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Who is Eligible for Home Health Care Under Medicare?
Medicare is a federal health insurance program that serves
as a vital support system for people aged 65 and older. Patients may be
eligible for Medicare earlier if they have certain disabilities, End-Stage
Renal Disease or ALS. Among Medicare’s unique benefits is home health
care, which provides skilled nursing, therapies and other care services to
those with specific health needs.
Basic Eligibility for Medicare Home Health Care Benefits
To be eligible for Medicare home health care benefits, the
patient must meet several key criteria to help determine if the patient’s
condition and home environment warrant home health care benefits.
Patients may be eligible for home health if they meet the
A patient is homebound if they are unable to leave their
home or must go through considerable effort when doing so, or that leaving home
is not recommended because of their medical condition. Homebound status is
determined by the patient’s primary care physician based on physical
limitations, such as disabilities, surgery recovery, severe illness or
Demonstrating a Medical Need
In addition to being homebound, the patient must require
intermittent skilled nursing care or skilled therapy services.
Physician Approval/Face-to-Face Encounter
The patient’s physician must authorize home health care
services and review the patient’s care plan regularly.
The patient must have the required face-to-face encounter
with their physician within the timeframes required by Medicare. The encounter
must also be related to the primary reason you need home health care.
Choosing Medicare-Certified Home Health Agency
The agency providing care must be certified by
Common Conditions Among Patients Requiring Home Health Care
Home health care services cater to a wide range of
conditions commonly experienced by patients aged 65 and above. These
conditions often require comprehensive care by an interdisciplinary
A few of the conditions commonly found among patients of
home health care include:
A home health care plan tailored to a patient's needs can
effectively address these conditions, providing the necessary support to
promote well-being, independence and quality of life for patients while helping
to avoid unnecessary hospitalizations.
Circumstances That May Lead to Discharge from Home Health
Several circumstances may negate a patient’s basic
eligibility and lead to the termination of home health care. These factors
Types of Care Covered Under Medicare Home Health Care
Medicare home health care provides a wide range of
skilled nursing, therapy and support services to address the medical
and therapeutic needs of eligible patients depending on their needs.
Skilled nursing care includes:
Therapy services include:
Additional dependent services are available once the patient
has a qualifying need for skilled nursing or skilled therapy services,
Services Not Included in Medicare Home Health Care
It’s important to be aware of services not included in
Medicare’s home health care benefit. Although some of these may be necessary
for your needs, you don’t want to be in a situation in which you expect to have
certain services covered but end up with a significant medical bill. Uncovered
Supplemental Services Outside of the Medicare Home Health
Although Medicare covers core home health care services,
certain services not covered by Medicare might be essential to a patient’s
well-being. These home and community-based services may vary according to the
patient’s location and program requirements. Patient eligibility is determined
through a patient assessment with approval from a patient's primary care
physician or social worker. Services like these include:
These non-medical services are generally funded through
out-of-pocket payments or community resource programs. Patients eligible for
Medicaid or Veterans Affairs (VA) benefits may receive additional support. To
find out more, contact your insurance plan or a home health care agency that
connects patients with these external resources.
Costs for Medicare Home Health Care
Understanding associated costs is crucial for patients and
their families when deciding to elect Medicare home health services.
It’s always important to fully understand the cost of benefits from your agency
of choice, but the following key points are a great place to start:
No Out-of-Pocket Costs for Medically Necessary Services
For eligible patients, Medicare covers the costs of all home
health care services deemed necessary by the physician, ensuring that these
patients do not have to pay out of pocket.
Transparency in Medicare Coverage
The home health care agency is responsible for informing the
patient of all costs associated with Medicare coverage. This level of
transparency allows patients to plan and manage their healthcare expenses.
Partial Responsibility for Medical Equipment
When a patient requires Medicare-covered medical equipment,
Medicare may be responsible for covering 20 percent of the cost.
Work with medical equipment provider to receive an estimate to help anticipate
and manage out-of-pocket expenses.
