Some Seniors Refusing Needed Care at Home

According to a recent article from Kaiser Health News, some seniors are refusing important medical care at home. Sometimes this is because of pride in independent living but sometimes it is because they are confused about what “home health care” is and whether or not insurance covers it.

Home Health Care is not the same as Home Care but, unfortunately, the terms are often used interchangeably and that is confusing. Home Health Care means your doctor has prescribed home health care involving intermittent skilled nursing care, physical therapy, speech-language pathology or continued occupational therapy. These services are paid by Medicare although you may be responsible for a portion of the bill for some equipment like wheelchairs, walkers, and oxygen equipment.

Home Care, on the other hand, generally refers to 24-hour a day care at home, meals delivered to your home and homemaker services like laundry, shopping, and cleaning. Home Care also includes help with Activities of Daily Living (ADL) such as bathing, dressing and using the bathroom when this is the only care you need. These Home Care services are normally not covered by Medicare, and unfortunately, this is where confusion can occur.

To understand what Home Health Care is and how Medicare defines it, be sure to download this free publication from the Center for Medicare/Medicaid Services (CMS).

When Home Health Care is advised after a hospital stay, some seniors refuse the care mistakenly thinking that it is not covered by Medicare and they are concerned that they cannot afford to pay out of pocket. In these cases, important follow-up treatment is not received and medical complications can result.

If you get your medical services through a Medicare Health Plan (such as a Medicare Advantage Plan), be sure to check your Summary of Benefits to see how Home Health Care is covered under that plan as it may be different than how Traditional Medicare covers it.

If you or someone you know is offered Home Health Care, be sure to discuss the options in detail with your doctor. Make sure you understand what is covered by Medicare and what is not. It is important that critical follow-up care is received to make sure that complete recovery occurs.


Author: Mike Mahoney

After over 30 years of helping North Idaho individuals and businesses select all types of insurance coverage, I am now focusing primarily on the Over 65 population. My specialty areas include Medicare Supplements, Medicare Advantage Plans, Part D Drug Plans, Final Expense, Dental and Travel insurance. If you also need coverage for your home, autos or business, I have associates on the North Idaho Insurance team that can quickly assist you.

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