLs) like bathing, dressing or shopping. These services are often called Private Duty or Personal Care and Support services. They may be paid for by a long term insurance policy, Medicaid, or by you and your family.
How to find a home care agency that suits your needs?
If you're searching for medical home care, your discharge planner, social worker or doctor can help you find a home care agency. If you have the Medicare Advantage plan, you may need to use a home care company that belongs to the plan network and your insurance company can give you this information.
If you're looking for “Personal Care services” and assistance with Activities of Daily Living, you can search for Home Care agencies in your area. Good questions for you to ask the agency are:
- What services and assistance do you provide your clients (ex. bathing, dressing, shopping, cleaning, laundry, cooking, etc.)?
- Do you have someone on call 24/7 for clients to contact?
- Do your caregivers undergo training, thorough background checks and drug screening before seeing clients?
- Are your caregivers regularly evaluted based on their performance? Do they report to a supervisor?
- How does the agency choose caregivers to come to my home? Do I have a preference on whom I'd like to be my caregiver?
How much do home care services cost?
Costs depend on individual's personalized care plan. Before starting service, our clinical team will conduct an in-home care evaluation to determine costs.
How to pay for home care?
According to the National Association for Home Care & Hospice (NAHC), people who require home care can primarily choose between three options to finance the care:
Based on your insurance and financial abilities, you may choose to pay for home care from you or your loved ones' personal savings. The costs are usually set or negotiated by the home care service provider.
2. Public Third-Party Payers
In the case of senior citizens who require home care, there are several options available. Most Americans over the age of 65 are eligible for the federal Medicare program. If the home care agency is Medicare-certified, Medicare funds may be used to pay for certain services provided by nurses, therapists or other medical professionals.
Medicare requires that the following conditions be met before reimbursing for home health services:
- The individual to whom the services are provided is an eligible Medicare beneficiary
- A physician certifies the need for services and establishes a plan of care
- The beneficiary must meet Medicare's definition of "homebound"
- The care must be provided in the patient's place of residence
- The individual needs skilled nursing on an intermittent basis, physical therapy, speech therapy or has a continued need for occupational therapy once one of the other skilled disciplines have established a plan of care
- The services are provided by a Medicare-certified home health agency
When the above conditions are met, physicians may also order home health aide services or medical social worker services.
Seniors can also use resources provided by the Older Americans Act (OAA), which stated in 1965 that federal funds shall be used to enable older individuals to remain independent in their communities. This funding covers certain costs related to transportation, chores and other tasks for people over the age of 60 who have the greatest social need. In addition, seniors may be eligible for services from the Veterans Administration if they are at least 50 percent disabled because of a service-related condition. Others who need care may turn to funds provided by Medicaid, a healthcare program for low-income individuals, or social services block grant programs provided to states each year from the federal government.
3. Private Third-Party Payers
Private health insurance plans typically cover some home care services for people who have acute needs and long-term care included. Commercial insurers such as Blue Cross and Blue Shield generally pay for professional in-home care with a cost-sharing provision, hospice services, home nursing and other needs. If the person who requires care has long-term insurance that includes in-home care coverage, the benefits can sometimes be used to pay the caregiver.