Question

2. In a home care visit, discuss how Medicare, Medicaid, and other health care insurances pays for the services.

Answer 1

Home care includes all medical support services provided at home, who ages and wants assistance to live independently; battling chronic health problems; healing from a medical setback; or has special needs or a disability. Nurses, assistants and therapists provide short-term or long-term care.

Medicare

Medicare is an insurance policy under which Health expenses are paid out of investment funds which were paid into by those insured. This mainly supports people over 65, whatever their earnings; and assists patients with younger disabilities and dialysis. Patients are paying part of the expenses by hospital deductibles and other expenses. For non-hospital coverage small monthly premiums are required.

Medicare pays to the Medicare-certified home health provider for the services received for a 60-day span considered as a "treatment sequence." Compensation is based on the condition and needs for treatment. Getting services from a Medicare approved home health provider will cut out-of-pocket expenses.

A Home Health Department approved by Medicare agrees:

· Medicaid bills.

· Consider only the amount approved by Medicare for its services

Medicare's home health benefit only pays for the home health agency's services. Certain prescription facilities, such as the doctor's appointments or supplies, are also usually provided by other Medicare benefits.

It primarily includes the

• Visits to hospital for medical needs

• physical therapy to help restore movement

• Visits to occupational therapy to boost the capacity to carry out routine tasks

• Visits to speech language therapy to assist with speech, expression, voice, comprehension and problem-swallowing

• Visits to medical social work to help clients and their families interact with Community services

Medicaid :

The Medicaid system is an assistance programme representing mainly low income individuals of any generation. Patients usually pay no part of the bills for the covered medical facilities. Sometimes, it requires a small co-payment. For a nursing home, Medicare has historically provided for long-term care, but as most patients would rather be cared for at home, and home care is cheaper. Medicaid home care services are typically delivered through "waiver" home- and community-based services to individuals who need a high level of care but want to stay

Medicaid pays for the following services

• In-home health care

• Personal care programs, such as washing, feeding and traveling assistance

• Home care programs, including homework support, such as shopping and washing

• Help caregivers

• Small improvements to your home to make it available

• Medical Devices

How other health care insurances pays for the services?

Private health insurance policies may pay for limited services for the elderly, but coverage may vary from plan to plan. Most forms of private insurance do not pay for non-medical home care services, and 100 per cent of in-house professional care is only provided.