Medicare Pays 100%: For qualified beneficiaries, Medicare pays 100% of allowable charges from LifeCare Health Services. This is because LifeCare is a Medicare-certified home health provider. Medicare beneficiaries who receive home health services from LifeCare will have no copay, no deductible to meet, and no cost sharing of any kind related to the home health services. Private health insurance also pays for home health services. Their qualification rules typically match those of Medicare.
Homebound: Medicare requires that home health patients meet the definition of homebound, but this definition is less restrictive than the term homebound implies. Homebound only means that leaving the home requires a considerable and taxing effort, and that trips away from the home are infrequent and of short duration. Many home health patients are only temporarily homebound due to illness, injury, or recovery from surgery. Trips to church, the doctor, the barber, etc do not disqualify a patient from home health benefits.
Skilled Need: For health insurance or Medicare to pay, the home health plan of care must include services that require a nurse or therapist. Skilled services would include wound care, rehabilitation, medication teaching, diet teaching, observation and assessment, etc. The skilled need criterion is meant to contrast against plans of care that only call for aide / personal care services such as bathing, grooming, dressing, assistance walking, etc. However, a home health plan of care from LifeCare can include personal care services so long as there is also a skilled need.
Physician Supervision: Home health plans of care must be signed by your doctor (MD, DO, or DPM). A home health patient must have seen their doctor within 90 days before or 30 days after the home health start of care. LifeCare will work directly with your doctor and do all the work of getting the necessary paperwork. LifeCare also works hard to keep your doctor in the loop with relevant information so he or she can effectively track your progress.