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Frequently Asked Questions and Their Answers
Q. How do I qualify for home health care and have Medicare pay for it?
A. In order to qualify for home health and have Medicare pay for it, you must be considered homebound, be under the care of a physician, and require a skilled service.
Q. What does homebound mean?

A. The patient is homebound if he/she experiences a normal inability to leave home. The patient’s physical condition and/or physical limitations are such that it would be a considerable and taxing effort for the patient to leave home.

Determination of homebound status depends on the illness or limitations of the patient. The need for supportive devices for assistance alone does not necessarily render the patient homebound.

Homebound status is not affected by frequent absences from the home when the reason is to receive medical treatment.

The patient is allowed brief and infrequent absences from the home for non-medical reasons, such as barber/beauty shop, to attend church, etc. However, these absences should be infrequent and of short duration.

Q. Can I go to Church on Sunday and still be considered homebound?
A. Yes. Medicare recently changed the definition of homebound to allow patients to go to Church on Sunday. However, you would still need to meet the above requirements for homebound status.
Q. Do I have to pay anything if I have Medicare?
A. If you qualify for home health through Medicare, you will not have to pay anything. Medicare pays for care. There is no deductible or out-of-pocket expense.
Q. If I don’t qualify for Medicare to pay for home health, can I still have it?
A. Yes. If your physician orders home health and you do not qualify under Medicare guidelines, you may pay for the services yourself. Call us for a fee schedule.
Q. How often will you come to see me?
A. At the time of admission to the service, an RN will assess your condition and needs and will set up a plan of care with you. The RN will discuss the frequency of visits with you and will also discuss expectations at that time.
Q. What does Home Health Aide do?

A. The primary function of a home health aide is to perform personal care, such as bathing, dressing, grooming, and caring for hair, nails, and oral hygiene. The aide spends anywhere from 45 minutes to 1 hour in the home. Once the personal care is complete, the aide may also perform other duties for the patient.

The aide may straighten the bedroom, clean the bathroom, change the bed linens, or fix a snack for the patient. The aide does not perform spring-cleaning, sweep and mop floors, vacuum etc. These duties are the duties of a provider, not an aide.

Q. What is the age range of patient/client/customers? Who do you serve?

A.

  • Medicare clients
  • 65 years old and above. The usual age of eligibility for those benefits is 65, although certain people qualify for the program earlier. (Medicare is available to people under age 65 who have been eligible for Social Security disability benefits for at least 24 months or who have end-stage renal disease.)
  • Medicaid Clients
  • The aged, blind, and disabled. Also, parents with dependent children are eligible with household incomes up to 15% of FPL. Children are eligible for Medicaid or CHIP with household incomes up to 201% of FPL, and pregnant women are eligible with household incomes up to 198% of FPL. (Source: https://www.healthinsurance.org/texas-medicaid/)