Eligibility Requirements for Medicare Covered Home Health Services

To be eligible for Medicare-covered home health services, a beneficiary must meet three requirements:

• he/she must be homebound,

• he/she must need part-time or intermittent skilled nursing care and/or skilled rehabilitation, or, after establishing prior eligibility, a continuing need for occupational therapy, and

• he/she must be under the care of a physician and need reasonable and necessary home health services that have been certified by a physician and established in a 60-day plan of care.

How does an individual qualify for Medicare to pay Home Health Care?

To qualify for the Medicare home health benefit, a Medicare beneficiary must be under the care of a physician, have an intermittent need for skilled nursing care, or need physical therapy, speech -language pathology, or continue to need occupational therapy. The beneficiary must be homebound and receive home health services from a Medicare approved home health agency (HHA).

Making Medicare Documents Work for You! Home Health Care:

Many clients have misconceptions about Medicare’s role in their receiving home health care. The booklet linked to below can answer the details about what it takes to qualify and how much benefit they can expect.

There is a huge opportunity right now for products that can fill the voids left by Medicare as your clients recover from serious injury or illness.

http://www.medicare.gov/Pubs/pdf/10969.pdf

Paying the Bills When Medicare Stops

UPDATE: Did you miss the webinar? Good thing we recorded it!

If you have any questions after the webinar give us a call at 1-800-689-2800.

 

  

In 1983 Medicare implemented the DRG Prospective Payment System for hospitals. This system caused patients to leave the hospital as soon as their condition was stabilized in what the Mayo Clinic would call “Quicker and Sicker."

October 1, 2012 Medicare Limits Hospital Readmissions*. More than 2,000 hospitals — including some nationally recognized ones — will be penalized by the government starting in October because many of their patients are readmitted soon after discharge.

Together, these hospitals will forfeit more than $280 million in Medicare funds over the next year. 

Nearly 2 million Medicare beneficiaries are readmitted within 30 days of release each year, costing Medicare $17.5 billion in additional hospital bills.*

So, what does all this mean??? The aforementioned phrase from the Mayo Clinic, “Quicker and Sicker”,  resonates today more than ever.

At Senior Marketing Specialists we have dedicated the month of June to Home Health Care and our NEW product from Kemper, Senior Solutions Home Health Care Insurance Plan.

 

With all the changes taking place in Medicare and health care in this country the need for policies paying cash to seniors in addition to Medicare and their Medicare supplemental plans is growing at an unprecedented rate.

Watch for webinars and more articles this month and ask yourself; “How will my clients pay the bills when Medicare stops.”

*http://www.kaiserhealthnews.org/Stories/2012/August/13/medicare-hospitals-readmissions-penalties.aspx