Frequently Asked Questions

What is Home Health Care?
Home Health Care is skilled health-care services that are provided in your home. Home Health Care can include nursing, therapy, social work and home health aide services. 

Why is Home Health Care important?
Home Health Care may be the best type of care for you because, it is convenient (no transportation problems), comfortable (there is no place like home), in general there is a shorter recovery time and often the costs are lower than hospital or long-term care facilities. 

Who pays for Home Health Care?
If all criteria are met Medicare, Medicaid and most Private Insurance Companies pay for Home Health Care.  Criteria that must be met includes being homebound (this means you leave the home infrequently because it is taxing, difficult and effortful and generally requires the assistance of someone else), services must be under the direction of your Physician (your Physician must order Home Health and certify that the care is medically necessary), services required must be skilled (this means that you must require care that is performed by a nurse or therapist, if you qualify for skilled services you may receive MSW and home health aide services)

• Medicare pays home health services at 100% with no co-pay or deductible.  The home health agency is reimbursed for a sixty-day period, the reimbursement depends on the level of care that is needed and determined by the answers to a Medicare questionnaire. Supplies that may be needed during the course of the sixty-day period are generally lumped into the home health reimbursement.
• Medicare HMO’s pay for home health services.  Services covered depend on the plan, you may be subject to a deductible and/or a co-pay.  
• Medicaid pays home health services at 100% with no co-pay or deductible. 
• Most Private Insurance Companies have a home health benefit.  They are generally subject to a deductible and co-pay.  Horizon Home Care contracts with many Private Insurance Companies and accepts their negotiated rates.
• Some Long-Term Care insurance policies cover certain home health services.  Each individual policy would have to be checked to see if there is a benefit for home health care.
• Private Pay – Home Health services can be paid by the patient or a patients trust.

What type of services can I receive from home health?

1. Part time or intermittent skilled nursing care.  This includes services by a Registered Nurse or Licensed Practical Nurse. 
2. Physical Therapy services to restore mobility, regain strength or relieve pain. 
3. Speech Therapy services to provide help in your home for many speech disorders.
4. Occupational Therapy services may help patients regain lost motion, stay active and achieve independence.
5. Medical Social Workers may help the patient and family adjust to new roles related to their illness or injury.
6. Home Health Aide services to help with personal care and exercise (under the direction of a Physical Therapist)

How long can I receive home health services?
You can receive home health services as long as you meet the criteria for the payer (you are homebound, you require skilled services that are medically necessary, and the physician continues to order services).

How do I choose a Home Health Care Agency?
It is important to find caregivers you are comfortable with and an organization that suits your needs.  Call the Home Health Agencies in your area and gather information, find out if the agency is Medicare certified and Joint Commission accredited (Joint Commission on Accreditation of Healthcare Organizations), what services they have available, what training their staff has, will the agency be in regular contact with your Physician, and ask them why you should choose their agency.  You may also want to ask your neighbors, family, friends, health care provider, hospital discharge planner or other professionals for their suggestions. 

Why should I use a home health agency that is Joint Commission accredited?
Joint Commission accredited agencies are held accountable for higher standards of care through  development and implementation of polices and procedures above and beyond those required by state and federal regulations.  Joint Commission accredited agencies are surveyed on a regular basis to ensure they meet the requirements of the organization.

What is quality assurance and why is it important?
Quality assurance is a process in which the organization evaluates its policies and procedures on a regular basis and makes changes as needed to avoid problems or negative outcomes.  The quality assurance group also monitors patient satisfaction, infection, hospitalizations, reviews medical records to identify problems, develops, and implements new procedures and evaluates the effectiveness of changes made. 

Quality assurance is an important process for all healthcare organizations to follow to ensure they are taking all measures possible to provide the highest quality healthcare.

What is Home Health Compare and why is it important?
Home Health Compare is a Medicare website that can be accessed via the Internet.  The website offers information about the home health agencies in your area, such as, Home Health Agency name, address and phone, services offered by agency, date agency became certified and type of ownership.  Most importantly you can access the quality measures for each certified agency.  The measures provide information about the agency’s patient population regarding improvement in physical and mental health and whether their ability to perform basic daily activities is maintained or improved. The quality information can be used to help compare home health agencies in your area. 

You can access Home Health Compare at www.medicare.gov/hhcompare. Select compare Home Health Agencies in Your Area, then service by state, county or zip code.  You can look at an individual agency or all agencies.  You may also select Compare all Quality measures and the program will compare all agencies in your area against one another.

How can I change home health agencies?
If you are dissatisfied with the services you are receiving and have been unable to resolve the problems you are having with your home health agency you may change to another home health agency.  To change home health agencies you will need to contact your Physician and let them know you would like to change agencies.  Either you or your Physicians office will need to notify the old home health agency to discharge you from their services and notify the new home health agency of your need to begin services.