Next Steps for Home Health Care
If you or your loved one has been diagnosed with a severe or
chronic illness, open communication and timely action can significantly impact
the quality of care and support. Take these recommended next steps if you think
home health care is the right choice:
1. Facilitate open communication.
If possible, encourage your loved one to communicate their
wishes and desires with you and other family members and caregivers. Ensure
everyone involved is aware of your or your loved one’s preferences and goals
2. Contact an agency for connections to resources.
A reputable agency can facilitate access to necessary
resources. In addition to offering access to essential services, the right
agency can provide comprehensive support for a seamless care experience.
3. Consider agencies with a full continuum of care.
A full continuum of care provides a comprehensive range of
healthcare services that address an individual’s care needs across different
stages of illness or recovery.
Choose an agency that offers a full continuum of care so you
or your loved one can smoothly transition from one program to another, if
necessary. This approach ensures they receive consistent, uninterrupted care
tailored to their care needs.
Severe or chronic illnesses create many challenges, but navigating Medicare home health care benefits shouldn't be one of them.
Contact Amedisys Home Health Care in the South Alabama Area with locations in Bay Minette: 251-580-8236, Brewton: 251-809-1717, Citronelle: 251-866-3261, Foley: 800-763-6382, Mobile: 251-380-0492 and Monroeville: 866-334-0260.
Safe Weight Loss Strategies for Older AdultsMaintaining a healthy weight is an important goal at any age. However, as we age, it can get trickier and more challenging to drop any excess weight we may be carrying. Especially those pesky holiday pounds. When it comes to losing weight, weight loss strategies for older adults should prioritize safety and long-term health rather than quick fixes.Although they are becoming increasingly popular, weight loss drugs arent always the most effective or safest method for weight loss. The same goes for the trendy fad diets you read about online. When it comes to losing weight, you need to look at it as a marathon, not a sprint.Adopting sustainable lifestyle changes is crucial for shedding excess pounds while safeguarding against potential health risks. Whether youre looking to slim down or just maintain a healthy weight, here are some healthy and safe weight loss strategies for older adults that will help you along your journey to Better HealthPlace Focus on Balanced NutritionA well-balanced diet is the foundation for healthy weight loss. Focus on nutrient-dense foods, including fruits, vegetables, whole grains, lean proteins, and healthy fats. Limiting processed foods, sugary snacks, and excessive salt intake is crucial for maintaining optimal health. Set a goal to eat a piece of fruit or a vegetable at every meal and for every snack. Incorporate avocados into your diet to increase your healthy fats. Instead of white pasta or rice, swap it out for brown or whole wheat. Making little adjustments to your diet can produce big rewards for weight loss.Practice Portion ControlControlling portion sizes is vital for managing caloric intake. Losing weight is all about burning more calories than you eat or drink. And if you focus on consuming fewer calories through portion control, that will make it easier to do so. Older adults may find it helpful to use smaller plates, which can create the illusion of a fuller plate and contribute to reduced portion sizes. Additionally, paying attention to hunger and fullness cues can prevent overeating. Youve heard the saying, Eating with your eyes. Well, you want to do the exact opposite and eat with your stomach. Dont rely on visual cues like a clean plate to stop eating. Listen to your stomach and stop when you feel full.Drink Up to Stay HydratedDrinking an adequate amount of water is crucial for overall health and can support weight loss. Sometimes, the body can confuse thirst with hunger, leading to unnecessary calorie consumption. Drinking water before meals can also contribute to a feeling of fullness, reducing the likelihood of overeating. Make it a goal to increase your water intake throughout the day. If you get bored with water, try swapping still water for sparkling. If you still crave something different, drink liquids that have some sort of nutritional value, such as broth and 100% fruit juice with no added sugar. You can also hydrate through your food. Oranges and cucumbers are great foods that offer a hydration boost. Participate In Regular ExerciseEngaging in regular physical activity is essential for weight loss and maintaining muscle mass. Again you want to burn more calories than you consume. Older adults should incorporate a mix of aerobic exercises, strength training, and flexibility exercises into their