Re: [QUAD-L] FOUND IT! - Medicare & Home Health Care

[David K. Kelmer]

Hi Lori,

 

It looks like the ''aide'' care is tied to the ''skilled nursing'' care. 

home health aide services on a part-time or intermittent basis. A home health aide doesn’t have a nursing license. The aide provides services that give additional support to the nurse. These services include help with personal care such as bathing, using the bathroom, or dressing. These types of services don’t need the skills of a licensed nurse. Medicare doesn’t cover home health aide services unless you are also getting skilled care such as nursing care or other therapy. The home health aide services must be part of the home care for your illness or injury. pg 13

I would think a SCI would require skilled care so the aide services should be allowed too. 

 

With Love,

CtrlAltDel aka Dave
C4/5 Complete - 29 Years Post
Texas, USA

Lori Michaelson <[EMAIL PROTECTED]> wrote:

Ok, Dave I see the "regular booklet" is vague on pages, 19, 25 and 41-42.  But is specified in another booklet.... read on ....   I know I'm not going crazy.  At one time I requested their booklet on "Home Health Care" and maybe it was in there.  FOUND IT! Page 12 on this site http://www.medicare.gov/Library/PDFNavigation/PDFInterim.asp?Language=English&Type=Pub&PubID=10969   I quoted it below in big purple letters.  I knew I wasn't crazy!  :-)   Ok..... as a start this info though .........   "Some home care can only be given by licensed health workers, such as if you need skilled nursing care and certain other health care services that you get in your home for the treatment of an illness or injury. Skilled nursing care includes services and care that can only be performed safely and correctly by a licensed nurse (either a registered nurse or a licensed practical nurse) or a licensed therapist. Remember, Medicare only pays for home care if you meet certain conditions. For more information, look at the Medicare booklet, Medicare and Home Health Care. You can also hire a home health care agency for care in your home if Medicare doesn’t cover it. In this case, you will need to pay for this care on your own. Home care costs can vary depending on where you live, the type of care you need, and how often you need care. Usually home care is charged by the hour. To locate home health agencies that provide services in your area, look at Home Health Compare on this website. You can also look at the National Association for Home Care website to get information about home care and hospice. This website includes information on how to find a home care or hospice agency and how to prepare for care. The following home health services may be available in your community: Skilled nursing care Homemaker/Health aides Personal care aides Respite care Medical equipment Home repair and modification Hospice " I found at http://www.medicare.gov/LongTermCare/Static/HomeCare.asp  .  AT LEAST it DOES SAY Health Aides and PCAs.   ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------   The Medicare and Home Health Care booklet is clickable above.  When AT it note that page 9 says what your agency must provide and guides you to pages 19-20.   The 4 criteria to get home health is stated on page 11.  I meet all four as I have a foley cath as my "skilled nursing need." Page 11 begins describing number of hours as well.   PAGE 12 says home health aides or nurses LESS THAN 8 HRS A DAY!  And 28 or fewer hours each week.   "Based on your need for care, on a case-by-case basis, the weekly total may be increased to up to 35 hours."     My needs remain the same and I'm only asking for 10 hours a week.  My Dr writes the orders and they should be followed.   Lori One who refuses to let these well-paid services I NEED and AM ELIGIBLE FOR be taken care of!  People doing their job ... imagine that!!!