Whether you’re managing a chronic condition or supporting a family member who needs a little extra help at home, home health care lets people get the support they need without leaving their home. Here’s our breakdown of how it works, what it covers, and how to figure out whether it’s a fit for your situation.

Key Takeaways:

  • Home health care generally falls into two categories: skilled medical care and non-medical personal support.
  • Most individuals qualify for some level of coverage through Medicare or Medi-Cal, though it depends on the situation.
  • The home health team will work with a durable medical equipment (DME) provider if mobility equipment, like a wheelchair, is needed. 

What Is Home Health Care?

Home health care refers to any medical or personal care that’s provided in an individual’s home, rather than in a hospital or facility. It’s intended for those who need ongoing support but don’t require a full-time stay somewhere else. That typically includes seniors who want to age in place, people recovering from surgery or an illness, individuals with chronic conditions, and those with disabilities that complicate daily living.

In short, the purpose of home health care is to help people stay as independent as possible while also making sure their medical and personal needs are being consistently met.

Types of Home Health Care

Skilled Home Health Care

Skilled home health care is medical care provided by licensed professionals. A doctor has to prescribe it, and it’s intended for people who need clinical support at home. Services typically include:

  • Skilled nursing care (e.g., wound care, medication management, monitoring vital signs, etc.)
  • Physical therapy
  • Occupational therapy
  • Speech-language therapy
  • Medical social services

Non-Medical Home Care

Non-medical home care covers day-to-day personal assistance rather than clinical services. A home health aide or certified nursing assistant usually handles this type of support, which can include help with bathing and grooming, meal preparation, light housekeeping, and transportation to appointments.

Some people find themselves needing both types of support, particularly following a hospitalization or a change in their health.

How Does Home Health Care Work?

Home health care typically begins with a referral from a doctor. After the referral is made, a home health agency will carry out an initial assessment, usually conducted by a registered nurse, to get an idea of what kind of support is needed and what the home environment looks like.

From there, a personalized care plan is put together, which will likely outline the services to be provided, the frequency of visits from a caregiver or clinician, and the goals of care, whether they’re regaining mobility after surgery or managing a chronic condition more safely at home.

Once care officially begins, visits will occur according to the agreed-upon schedule. How often a caregiver visits depends entirely on the individual’s level of need; some people have weekly visits while others need daily support. Throughout this process, the home health team communicates with the patient’s doctor to ensure everyone is on the same page and nothing is overlooked.

What Does Home Health Care Include?

The specific services included in a home health care plan depend on what the patient needs and what has been prescribed or authorized. A plan might include any combination of the following:

  • Nursing visits for wound care, IV therapy, medication management, and monitoring of chronic conditions like heart failure or diabetes.
  • Physical therapy to help restore strength and mobility after a hospitalization or injury.
  • Occupational therapy to help patients maintain or relearn the ability to perform daily tasks independently, including getting dressed and moving safely around the home.
  • Speech-language therapy for those dealing with difficulty swallowing or communication following a stroke or neurological event.
  • Medical social services to connect patients and families with community resources and help coordinate care.
  • Personal care assistance from a home health aide for bathing, grooming, meal preparation, and light housekeeping when non-medical support is also needed.

If mobility equipment is part of what the patient needs, the home health team will work with a durable medical equipment (DME) provider to make sure the equipment is ordered and delivered.

Who Needs Home Health Care?

Home health care is typically associated with older adults, but it’s not strictly limited to seniors. As mentioned above, it can be an option for people recovering from surgery or a stroke, those managing chronic conditions like heart failure or COPD, or individuals with physical disabilities or complex medical needs.

All in all, if you’re having a hard time keeping up with cooking or bathing, you’ve recently fallen or have had several near-misses, or notice changes in your mobility, home health care might be something worth discussing with your doctor, regardless of your age.

How Much Does Home Health Care Cost?

Costs vary quite a bit depending on the type of care, how often it’s needed, and where you live. As you’d expect, areas with a higher cost of living, like California, are usually on the higher end. That said, as a general range, non-medical home health aide services tend to fall somewhere between $25 and $40 per hour. Skilled services like nursing or therapy are billed differently.

Is Home Health Care Covered By Insurance?

This also depends on the type of care and the insurance plan. Medicare typically covers skilled home health services if they’re prescribed by a doctor and the patient meets homebound requirements. That usually includes nursing and therapy visits. It does not cover non-medical help like bathing or meal prep.

Medicare Advantage

Medicare Advantage plans can vary, but some offer additional in-home benefits beyond what original Medicare covers. It really depends on the specific plan.

Medi-Cal

In California, Medi-Cal (California’s Medicaid program) may cover home health and in-home supportive services for those who qualify based on income and medical need.

If mobility equipment is involved, that’s usually covered separately under Medicare Part B. In most cases, Medicare pays 80% of the approved cost, with the remaining 20% covered by the patient or secondary insurance.

What Are the Main Benefits of Home Health Care?

The most obvious benefit is being able to stay at home. Most people, given the choice, would rather recover or receive ongoing care in a familiar environment than in a facility. That alone can have its own health benefits. However, beyond that, home health care can:

  • Reduce Hospital Readmissions: Having a nurse or therapist check in regularly can mean potential issues get caught before they escalate into something more serious.
  • Support Independence: Occupational therapists specifically help people preserve their ability to perform daily tasks on their own.
  • Reduce Isolation: Regular visits from a caregiver or clinician give people something consistent to look forward to and may help reduce the sense of being cut off from others.
  • Give Family Caregivers Peace of Mind: Knowing that a trained professional is checking in regularly can take some of the weight off family members who may be managing a lot on their own. It also means there’s someone else watching for changes that a family member might not know to look for.

Where Should I Look for Home Health Care Options?

A doctor is generally the best place to begin. They can refer you to agencies and start the process. It’s also worth asking around. If someone you know has gone through this, their experience will tell you a lot more than a list of agencies online. Once you have a few options, don’t hesitate to ask questions, especially about how they build care plans and how they communicate with doctors.

Have Questions? Here’s Where Freedom Mobility Fits In

At Freedom Mobility, we work with home health therapists and agencies to make sure patients get equipment that actually fits how they live at home. That includes handling insurance and delivering and fitting equipment in person. If something needs to be adjusted later, or repaired, we can come back out for that too.

Trying to figure out your next steps? Just have questions? Feel free to contact us or give us a call at 800-980-5696 to learn more.