Home Health Care

Maybe you have a loved one with a chronic condition like congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), or diabetes. Or perhaps you’re recovering from a joint replacement or going through cancer treatment. Home health care may be the best option for meeting your medical needs when you don’t need to be in a hospital.

Here’s a look at home health care — what it is, who’s eligible, and why it works well for many people.

What Is Home Health Care?

Home health care is skilled medical care you receive at home instead of at a hospital or in a skilled nursing facility.

Home health care

Home health care is short-term intermittent skilled medical care that your doctor prescribes for you after illness, injury, or surgery. A team of professionals including registered nurses, physical therapists, occupational therapists, speech therapists, speech therapists, dietitians, social workers, and home health aides provides treatment at home.

Typical home health care treatments and therapy include:

  • Wound care for pressure sores or surgical wounds.
  • Occupational therapy to ensure the patient can safely perform activities of daily living such as eating, dressing, and bathing.
  • Physical therapy to assess home safety and introduce exercise to improve range of motion, strength, mobility, and balance.
  • Speech therapy to address speech, language, and swallowing after a stroke, surgery, or other illness.
  • Intravenous medications or nutrition therapy.
  • Education for the person receiving treatment.
  • Caregiver education.
  • Monitoring vital signs.
  • Assistance with medication management.
  • Personal care with the help of a home health aide.
  • Social work support to coordinate additional resources.

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Why Home Health Care Is Important

Home health care can be a vital part of managing a chronic illness or helping you recover from an injury, illness, or surgery. Doctors and patients often prefer it to a hospital or skilled nursing home stay. Here’s why:

  • Most people are more comfortable in their own homes than they are in a hospital or skilled nursing facility. That feeling of well-being and comfort may keep your spirits up and help you regain your health faster.
  • The care you receive at home is just as effective as care you’d receive in a medical facility.
  • Home health care can be less expensive than care in a hospital or skilled nursing facility.
  • Among familiar surroundings, you can regain your independence more quickly than in a medical facility.
  • Home health care can reduce hospital readmissions and lower depression and anxiety, compared with people treated in the hospital.
  • It’s convenient. You don’t need to travel anywhere for medical treatments.

Who Qualifies for Home Health Care Services?

Many seniors and other people qualify for home health care services. The most important thing to know is that you need a doctor’s prescription for home health care. If you’re in the hospital, you need to have the prescription before you get released. The doctor must also certify that you are homebound, meaning that leaving home requires considerable effort.

People typically receive home health care for these conditions:

  • Heart failure or other heart conditions.
  • Postpartum complications.
  • Stroke.
  • Chronic kidney disease (CKD).
  • Diabetes.
  • Chronic obstructive pulmonary disease (COPD) or other respiratory conditions.
  • Alzheimer’s disease, dementia.
  • Cancer.
  • Multiple chronic conditions.
  • Serious illness (pneumonia, infection, flu).
  • Joint replacement or surgery (knee, hip, shoulder).
  • Falls, dizziness, or loss of balance.
  • Trouble eating or swallowing.
  • Depression.
  • Amputation.
  • Trouble managing medications.

Individual situations can differ, so it’s essential to talk to your doctor about your eligibility for home health care services.

Does Insurance Cover Home Health Care?

Medicare, most insurances, and veteran benefits cover home health care, and typically there is no co-pay.

After receiving a referral from the doctor, a Medicare-certified home health care agency coordinates services.

Medicare and other insurances do not pay for:

  • 24/7 home care.
  • Meals delivered to your home.
  • Home services that aren’t related to your care, such as shopping, cleaning, and laundry.
  • Help with personal care (bathing, dressing, using the bathroom) when this is the only care you need.

Individual circumstances vary, so it’s always a good idea to talk to your insurance company about what services they cover.

Medicare.gov, What's home health care? Link

Medicare.gov, Home health services, Link

Health.pa.gov, Home Health Agencies, Link

Aging In Place, Different Types of Home Care, Link

AARP, Does Medicare Cover Home Health Care? Link

National Library of Medicine, Home Care: More Than Just a Visiting Nurse, Link

Caregiver Action Network, When Keeping Your Loved One at Home Means Bringing in Help, Link

Rhode Island Partnership for Home Care, Advantage of Home Care, Link

JAMA Network, Hospital-at-Home Interventions vs In-Hospital Stay for Patients With Chronic Disease Who Present to the Emergency Department, Link

About UPMC

Headquartered in Pittsburgh, UPMC is a world-renowned health care provider and insurer. We operate 40 hospitals and 800 doctors’ offices and outpatient centers, with locations throughout Pennsylvania, Maryland, New York, West Virginia, and internationally. We employ 4,900 physicians, and we are leaders in clinical care, groundbreaking research, and treatment breakthroughs. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside as one of the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. We are dedicated to providing Life Changing Medicine to our communities.