For you, the consumer – A summary of important information you need to know about home health care: Remember to ask questions!

Home Health Care is a Medicare/Medicaid benefit (for 65 yrs. or older or the disabled). Your eligibility comes from (but not limited to) a discharge from a hospital or rehab center.

• The amount of care you will receive is determined by your diagnosis and evaluation/assessment conducted by the Home Health Care Agency.

• The benefit can run a maximum of 90 days (your certification period). But the Home Health Agency (HHA) can release you from care (discharge you) at their discretion.

• If you keep services for the entire 90 days, another evaluation will be conducted to determine (re-certification) for extended 90 days.

• There is no minimum service time guarantee and it all depends on the assessment/evaluation from the Home Health Care Agency and your primary care physician (PCP).

You have a CHOICE on your provider:

• Many health care organizations have internal home health care services and may gently persuade you to choose their service because it is within their best interest to keep you within their continuum of care.

• Remember – you have a CHOICE – Ask your Social Worker (or whomever is in charge of your discharge plans) or your health care provider for at least three (3) other choices – they will give you information on other home health care organizations that are reputable in the community.

• Interview the Home Health Care Agency prior to starting service with them. Ask to meet their representative.

• You need to have total TRUST in your Home Health Care provider! See: How to Change or Choose the Right Home Health Care Services .

Research All Your In-Home Benefit Options:

• If you need home health care, and feel you may not be getting what you are eligible for – contact your Primary Care Physician (PCP). Talk to them about what you think you might need and have him give you a referral.

• Find out if you are eligible for Medicaid or (State) funded services. You should contact your Aging Service Access Point (ASAP) nearest you (Elder Services) to check your eligibility.

If you have other insurance – ask about in-home care benefits

• Contact the Executive Office of Elder Affairs (EOEA) and inquire about other State benefits that you may be eligible for. If you are a Veteran – contact the Veterans Administration.

Still need more help?

• After you have researched your eligibility for Medicare and State funded home care services – and you still need more help – you may want to check into private pay in-home care.

• This may be to supplement what you are already receiving from Medicare or Elder Services – or after you are no longer eligible for those benefits, but you still want/need services.

• There are hundreds of private pay in-home care agencies. You need to choose wisely! Please see: Choosing a Private Pay Home Care Agency. ...

Written by Zoltan Gaspar

Home care providers differ in many ways: types of services provided, fees for services, policies and procedures, and administrative structure. They are large and small, non-profit and for-profit, Medicare-certified and non-Medicare certified.

The types of home care agencies listed below are not all all-inclusive. Home care service providers offer a range of services including short-term medical care, long-term personal care, and housekeeping. It is helpful to clarify the type of reimbursement an agency accepts as well as the level of care it provides.

Social Service Agencies

In some communities, home care services are available through social service agencies. Most of these organizations are non-profit; many have a religious affiliation. These agencies often furnish other services in addition to home care. For example, an agency may conduct a preliminary assessment by a nurse or social worker, and/or involve a social worker to help with decision making, counseling, coordination and adjusting to a care plan.

Homemaker/Home Care Agencies

These agencies provide a variety of non-medical home support services. They can provide homemakers, home health aides, chore housekeepers and other workers. The workforce is generally not under the direct supervision of a medical professional and services are not usually Medicare reimbursable.

Home Health Care Agencies

These agencies, some of which are hospital affiliated, focus on the medical aspects of care. Their professionally trained personnel (e.g., registered nurses, licensed practical nurses, physical therapist , etc.) can do dressing changes, monitor vital signs, and perform other tasks as required by the physician or nurse. Most also offer the services of certified nurse assistants who are supervised by licensed professional nurses. Some agencies do provide non-medical home care services.

Nurse Agencies

These agencies may be, but are...