FAQ's

What is home health?

Home health is designed to help you recover in the comfort of your home through rehabilitation and skilled nursing services. Home health must be ordered by your physician when he or she determines your condition requires you to remain in the home for rehab and recovery

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

The difference between home health and personal home care assistance is the necessity for skilled services. Home health care requires skilled services that would come from a physician’s order. This includes things like registered nurses, physical therapy and occupational therapy.

Personal care assistance involves unskilled services that are typically paid for through private pay (not paid by insurance). These services include help around the house, transportation, bathing and some light meal preparation. 

Will my insurance cover home health services?

Home health is covered 100% by Medicare, and we accept most forms of insurance. Part of the admission process includes verification of insurance. We can help answer your financial and insurance questions. 

Do you provide caregivers for someone in an assisted living facility?

Yes, we do. We first arrange a meeting with the family to conduct a thorough assessment and develop a plan of care. This is not only to fully understand what activities or senior care services are needed, but also to get a sense of what kind of personality might best suit him or her. After this is completed, we will match the person with a caregiver. If at any time you would like to change your caregiver, this can easily be arranged.

Does Medicare pay for in-home senior care services when they are clearly needed?

If your doctor has prescribed clinical help that would be administered by a registered nurse, physical therapist or occupational therapist, Medicare will pay. Also, while under the care of an in-home clinician, a personal care attendant can be assigned under Medicare coverage for bathing and certain other types of personal care.

Medicare will not pay if you need help with daily activities such as non-prescribed personal care, meal preparation, medication reminders, housekeeping and other typical senior care services. Insurance plans that cover these services are privately purchased long-term care insurance, and workers’ compensation insurance, in some instances.

How long does home care last?

There is no set length of time for home care—it can vary greatly based on a person’s unique needs. Some home care services may last for a few weeks, while others may be lifelong. If a physician is prescribing your home care, he or she will oversee services until your recovery goals are met. However, if you are making the decision to start home care on your own, you can determine how many hours a week of care you need, and how often. Some home care providers may have a minimum hourly commitment to start care, or require you to sign a contract for a certain duration of time, so it’s important to ask any provider you consider

Can you only get home care in a private residence?

 No. Home care services can be provided wherever home is—a private residence, a senior living community, or while staying with a friend or family caregiver. 

How do people pay for home care?

This varies from situation to situation. There are many different ways people pay for their home care costs. Some services may be covered by a type of insurance you have, or by Medicare or Medicaid. Some may be covered by workers’ compensation or by Veterans benefits. Also, services can be paid for directly by the person receiving care, which is commonly referred to as “private pay.”

To ensure you are receiving the right service, at the right time, under the right benefit, it’s important to be aware of all of the various sources available to help pay for your home care services (such as Medicare, your health insurance plan, long-term care insurance, or others.) A home care provider may have specialists who can help you understand if the services you need may be covered by outside sources, and then contact those sources to determine your eligibility. Then, if your care services are in excess of what your coverage allows, you have the option of paying the difference out of pocket. 

 I need to find home care that is “Medicare-certified.” What does that mean?

Many people researching home care may have been prescribed home health services by their physician, and are trying to find a provider whose services are covered by their Medicare home health benefit. The Medicare benefit covers 100 percent of home care services when certain qualifying conditions are met.

If you have Medicare coverage, you must choose a home health care provider that Medicare has approved. Cedar Lake’s Home Care Services are Medicare-certified.

More specific information about the Medicare home health benefit can be found on the medicare.gov website. 

Who comes into my house to provide the care?

Different types of care require different certifications and training. Depending on your specific needs, the caregivers and clinicians coming into your home can vary. You could have different caregivers at different times of the day, week, or month as part of your care. Personal care services are most often provided by a home health aide (HHA) or certified nursing assistant (CNA). Private duty nursing care and home health care services are provided by registered nurses (RNs) or licensed practical nurses (LPNs), physical therapists (PTs), occupational therapists (OTs), or speech language pathologists (SLPs). A medical social worker (MSW) can help individuals and family members connect with community resources.

Additionally, depending on the provider you choose, there may be other professionals who don’t come to your home on a regular basis, but can be instrumental in helping to manage your care. These experts may help with things like overseeing your overall care experience, coordinating schedules, billing insurance companies and Medicare directly, and verifying your benefits eligibility. 

Why would somebody use home care?

Home care enables a person to live as independently as possible without having to give up the comforts of their own home. It allows them to be in a familiar environment, sleep in their own bed at night, and stay close to loved ones like family, friends, and pets. It also brings peace of mind to know they have access to skilled, consistent, reliable care when it’s needed, even if those needs change.

When compared to other alternatives of care, home care can be significantly more cost effective. According to the Centers for Medicare and Medicaid Services (CMS), at-home care is usually less expensive, more convenient, and effective.