What is HomeCare The HomeCare Team
Home Medical Equipment
Medicare Guidelines for Coverage
How to Arrange for Care
FAQs (Frequently Asked Questions)
What is HomeCare
Since 1983, Carle HomeCare has provided care for patients in their homes. With close
monitoring and patient and family education, many treatments that may have once kept
patients in the hospital are now being done safely at home. In addition to the comfort of
familiar surroundings, Carle HomeCare is a cost effective option and is often covered by
Medicare, Medicaid and most insurance companies.
Patients must be homebound, have a physician's order and insurance authorization to be
eligible for home health services. Examples of conditions that may require home health
care are cancer, AIDS, diabetes, heart and lung diseases, fractures, and strokes, chronic
illness, and disabilities.
The Carle HomeCare Team
The Carle HomeCare Team offers a wide range of services and includes registered nurses,
certified home health aides, medical social workers and physical, occupational and speech
therapists.
They work with you, your family and physician to develop a plan of health care or
treatment that will meet your needs. The HomeCare team will:
- Evaluate and assess your needs and coordinate patient care and services with your
physician and other healthcare team members
- Provide you with continuity from the clinic, hospital or extended care facility into the
home
- Promote a safe home environment for your activities
- Train you for self-care whenever possible and/or offer your caregivers education so they
can manage treatments at home
- Case manage to use community resources to meet your changing healthcare needs
- Work toward reaching your highest level of wellness and independence
Home Medical Equipment
You may need home medical equipment as part of your plan of care. Our staff will help
you decide what you need and help you arrange with a home medical equipment company to
deliver the supplies, equipment and oxygen to your home. Equipment can include hospital
beds, wheelchairs, respiratory equipment, monitors, walkers and dressing supplies. Carle
Home Services has a formulary of supplies needed for wound care, catheter care and ostomy
care. If you are receiving Medicare-covered home health care, all necessary supplies
needed for these treatments and other procedures must be coordinated with your HomeCare
nurse. Medicare will not reimburse the home health agency for these supplies and will not
reimburse you or your supplier. Your HomeCare nurse will discuss this with you.
Medicare Guidelines for Coverage
What are the Medicare guidelines used to establish coverage?
The following criteria are required for Medicare to pay for your home health care
services:
- You are home bound. This means that due to your illness or injury it takes a
considerable taxing effort for you to leave your home and your absences are infrequent and
of relatively short duration. If you are able to drive, then you probably do not meet the
homebound requirement.
- You have had a recent illness or injury or worsening of a condition that requires
skilled nursing care on an intermittent basis.
- You are an eligible Medicare beneficiary and under the care of a doctor who has ordered
the treatment or services we are providing.
- Care is provided on an intermittent basis. This means Medicare will not pay for our home
care staff to stay with you for an extended period of time. We will only visit you for the
length of time it takes to provide specific treatment ordered by your doctor. If all of
these requirements are met, Medicare will also pay for medically necessary occupational
therapy, medical social services, home health aides and medical supplies.
How to Arrange for Care
You, your family, or your doctor can call us when home health care services are needed.
We will coordinate your care with your physician, who will supervise the services you
receive.
To arrange for home health care, call (800) 877-8555.
For general information, call (800) 239-3620
Carle Home Services does not discriminate based on race, color, creed, sex, national
origin, disability, sexual preference or age.
FAQs (Frequently Asked Questions)
Q. Do I Qualify for HomeCare?
A. To qualify for home health care, you must be homebound, have a doctor's
consent (which we can obtain), and require the services of a skilled
caregiver, such as a skilled nurse or a physical therapist.
Q. What Services Are Offered?
A. Carle HomeCare offers a variety of services, including skilled nursing,
rehabilitation therapy, home health aides and medical social workers. We also offer a
variety of special programs that cater to particular needs.
Q. When is HomeCare right for you?
A. Every patient’s situation is unique. While your physician must ultimately
determine your appropriateness for home care, we encourage you to call us to discuss your
situation.
Q. When should a decision about needing home health care be made-and who should
make it?
A. At any time during an illness, it's appropriate to discuss all of a patient's care
options, including home health care. By law, the decision belongs to the patient. HomeCare
staff members are always available to discuss them with the patient, family and physician.
Q. Should I wait for our physician to raise the possibility of home health
care, or should I raise it first?
A. The patient and family should feel free to discuss home health care at any time with
their physician, other healthcare professionals, clergy or friends.
Q. What if our physician doesn't know about home health care?
A. Most physicians know about home health care. If your physician wants more information,
it is available by having them call Carle HomeCare at (877) 877-8555 or by contacting the
National Association of Home Care.
Q. What does the Carle HomeCare admission process involve?
A. One of the first things Carle HomeCare will do is contact the patient's physician to
make sure he or she agrees that home health care is appropriate for this patient at this
time. A registered nurse will come to your home to assess your needs and to develop a plan
of care with you and your family. This visit will take from one to two hours. You will be
asked to sign consent and insurance forms. These are similar to the forms patient’s
sign when they enter a hospital.
Q. Is there any special equipment or are there any changes I have to make in my
home once care begins?
A. Your home care provider will assess your needs, recommend any necessary equipment, and
help make arrangements to obtain it. Often the need for equipment is minimal at first and
increases as the disease progresses. In general, Carle HomeCare will assist in any way it
can to make home care as convenient, clean and safe as possible.
Q. How many family members or friends does it take to care for a patient at
home?
A. There's no set number. One of the first things the HomeCare team will do is prepare an
individualized care plan that will, among other things, address the amount of care needed
for the patient. HomeCare staff visit regularly and are always accessible to answer
questions and provide support.
Q. Must someone be with the patient at all times?
A. This is very dependent on your needs and abilities. Your HomeCare nurse will discuss
this and provide suggestions and options.
Q. Who pays for the services?
A. Medicare, Medicaid, HMOs and many other health insurance plans offer coverage
for home health care services. Generally, health insurance will cover any services and
supplies that are medically necessary and ordered by a physician who signs and oversees
the patient’s plan of care.
There are certain medical and eligibility requirements that need to be met before
Medicare, Medicaid or other insurance companies will authorize care. Some services and
materials may be subject to a co-payment. Our staff will work with you and your insurance
company to coordinate benefits. To be sure of coverage, families should of course, check
with their employer or health insurance provider.
Q. What insurance companies do you work with?
A. In addition to Medicare and Medicaid, Carle HomeCare works with the following
insurance companies:
- Aetna U.S. Health Care
- Blue Cross and Blue Shield of MA
- Cigna Healthcare
- Health Alliance Medical Plans
- Mutual of Omaha
- Premier Choice
- Unicare
- Most Commercial Insurances
Q. How Do I Go About Getting HomeCare Services?
A. Today, it could not be simpler for us to start helping you. All you have to do
is call. You, your family, or your doctor can call us when HomeCare services are needed.
We will coordinate your care with your physician, who will supervise the services you
receive.
One phone call to our Referral Line will have you on your way to quality home care at
its best. Call us toll free at (877) 877-8555. |
