Home Health Care: A Comprehensive Guide

Shawn Plummer

CEO, The Annuity Expert

If you are a senior citizen or have a loved one who is, you may be wondering what home health care is and how to pay for it. Home health care is a type of care that allows seniors to live in their own homes while still receiving the medical attention they need. In most cases, home health care is paid for by Medicare, but other options are also available. This guide will discuss home health care, how to pay for it, and some benefits of using it.

Home Health Care Definition

Home health care is a type of health care that is provided to individuals in their homes. It typically involves providing skilled nursing care, therapy services, and other health care services that are needed intermittently. The goal of home health care is to allow individuals to receive the care and support they need to maintain their health and independence while remaining in the comfort and familiarity of their own homes.

Home health care may be provided to individuals of any age who have a chronic illness, disability, or other health care need that requires skilled nursing care or therapy services. The services provided may include wound care, IV therapy, medication management, pain management, and other types of care needed to manage a person’s medical condition. In addition to medical care, home health care may also include assistance with activities of daily living, such as bathing, dressing, and eating.

What Is Home Health Care?

Home health care is provided to people with a severe illness or disability who cannot leave their homes. Skilled nursing care can include various services, such as nurses, physical therapists, or a certified nursing assistant coming to the home to provide care, medical social services, and occupational therapy, or it can involve providing equipment and supplies that the person needs to be able to stay at home.

Home health care can be an essential option for people who want to remain in their own homes (instead of a skilled nursing facility) but need assistance. It can allow them to age in place and maintain their independence.

Home health care can be a more affordable option for many people than moving into a long-term care facility for nursing care. And it can also allow people to receive the care they need in a more comfortable and familiar setting.

Home Health Care Examples

Examples of home healthcare services include:

  • Skilled nursing care, such as wound care, IV therapy, and medication management
  • Physical therapy, occupational therapy, and speech therapy
  • Assistance with activities of daily living, such as bathing, dressing, and eating
  • Monitoring of vital signs and other medical conditions
  • Management of chronic illnesses, such as diabetes and heart failure
  • Palliative care and hospice care for individuals with terminal illnesses
  • Care for individuals with disabilities or cognitive impairments, such as Alzheimer’s disease or dementia
  • Support for caregivers, including education and training on how to care for a loved one at home.

Home healthcare services may be provided by a team of healthcare professionals, including nurses, therapists, and social workers. The services are typically coordinated by a home healthcare agency and may be covered by insurance, Medicare, or Medicaid. The specific services provided will depend on the individual’s needs and preferences and will be tailored to their unique situation.

How Do Home Health Care Services Work?

When most people think of health care, they picture hospitals and clinics. However, an increasing number of patients are receiving care in the comfort of their own homes. Home health care is a broad term that can refer to various services, from skilled nursing to physical therapy. Home health care is generally less expensive and more convenient than traditional medical care because all services are at the patient’s home.

A home health care agency provides most home health care services. These agencies are typically staffed by home health care professionals, including nurses, therapists, and home health aides. Patients can receive a wide range of services from home health agencies, including wound care, IV therapy, and pain management. In some cases, home health agencies may also offer social services and psychological support.

Not all home health services are covered by insurance. However, many insurance plans will cover at least some home healthcare costs. For example, a Medicare Advantage Plan and Medicare will pay for home health care if it is considered medically necessary and if the patient meets specific criteria. Medicaid may also cover home health care costs in some states.

Some patients prefer to receive home health care rather than stay in a hospital or skilled nursing facility. This can be a good option for patients with a chronic illness or who need ongoing assistance with activities of daily living. Home health care can also benefit patients who wish to remain in their own homes as they age.

Personal Care Services

Personal care aide services are nonmedical help with Activities of Daily Living (ADLs):

  • bathing
  • continence
  • grooming
  • eating
  • toileting
  • dressing
  • ambulating
  • transferring

Homemaking services (home care assistance) include a wide range of activities that ensure someone can stay home. They may include the following:

  • food shopping and meal preparation
  • housekeeping and light chores
  • lawncare and heavy chores
  • financially assisting by paying bills and budgeting
  • meal delivery programs (meals on wheels)
  • running errands
  • transportation services to doctors’ appointments
  • handyman duties, including home repair and maintenance services
  • therapy services (speech therapy, physical therapy, etc.)

In-home LTC services, in addition to family members and friends, are provided by a variety of care assistance organizations and agencies.

Home Health Care Services

Home health care service providers are subject to state and federal regulations and require quality care. As a result, many of them have been certified by Medicare and Medicaid.

A wide range of services is covered, including travel to and from the patient’s home. In addition, home health care may be paid for by Medicare when a physician orders supervision or treatment that enables a patient to live at home and engage in routine daily activities without significant assistance.

Home health services are healthcare services that enable seniors to manage their health care at home efficiently. The objective is to promote, keep, or restore a person’s health. There is a lot of individualization in care, which typically includes the following:

  • registered nurses and licensed practical nurses
  • home care aide
  • medical social workers
  • case managers/geriatric care managers
  • physical therapists
  • occupational therapists
  • speech therapists
  • hospice organizations

Home Health Care Facilities

A home health care facility is a type of health care facility that provides services in the home. This may include skilled nursing care, therapy services, and other health care services that are needed on an intermittent basis. The goal of home health care is to allow individuals to receive the care and support they need to maintain their health and independence while remaining in the comfort and familiarity of their own homes.