routine. Its advisable to start slowly and gradually increase intensity, focusing on activities that are enjoyable and sustainable. Make realistic and attainable goals. Instead of saying youre going to work out every single day, set a goal to walk for 15 minutes three days a week. Then, gradually work up to every single day. Get Adequate SleepAdequate sleep is a crucial yet often underestimated factor in successful weight loss. Research consistently shows that insufficient sleep can disrupt hormonal balance, affecting key regulators of hunger and satiety. Furthermore, inadequate sleep can impair glucose metabolism and insulin sensitivity, promoting the storage of excess calories as fat. Prioritize quality sleep by aiming for seven to nine hours of quality sleep per night. Monitor Your Progress GraduallyWeight loss strategies require monitoring your progress. However, rather than focusing solely on the scale, you should monitor progress through various measures, including changes in energy levels, improved mobility, and better overall well-being. Celebrating small victories can help maintain motivation and reinforce positive lifestyle changes. Again, losing and maintaining a healthy weight is a marathon. Consult with a Healthcare ProfessionalReady to take charge of your health and achieve your weight loss goals? Look no further! Contact a VIPcare primary care provider today at 251-257-2886 and embark on a personalized journey towards a healthier, happier you. With our expert guidance and support, together, we can make your wellness aspirations a reality. Don't wait any longeryour best self awaits!
Wings of Comfort: The Retreat Hospice by Saad Outdoor Oasis Transformed by Home Depot's GenerosityAt The Retreat Hospice by Saad, a haven dedicated to providing compassionate care during life's final season, an extraordinary transformation unfolded in 2023, thanks to the benevolent partnership with The Home Depot Foundation. This collaboration showcases the power of community service and highlights the incredible impact that thoughtful gestures can have on the lives of those facing the challenges of hospice care.Each year, local Home Depot stores rally theireams, resources, and expertise for community improvement projects. The range of initiatives is vast, from building homes for veterans to crafting bird sanctuaries for families in need. The Retreat Hospice became a recipient of Home Depot's volunteer projects, turning their grounds into a serene haven for patients and their families.Brian Clifford, the local Home Depot manager, collaborated closely with the dedicated team at Saad to bring to life a project that would resonate with the unique needs of Southern Alabama's population. The result was an oasis designed to connect patients with the tranquility found in nature, particularly through the enchanting world of native birds.One heartwarming suggestion from the family of a guest at The Retreat Hospice led to the creation of bird-friendly spaces visible from patient rooms. When the opportunity arose for Home Depot to enhance the hospice's grounds, the decision was clear a project that aligned with the desires of those seeking solace in the beauty of nature.Home Depot's generous donation included over 20 unique birdhouses, bird baths, feeders, vibrant flowers for a butterfly garden, lush shrubbery, potted plants, and new rock lining the walking trails. The transformation aimed to offer guests and their loved ones a variety of spaces for reflection, connection, and respite.The birdhouses, strategically hung from trees just outside each patients porch, have become focal points where families can be found rocking together, sharing laughter, shedding tears, reading, or simply enjoying quiet moments alone. The addition of beautifully landscaped areas and improved walking trails further enhances the hospice's commitment to providing a peaceful and comforting environment.The collaboration between The Retreat Hospice and Home Depot represents more than just physical improvements; it symbolizes a community coming together to support one another. The project not only contributes to the well-being of current patients and their families but also leaves a lasting legacy of compassion and kindness.To Home Depot, The Retreat Hospice expresses heartfelt gratitude for the choice to partner with them. The generosity and joyful service displayed by Home Depot's "army in orange" have left an indelible mark on the hospice's mission to care for the community with excellence. This transformative project will continue to be a source of comfort and solace for those navigating the final season of life, reminding everyone involved of the profound impact that acts of kindness can have on the human spirit. The Retreat Hospice by Saad is a private, freestanding hospice respite located in Mobile, Alabama. They offer 24-hour resort-level care. Contact the Retreat Hospice by Saad at 251-380-3810.
