What is Home Health?

Home health provides a wide range of skilled services to meet various medical needs in the comfort of your home. These services include nursing care, physical therapy, occupational therapy, speech therapy, and respiratory therapy. When you choose a home health agency, a licensed professional will be sent to assess your home health needs and develop a personalized care plan.

Key Home Health Services

Nursing Care: Skilled nursing services include wound care, medication management, and monitoring chronic conditions.

Physical Therapy: Tailored programs help patients regain mobility, strength, and balance after surgery or injury.

Occupational Therapy: Focuses on improving daily living activities and adapting home environments for safety and independence.

Speech Therapy: Helps patients with speech, language, and swallowing disorders.

Respiratory Therapy: Provides specialized care for individuals with chronic respiratory conditions.

Paying for Home Health Care

Payment for home health care can come from multiple sources, depending on the individual’s age, diagnosis, and financial status. Home health agency staff typically help verify coverage before services are provided. Most agencies handle all paperwork and billing, making the process smoother for the patient and their family.

Payment Options for Home Health Services

Medicare

Most Americans aged 65 and older are eligible for home health care services through Medicare if the services are ordered by a doctor.

Medicaid

Medicaid is a joint federal-state health care program for low-income individuals. In Pennsylvania, Medicaid covers home health care services if eligibility requirements are met, and prior approval is required for services and equipment.

Private Insurance

Private insurance policies often cover home health care services, particularly for recovery from surgery or illness. Coverage for long-term care varies by plan. Policies may also cover hospice services, including nursing, therapies, personal care, and medical supplies.

Long-Term Care Insurance

These policies have expanded to cover in-home care as well as nursing home care. Coverage details vary among plans, but most include home care benefits.

Workers’ Compensation

Home care services may be covered under workers’ compensation following an injury or accident. Coverage details depend on the policy and the nature of the injury or illness.

Veterans’ Benefits

Veterans may be eligible for home care services through authorization of skilled and custodial services. These services are often ordered through a Veterans’ hospital or clinic.

Finding a Home Health Agency

Finding the right home health provider is a key step in ensuring the best care for you or your loved one. It’s important to choose a provider that not only meets your needs but also feels like a good fit. Start by exploring your options and gathering information on potential providers.

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Pennsylvania Homecare Association (PHA) Website

PHA’s website includes a “Find a Provider” feature. You can search for an agency by location or the specific services you need, making it easier to find a suitable match.

Pennsylvania Department of Health

Home health agencies are licensed by the Pennsylvania Department of Health. You can search for licensed agencies near you on their website.

Hospital Discharge

If you are being discharged from a hospital and prescribed home health services (e.g., physical therapy following a hip fracture), a hospital social worker or case manager will provide you with a list of Medicare-certified agencies to consider. Choosing a Medicare-certified agency ensures that the services qualify for coverage and meet federal quality standards.

Medicare’s Home Health Compare Tool

To compare how well home health care agencies perform, you can use Medicare’s Home Health Compare tool. This online resource allows you to compare agencies based on quality measures and patient feedback.

Questions to Ask When Interviewing a Home Health Agency

Once you’ve found a few options, it’s time to find the one that’s just right for you. Before starting services, ask the important questions to determine if the agency is a good fit. Be sure to cover key details about their services, staff qualifications, and care plans.

View our sample questions below to get started.
  • Are you licensed by the state?
  • re you certified by Medicare?
  • Do you have any accreditations from professional organizations? If so, please tell me about them.
  • Are the workers you send your employees or contracted employees?
  • What type of background checks do you conduct on your employees?
  • If the worker does not show up when scheduled, will you send a replacement immediately?
  • What type of progress reports can I expect from each type of professional providing care?
  • Will you send a replacement if the worker is not compatible with the person receiving care?
  • What can I expect to pay if services are not covered by Medicare, Medigap, Medicaid, or a long-term care insurance policy?
  • Whom do I speak to regarding care status?
  • How do we appeal to Medicare if we think more care is needed?
  • Can you put me in touch with someone who has used your services?