Home Health Care

Last Updated: October 23, 2020

Written by the Open Caregiving Team. Editorial review by Joyce O. Murphy RN, MSN.

What is home health care?

Home health care allows people who require medical care to remain at home.

  • They may be recovering from a hospitalization or require skilled nursing or therapy services.
  • These home health care services are prescribed by a doctor so your family member can receive treatments in the comfort of their home.

Our page on home care offers information about providing for non-medical care at home for your loved one.

What are the types of home health care?

Short-term home health care

Also known as Medicare-certified Home Health Care, Intermittent Skilled Care, Visiting Nurse Services: Is physician prescribed care. It may follow a hospital stay and is centered around helping an individual recover from an illness or injury. Medicare will cover this kind of care for a certain period of time for eligible individuals. Your family member’s care may be renewed periodically based on a doctor’s assessment.

Short-term Home Health Care services may include:

  • Therapists for rehabilitation include physical, occupational, and speech therapists who may make home visits to evaluate a need for services. Ongoing visits are part of a plan to aid in recovery.
  • Skilled nursing visits are done to develop and coordinate a recovery plan that includes regularly planned visits by the nurse. The nurse provides updates to your loved one’s doctor.
  • Home-health aide services help with activities of daily living and assist nurses, including updates about your family member between nursing visits.
  • Doctor visits happen periodically to check on the progress of a patient. These most commonly occur at the physician’s office.
  • Medical equipment is most often provided by a third party, such as is done with oxygen and wheelchairs. Some home health care agencies have equipment you can borrow.

Long-term home nursing care

Also known as Home-based Skilled Nursing, Long-term Nursing Care, Hourly Nursing: This is personalized nursing care for individuals with a chronic illness, injury, or disability. Private Long-term Nursing Care services may include:

  • Home nursing care that is led by a registered nurse who follows a doctor’s orders. The nurse develops a plan of home care to keep the individual comfortable, healthy, and safe.
  • Home-Health Aides (HHAs) or Certified Nursing Assistants (CNAs) help with activities of daily living, medication reminders, and may assist a registered nurse with medical care in the home. Some HHAs are certified to administer medications.
  • Dietitian services are available to assess and guide the dietary aspect of the treatment plan.
  • Medical equipment rental or purchase is arranged by your loved one’s care manager, who is often the nurse acting on physician’s orders.

Who needs home health care?

Home health care is prescribed by a doctor after a hospitalization or chronic illness diagnosis. It is provided to help older adults receive the health care they need while living independently for as long as possible.

Your loved one may need home health care if their doctor believes they require:

  • Occupational therapy
  • Physical therapy
  • Speech therapy
  • Skilled nursing
  • Medication management
  • Care for a wound
  • IV (intravenous) administration
  • Treatments that include Injections

Home health care may also include home care, which focuses on helping individuals with their activities of daily living and maintaining their household.

What are the pros and cons of home health care?

Pros of home health care

  • Personalized and Private Care Plan: Home health care allows for care that is tailored to your loved one’s needs. It is managed by familiar medical professionals who pay close attention to changes in a person’s mental or physical condition.
  • Living in the Comfort of Their Home: Moving to a long-term-care facility can be a big commitment and hard transition for people who are aging or ill. Home health care lets your family member get the care they need without leaving home.
  • Maintaining Some Independence: Home health care is personalized, allowing your loved one to safely maintain independence for as long as possible.
  • Companionship: Home health care may allow professional caregivers to develop a meaningful relationship with your loved one. They become a supportive companion for sharing stories, interests, and activities. This lessens a sense of isolation because of the hours spent together.
  • Peace-of-mind and Flexibility for the Family: Home health care gives family members the flexibility to visit whenever they’d like. It offers you peace of mind that your loved one has one-on-one supervision.
  • Continuing Care: With the wide range of home services available, home health care is able to adapt and change as your loved one needs more or less skilled care.
  • May Be More Affordable: Home health care may be more affordable as those who own their home will not have to pay for room and board at a long term care facility. Your loved one’s health and ability to get around may require extra costs. More about this in the next section.

Cons of home health care

  • Home Improvement Costs: The cost of making a home accessible and comfortable for a person who is aging, ill or disabled can get expensive. You may need to install ramps, special bathroom equipment, railings, and lifts.
  • Differing Caregivers: Some home care agencies will send varying caregivers at different times, which can upset your loved one. Too many new people in their home can be confusing.
  • Finding a Compatible Caregiver Can Be Difficult: It can take time to find a caregiver with whom your loved one is comfortable and welcomes into their home.
  • Less Structure and Socialization Than a Facility: Home care does not have the activities, variety of people, and socialization that long-term-care facilities provide.

How much does home health care cost?

The cost of home care is dictated by:

  1. The number of hours the caregiver spends with your loved one. This is the factor that most determines your home care costs. When your loved one requires visits for a few hours each day, services are less costly than a full-time caregiver.
  2. The level of care, services and supplies your loved one requires. The costs of home care rise with the need for more skilled care and specialized supplies or equipment.
  3. The state in which your loved one resides in. The hourly cost of home care can vary greatly by state. The least expensive states come in around $17 per hour and the most expensive fees are about $31 per hour.