Home health care facilities may be run by a home health care agency responsible for coordinating patient services. These agencies may employ nurses, therapists, and other healthcare professionals to provide care in the home. Sometimes, a hospital or other healthcare provider may operate a home health care facility. The services may be more extensive, including hospital-based care, IV therapy, and wound care.

Home health care facilities, unlike nursing homes that supply long-term care for people who can’t live independently and assisted living centers that offer assistance with everyday tasks like grooming or eating but not clinical services, provide skilled medical aid.

Hospice Organizations

Hospice care may be received in a facility or at home. Hospice offers professionally coordinated services, including counseling, medical treatment, pain management, symptom management, social services, and spiritual support for terminally ill people and their families.

Who Is Authorized To Provide Home Health Care?

Registered Nurses/Licensed Practical Nurses

Practical nurses who are fully qualified and licensed assist with treatment ordered by a patient’s doctor. Such care might include giving prescribed medical therapies, administering medication, monitoring chronic conditions, administering injections, checking blood pressure, and caring for sores.

Home Health Aides

Home health aide services do not provide skilled care as licensed nurses but can improve quality of life by providing personal care, exercises, light housekeeping, and other daily living support.

In most states, home healthcare aides must be certified. Home care aides may or may not work for a social service organization under the supervision of a nurse. Their goal is to assist people who are not self-sufficient in their homes to maintain and sustain their daily living functions.

Case Managers/Geriatric Care Managers

Long-term care managers, also known as geriatric care managers, are specialists who evaluate the mental, physical, social, and financial circumstances of people who may require long-term care. Case management begins when the case manager analyzes various data to determine what’s required for each client. The case manager then creates a care plan and manages housing, medical, social, and other services based on what is learned.

Caregivers and their families may turn to case managers for help with long-term care needs. Case managers are frequently social workers or health care experts who specialize in assisting caregivers and their families with long-term care issues.

Case/geriatric managers commonly provide the following services:

  • Creating a care plan
  • Providing information, arranging, and assisting with LTC services
  • Monitoring long-term care needs over time

Who Qualifies For Home Health Care?

To qualify for home health care, a person must be considered homebound, meaning they cannot leave their home without difficulty or assistance. In addition, a person must require skilled nursing care or therapy services intermittently and be under a doctor’s care. The person must also be eligible for Medicare or Medicaid or have private insurance that covers home health care services.

To determine whether a person is eligible for home health care, a healthcare professional will conduct an in-home assessment to evaluate the person’s medical condition, functional abilities, and care needs. The healthcare professional will also work with the person’s doctor to develop a plan of care that outlines the specific services that will be provided. If the person meets the eligibility criteria and needs home health care services, they may be able to receive care in their home.

Who Pays For Home Health Care?

Typically, home health care is paid for by a combination of private insurance, Medicare, and Medicaid. Private insurance may cover some or all home health care costs, depending on the specific policy. Medicare and Medicaid are government programs that provide health insurance for people with low income or disabilities and may also cover home health care costs. In some cases, the patient may be responsible for paying a portion of the cost of home health care out of pocket. It’s best to check with your insurance provider to determine exactly what your policy covers.

How Much Does Home Health Care Cost?

According to Genworth, the 2021 annual median cost for home health care (nationally) is $59,488 for homemaker services and $61,776 for home health aides.

Home Health Care Insurance

A long-term care annuity is a hybrid annuity set up to assist in paying for home health care without causing retirement funds to be depleted. To create a tax-free long-term care insurance benefit, an LTC annuity doubles (200%) or triples (300%) the investment (based on medical records). If money is left over in the annuity, the remainder passes along a death benefit to beneficiaries.

If you don’t have a lump sum of money, another great option is a long-term care life insurance policy (LTCi). In simple terms, these policies are designed specifically for long-term care and allow the insured to access the life insurance’s death benefit while alive to pay for LTC costs. In addition, applicants can pay a fixed premium monthly or annually instead of a one-time deposit.

Next Steps

 If you’re looking for home health care, it’s essential to do your research and understand what options are available to you. The best way to get started is by talking to your doctor and researching different agencies in your area. You can also contact your insurance provider to determine what services are covered by your plan. And finally, consider purchasing long-term care insurance to help reduce the cost of home health care services.

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Home Health Care: What Is It And How Do You Pay For It?

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Shawn Plummer

CEO, The Annuity Expert

I’m a licensed financial professional focusing on annuities and insurance for more than a decade. My former role was training financial advisors, including for a Fortune Global 500 insurance company. I’ve been featured in Time Magazine, Yahoo! Finance, MSN, SmartAsset, Entrepreneur, Bloomberg, The Simple Dollar, U.S. News and World Report, and Women’s Health Magazine.

The Annuity Expert is an online insurance agency servicing consumers across the United States. My goal is to help you take the guesswork out of retirement planning or find the best insurance coverage at the cheapest rates for you. 

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