About Us

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Most Americans older than 65 are eligible for the federal Medicare program. If an individual is homebound, under a physician's care, and requires medically necessary skilled nursing or therapy services, he/she may be eligible for services provided by a Medicare-certified home health agency. Depending on the patient's condition, Medicare may pay for intermittent skilled nursing; physical, occupational, and speech therapies; medical social work; HCA services; and medical equipment and supplies. The referring physician must authorize and periodically review the patient's plan of care. With the exception of hospice care, the services the patient receives must be intermittent or part-time and provided through a Medicare-certified home health agency for reimbursement. Hospice services are available to individuals who are terminally ill and have a life expectancy of six or fewer months. There is no requirement for the patient to be homebound or in need of skilled nursing care. A physician's certification is required to qualify an individual for the Medicare Hospice Benefit. The physician must also re-certify the individual at the beginning of each six-month benefit period. In turn, the patient is required to sign a statement indicating that he/she understands the nature of the illness and of hospice care. By signing this statement, the patient surrenders his/her rights to other Medicare benefits related to terminal illness.  

 Medicaid is a joint federal-state medical assistance program for low-income individuals. Each state has its own set of eligibility requirements. However, states are mandated only to provide home health services to individuals who receive federally-assisted income maintenance payments, such as Social Security income, Aid to Families with Dependent Children (AFDC), and individuals who are "categorically needy", such as certain aged, blind, and/or disabled individuals who have incomes that are too high to qualify for mandatory coverage, but below federal poverty levels. Individuals younger than 21, who meet income and resources requirements for AFDC, yet who otherwise are ineligible for AFDC, also qualify as categorically needy. Under federal Medicaid rules, coverage of home health services must include part-time nursing, HCA services, and medical supplies and equipment. At the option of the state, Medicaid may also cover audiology, physical, occupational, and speech therapies, and medical social services. Hospice is a Medicaid-covered benefit in 38 states. The Medicaid hospice benefit covers the same range of services that Medicare does. 

Veterans who are at least 50% disabled due to a military service-related condition are eligible for home health care provided by the Veterans Administration (VA). A physician must authorize these services, which must be delivered through the VA's network of hospital-based home care units. The VA does not cover non-medical services provided by HCAs.  

Some community organizations, along with state and local governments, provide funds for home health and supportive care. Depending on an individual's eligibility and financial circumstances, these organizations may pay for all, or a portion of, the needed services. Hospital discharge planners, social workers, local offices on aging, and the United Way are excellent sources for information about community resources.  

Commercial health insurance policies typically cover some home care services for acute needs, but benefits for long-term services vary from plan to plan. Commercial insurers generally pay for skilled professional home care services with a cost-sharing provision. Such policies occasionally cover personal care services. Most commercial and private insurance plans will cover comprehensive hospice services, including nursing, social work, therapies, personal care, medications, and medical supplies and equipment. Cost-sharingvaries with individual policiesbut often is not required.  

 Individuals sometimes find it necessary to purchase Medigap insurance or long-term care insurance policies for additional home coverage. Such insurance is designed to bridge some of the gaps in Medicare coverage. Some Medigap policies offer at-home recovery benefits,which pay for some personal care services when the policy holder's physician must order this personal care, in conjunction with skilled services. Home care coverage in Medigap policies is not designed to cover extended long term care. This type of coverage is most helpful to individuals recovering from acute illness, injuries, or surgery. 

Physical Therapists (PTs) work to restore the mobility and strength of patients who are limited or disabled by physical injuries through the use of exercise, massage, and other methods. Using specialized equipment, PTs often alleviate pain and restore injured muscles. They also teach patients and caregivers special techniques for walking and transfer. 

Social Workers provide counseling and evaluate the social and emotional factors affecting ill and disabled individuals. They also help patients and their family members identify available community resources. Social workers often serve as case managers when patients' conditions are so complex that professionals need to assess medical and supportive needs and to coordinate a variety of services. 

 Speech/Language Pathologists work to develop and restore the speech of individuals with communication disorders. Usually, such disorders are the result of traumas, such as surgery or stroke. Speech therapists also help retrain patients in breathing, swallowing, and muscle contro

Occupational Therapists (OTs) help individuals who have physical, developmental, social, or emotional problems that prevent them from performing the general Activities of Daily Living (ADLs). OTs,instruct patients on using specialized rehabilitation techniques and equipment to improve their functions in tasks such as eating, bathing, dressing, and basic household routines.  

 Dietitians provide counseling services to individuals who need professional dietary assessment and guidance to properly manage an illness or disability.  

 Home Health Aides (HHAs) assist patients with ADLs, such as getting in and out of bed, walking, bathing, toileting, and dressing. Some aides have received special training and, under the supervision of a nursing professional, are qualified to provide more complex services.