To get an approximate understanding of how much home care will cost you, follow these steps:

  1. Estimate the number of hours of home care your loved one needs per week and month.
  2. Find the average hourly cost of home care in your state using the Genworth cost of care calculator.
  3. Multiply the number of hours needed per week and per month by the average cost of home care in your state.
  4. You now have your estimated weekly and monthly cost of home care.

Full day rates and overnight rates will differ from the standard hourly rate and are usually discounted.

Does Medicaid pay for home health care?

State Medicaid programs will often pay for the personal care part of home health care. To learn more about Medicaid and if it may pay part of your loved one’s personal care, see our Home Care page.

Does Medicare pay for home health care?

Home health care is covered by a Medicare-certified home health agency (HHA) under Medicare Part A after a hospital stay. Medicare Part B provides coverage if your loved one is homebound and needs skilled care or therapy.

Medicare Part A will cover the first 100 days of your family member’s home health care if:

  • Your loved one was admitted to a hospital or skilled nursing facility for at least three days in a row. Their hospital stay must have been within 14 days of their first day of home health care.
  • Your loved one is Medicare-certified as homebound and requires skilled care. If they require care beyond the first 100 days, you must have Medicare Part B for that to be covered.

Medicare Part B will cover your loved one’s home health care if:

  • Medicare considers them to be homebound.
  • They require intermittent skilled nursing care or therapy services including speech, physical or occupational therapy.
    • Medicare defines intermittent as at least once every 60 days and at most once every 3 weeks.
  • Your loved one meets with their physician who prescribes skilled nursing care or therapy services. This visit must be:
    • Within the 90 days before their first home health care visit.
    • Or in the 30 days after their first home health care visit.
  • Your loved one’s physician signs a home health certification verifying your loved is homebound and requires short-term or intermittent skilled care. They have created a plan of care and have reviewed it with your loved one in a face-to-face meeting.

For more information on Medicare’s home health care policies, review the Medicare Interactive guide.

Note: If Medicare denies paying for your loved one’s home health services, private insurance will likely do the same. Check with your family member’s health or long-term insurance provider.

  • Your loved one’s home health care manager can guide you with transition planning.

How to find affordable home health care services near me?

Home Health Compare

Medicare provides a home health search and compare tool with ratings and information on each home health care agency.

Area Agency on Aging

Your local Area Agency on Aging may be a great resource to find affordable home care resources including:

  • Adult Day Care
  • Caregiver Training/Support
  • Case Management/Aide
  • Homemaker services
  • Companionship
  • Counseling (Gerontological): Individual
  • Emergency Alert Response
  • Volunteer escorts to run errands to
  • Meals Delivered to the home
  • Housing Improvements or accessibility additions
  • Nutrition Counseling
  • Personal Care
  • Pest Control
  • In Home respite care
  • Specialized Medical Equipment and Supplies
  • Transportation to and from appointments

PACE (Program of All-inclusive Care for the Elderly)

PACE programs are state run initiatives designed to help homebound individuals with home medical and personal care services. Find out if your state offers a PACE program by visiting the Medicare “find a pace plan” page.

Veteran Affairs

Veteran Affairs (VA) offers a wide range of home health care services for eligible veterans:

Questions to ask when hiring a home health care agency

  • How many years have they been providing home health care services? If they have multiple services, when were they added?
  • Are they Medicare or Medicaid certified and state licensed?
  • What will Medicare or Medicaid specifically cover, and what will your family have to pay out-of-pocket?
  • Do they outline the financial and legal aspects of the agency contract?
  • Do they have a medical professional evaluate your loved one’s needs before working with the family to create a plan of care?
  • What types of home health care do they provide?
  • What training or certifications do the health care workers have at each level?
  • Do they offer all the services that you require?
  • Do they have documentation that lists the rights and responsibilities of the agency, care recipients, and staff?
  • Do they have insurance?
  • Do they properly compensate their staff and offer them fair benefits?
  • Do they assign a manager or supervisor to regularly visit, oversee care, and answer questions from the family?
  • How do they handle 24/7 emergencies and back-up coverage?

What is the difference between home care and home health care?

Home Care

Non-medical services that help an individual age at home safely and comfortably.

Non-medical services include:

  • Assistance with ADLs
  • Homemaker services
  • Respite care
  • Meal prep and delivery
  • Transportation
  • Companionship
  • Medication reminders

Non-medical services do not include:

  • Skilled nursing services
  • Medication administration
  • Wound care
  • IV care
  • Injections

Home Health Care

These are doctor ordered services to help your loved one recover from a hospital stay, illness or injury. Home health care is usually delivered on a more short-term basis than home care.

  • Home health care has skilled healthcare professionals who assess your loved one’s condition.
  • They ensure that the treatments and therapies your loved one needs are in place.

Can home health care include home care?

Yes, it is possible to receive both home health care and home care at the same time. This happens when someone requiring home health care needs added help with their personal and home care.

The home health care agency should make a plan when Medicare coverage is due to end. This may mean finding a different agency to provide care for your loved one at home.

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