Home Health Care in California

What you need to know about Medicare Home Health Care Services in California

  • Medicare home health is designed for short term intermittent care only under a physician’s order.
  • An initial home health order by a physician is good for up to 60 days based on a skilled need for service.
  • Medicare recipients must have seen their physician within 90 days of the order and requires a face to face encounter.
  • A medical need such as new diagnoses or exacerbation of a disease type is required in order for services to be covered for either a registered nurse and/or physical therapist.
  • A Medicare participant must be considered homebound where it is a taxing effort for them to leave their home.
  • Home physical therapy is not as aggressive as outpatient physical therapy where equipment and weights can be utilized.  Home physical therapy is a great way to start care versus outpatient therapy as a patient can benefit from a visiting nurse to monitor their health at home.
  • Medical supplies such as wound care bandages are covered under Medicare and the visiting nurse will bring supplies.
  • There is no co-pay or out of pocket expense for Medicare home health.
  • Medicare does NOT pay for custodial care, assistance with daily living or companionship. It is good to know however a physician can request a home health aide to assist with bathing up to three times a week under Medicare.
  • Although your physician may suggest a particular home health care agency, under Medicare guidelines it is patient’s choice as to which provider they wish to allow in their home.
  • It is customary for the physician that sees patients in a skilled nursing and rehabilitation facility to order home health care upon discharge from their facility. The home health care nurse and/or physical therapist can help ensure safety and communicate care with the primary care physician for post rehabilitation follow up.
  • Medicare home health can treat a resident in an assisted living facility, residential care home or home environment just as long as there is not a duplication of services.
  • A Hospice organization has the ability to provide Medicare home health services where both Hospice and a Medicare Home Health Care Agency bill under Medicare Part A.

Should a patient elect outpatient physical therapy instead of home health care services, those services will be billed under Part B and there is a co-pay.

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Arranging Non-Medical Home Care Services in California

In the State of California, assistance with activities of daily living such as bathing, dressing or eating are not considered a skill set covered by Medicare.  Seniors that wish to maintain their independence as long as possible in a home environment generally hire a private duty home health aide or companion to assist with these tasks.  From preparing meals to running errands or a trip to the doctor’s office, private duty home care allows seniors to age in place.  Home health aides are state licensed caregivers knowledgeable in transferring assistance and non-medical services.

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