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Home health is typically covered by Medicare, Medicaid and some private insurance plans for eligible patients. Medications are not covered under Medicare, and medical equipment and supplies may be covered at 80% under Medicare Part B. Hospice services are covered by Medicare, medical assistance and most private insurance. There is no outside cost to patients regardless of how often they receive visits, how many supplies are used, or how much equipment is needed. Both hospice and home health have a team of healthcare providers that includes nursing, social work, physician services, and rehabilitation.
If you have Original Medicare, you can go to any Medicare-certified home health provider. Home health also has a team of health professionals whose goal is to work with the patient towards improving health and wellbeing. For example, the physical therapist can train the patient on using a hospital bed, or making safe transfers and using the toilet. Hospice is for patients who have a physician certify that they have a terminal condition likely to cause death within six months.
Anywhere Access
This approach empowers us to support virtually any need of our clients, with seamless transitions between services if the need arises. We frequently receive the following questions from patients, family members, and healthcare professionals who are seeking more information on the differences between hospice and home health care. Home health care visits are based on the needs of the patient and caregiver. They typically decrease over time as the patient’s health improves and their needs decrease. The patient receives visits on an intermittent basis for as long as they meet eligibility criteria and their doctor deems care medically necessary.
WVU Medicine Home Health is a provider of home health services to individuals on an intermittent basis who are confined to the home with an illness or following surgery. We assist individuals and families in making a smooth transition from the hospital or nursing facility to home. Additionally, those currently at home who are experiencing a change in care needs may also receive services. Care is provided by our professional staff of registered nurses, home health aides, physical, occupational, and speech therapists, and medical social workers. WVU Medicine Hospice provides care, most often in a patient’s home, during the last months of a terminal illness.
JOIN OUR TEAM
At HFRD we are fully committed to ensuring the needs of our patients and their families are met. Home Health agencies work with patients and families by providing preventative, rehabilitative, and therapeutic services to patients in a patient's home or place of residence. All home health agencies shall provide nursing, homemaker-home health aide, and physical therapy services. We are honored and humbled to be part of such wonderful program of caring. Our goal at HFRD is to provide oversight, licensing, certification, and the health care planning of various health care facilities and services in Georgia. Hospice eligibility is determined by a medical provider who must assess that an individual has less than 6 months to live due to a life-limiting, terminal illness.
Know that you are billing for the care you are giving and not missing reimbursement opportunities. Get the information you need with analytics tools, such as our home care value-based purchasing and PDGM dashboards, to improve the clinical and financial performance of your agency. Palliative care is a type of home health care that serves patients with an ongoing quality of life-limiting illness, primarily seeking to relieve symptoms, pain, and stress. What is the difference between home health care and palliative care? Home health services are aimed at helping patients recover from a serious illness or injury. For Medicare patients who have met the home health criteria, home health care is covered for conditions not related to the terminal diagnosis while the patient is on hospice.
Care Settings
Finding a good home health company is similar to the process of finding hospice, and you can follow the steps above. One added method is to look online for reviews of various companies. As part of your selection process, make sure you inquire about length of time and continued qualifying criteria. Also find out how often nursing, aides, and therapy staff will come each week. Just as with hospice, aides help patients who receive home health with bathing, dressing, and transfers.
Services typically include physical therapy, occupational therapy or wound care following a hospital stay or surgery. Home health is a widely used, time-limited medical service for people who want and need rehabilitation at home, assisted living, or other long-term care settings. Your loved one may have a personal hope and desire to get better, and they have the right to try. Although perspectives are changing, many people wait too long to give hospice a try. Our guide will assist you with knowing the differences between hospice and home health and how and when to choose.
Hospice vs. Home Health: Costs and Paying for Care
Both are generally covered by insurance if you meet the criteria. Both hospice and home health care are medical support services, even though different philosophies guide them. We employ a vast team of skilled clinicians, each focused on developing meaningful relationships with patients and their loved ones.
We neither hasten nor postpone death, but affirm life, emphasizing quality and comfort. Our healthcare team of professionals includes physicians, registered nurses, home health aides, social workers, therapists, and clergy and bereavement counselors. While nearly all hospice patients have zero out-of-pocket expenses related to their terminal diagnosis, home health care patients may be required to pay for medications, supplies, and equipment. Home health services do not cover inpatient stays if symptoms escalate and become unmanageable at home. Family caregivers of home health patients receive training and education, but don’t have access to the additional layers of psychosocial support enjoyed by hospice caregivers. Welcome to Georgia’s Home Health Program at the Healthcare Facility Regulatory Division website.
With hospice, the Medicare hospice benefit covers all prescription and over-the-counter drugs related to the patient's terminal diagnosis. Learn more about the differences between home health and hospice care in the sections below. General inpatient care is provided when the patient’s symptoms cannot be managed at home. The patient is admitted to the hospital and hospice works with the hospital to manage their symptoms. To qualify for home health care coverage, patients have to meet certain eligibility criteria. For example, they must be considered homebound, which means they have limited ability to leave their home without help.
Although there are many differences between hospice care and home health care, both types of care can help older adults “age in place” in their homes. Ask your health care provider if home health or hospice care is an option for you. This can include a private residence, assisted living and group homes. It cannot be provided in most inpatient settings, like a hospital or nursing home. A physician must certify that the individual requires intermittent skilled nursing care, or physical, speech-language pathology, or continued occupational therapy services.
The most important part of the process is to remember that you and your loved ones are the consumer and can choose any company your insurance covers. Physicians and rehab facilities often have contractual arrangements with specific hospice or home health companies and will recommend that you select those companies over others. For home health, the nurse will determine whether the patient is an appropriate candidate for home health nursing and therapies. In some cases, the patient may require more medical assistance than home health can safely offer. Or the patient might have such severe cognitive impairment that home health is not a viable option due to confusion, aggression, and significant memory problems. If you have a Medicare Advantage Plan, your options for home health companies might be limited to the ones your plan contracts with.
Home health has a shorter certification period, and the criteria for continuing is more stringent. For example, if your loved one needs home health but has dementia, they may be unable to complete the rehabilitation tasks and make progress. At that point, home health can discharge the patient and suggest hospice if appropriate.
A specially trained team of professionals and caregivers provide care for the "whole person", including his or her physical, emotional, social, and spiritual needs. With a Medicare Advantage Plan, once you start hospice, Original Medicare will cover everything you need related to your terminal illness. Original Medicare will cover these services even if you choose to remain in a Medicare Advantage Plan.
Experience HIPPA-compliant messaging that allows your medical staff to message all team members at once with a comprehensive approach to care. Guide caregivers to create complete documentation and ensure a smooth claims process. Real-time gain/loss tools help identify key referral sources, actively adjust the plan of care and ensure accurate billing for services rendered. Multiple filters allow real-time evaluation of critical criteria that may impact care.
