By Jenna Cotterman MOT, OTR/L, COQS
Home Health Therapy Manager
Bridge Home Health & Hospice
Amidst the COVID-19 pandemic, being able to stay at home to receive nursing care and therapy services may be a newer thought to some.
Many aging individuals aren’t aware of the insurance benefits they already have that include in-home care. Those with Medicare as their primary insurance are typically covered 100 percent for home care services, as long as certain criteria are met.
One of these is being “homebound.” It may sound like a scary term, but it is less restrictive than it sounds.
Being homebound is actually two-fold.
• First, a person must need help to leave their home. This help can be from a device (wheelchair, walker or cane), from another person (spouse, child, other caregiver), or special transportation. This help can be needed because of a physical illness or injury, or because of a diagnosis such as Dementia, that makes the person unsafe to leave the home alone. The person may also have a condition that could become worse if they leave the home, such as a wound infection or lung infection.
• Secondly, the person must have a normal inability to leave the home, and leaving and returning home requires a “considerable and taxing” effort.
Knowing that, it is also important to know that being homebound does not mean the person is never allowed to leave home. Medicare does allow outings for religious services, doctor’s appointments, hair appointments, short walks around the block, short drives away from home, family reunions and events, funerals, graduations and attending adult daycare at accredited facilities. Patients can also be homebound and still drive themselves to appointments.
Many Medicare advantage plans follow the same rules for in-home services, and most Medicaid policies do not require homebound status at all.
Other criteria that are needed for home health care are: a doctor’s prescription for in-home care, a doctor who is willing to sign all home-care orders and a “skilled” need for in-home nursing or therapy (meaning there are things the nurse or therapist needs to teach the patient or caregiver to help keep the patient safe and out of the hospital).
This need can be related to teaching about a diagnosis, medications, wound care, ostomy care, home equipment, therapy home exercise programs or anything else necessary to help keep the patient out of the hospital.
It is important to know the home care benefits available to you, because the ultimate goal is to be able to receive the care you need while staying safe and staying at home.