Guardianship Versus Powers of AttorneyOne of the most common questions I get as a practicing elder law attorney is, what is the difference between guardianship and a power of attorney? A power of attorney is a document that a person executes when they are competent to appoint someone to be their agent for either healthcare matters, financial matters or both. The defining characteristics of powers of attorney is that it is a voluntary action by the person, and it can be revoked at any time so a power of attorney cannot be used to trump someones free will in order to place them in a facility for example, against their wishes.A guardianship is a process where one typically files a pleading, requesting to be appointed as a persons guardian. In this case, we must demonstrate that the person we seek to protect is incompetent to manage either their healthcare, or their finances, or both.The guardianship typically comes about in two primary ways. First, if the person we seek to protect never executed a power of attorney, and now is incapable, a guardianship would be necessary in order to handle things like an admission to a hospital or long-term care facility because no one has been appointed to consent to treatment for them. Second is a situation where the person we seek to protect is actively combative to the plan in place to handle their health matters. In this case, we must seek guardianship in order to overcome their wishes, particularly if they are unwise. For example, if your parent develops dementia, but insists that there is nothing wrong with them, that they should continue to drive and live independently and manage their medication, despite evidence that those things are dangerous in their current condition, guardianship is typically necessary in order to restrict their freedom.In some states, like Florida, the guardianship will also cover financial matters. in Alabama, the conservatorship is established at the same time as a guardianship in order to handle healthcare matters for those cases where there is no power of attorney, and the conservatorship is necessary in order pay their bills, access finances, and so forth.To establish financial guardianship, no matter what its called, we typically must be bonded so the person who is applying must be credit worthy and able to obtain a bond from a surety company. This ensures that the persons financial well-being is well taken care of. If there is no one available, or if no one wishes to handle finances, every county typically has, or can appoint someone, as a county conservator to serve as that persons conservator. This is helpful in cases where its a very difficult or complex financial situation. Then it may be preferable to have a professional appointed and giving a relatively small fee for doing so. This leaves the guardian to care for the healthcare of the individual without the added stress of complicated financial matters. Contact an elder attorney for more information about what your needs are and please dont put off executing a power of attorney in favor of those people that you trust as soon as you can to avoid what could be difficult and unnecessary proceedings in Probate Court down the road.This article was contributed by Kyla Kelim with Aging in Alabama. Kyla is an experienced Elder Law attorney. Contact Kyla at 251-281-8120.
Whether youre recovering from surgery or illness, or living with an ongoing condition like diabetes or heart problems, Amedisys Home Health Care in Foley is here to help. We can help you recover, manage your condition and live as independently as possible. Following the plan of care developed with your doctor, our home health care team can deliver the care you need where you need it most: at home.With Amedisys Home Health Care in Foley, youll work with an experienced team that understands the challenges youre facing and is passionate about helping you get better. You and your family will have peace of mind knowing youre being cared for by highly trained, carefully screened home health care professionals.
Amedisys Home Health in Mobile provides in-home health care for people managing chronic illness or recovering from a surgery or injury. We make visits to patient's homes in cities throughout Mobile County. These include Mobile, Theodore, Semmes, Grand Bay, Saraland, Wilmer, Eight Mile, Irvington, Prichard, Satsuma, Dauphin Island and other communities within about 50 miles of our care center. Call us at (251) 380-0492 to find out if we provide home health care in your area.
We provide high-quality home health in Citronelle tailored to your needs. We are a company of people taking care of people. We believe healthcare is a relationship built on trust, respect and a commitment to meeting your needs. You will receive care from an experienced team that makes your needs and wishes their highest priority. For us, helping people is a higher calling that we feel privileged to do every day. Our skilled home health teams can help you feel better, avoid unnecessary trips to the hospital and stay independent, all in the comfort of your own home. Our commitment to quality patient care has earned us accreditation by the Accreditation Commission for Health Care. We provide education and resources for families and caregivers. Amedisys is the right choice to meet your home health needs.