Some Facts About Medicare

By Frances T. Traver
Manager, Clinical Services
Saint Francis Home
Care Services, Inc.

Saint Francis Hospital’s Home Care Services, Inc., the Certified agency, often receives calls about types of assistance available for those recovering from an illness or injury.
While we accept Medicare payments, Medicare requires that your condition meets certain requirements before we can assign you a nurse or therapist.
Your physician must agree you need home care services and needs to guide our staff regarding your needs. We stay in contact with your physician throughout your care.
Second, the care you receive may require the skill of a professional nurse or therapist. Medicare has guidelines. For example, a nurse may help you with wound care or injections. Medicare would also cover a nurse to assess the status of your illness. If you have a heart condition for which you were recently hospitalized, Medicare would cover for a nurse to come to your home to assess blood pressure and heart rate. However, once you are doing better Medicare would no longer cover a nurse to assess the condition.
Medicare also would cover a professional nurse to teach you to manage your illness. Our staff demonstrates good outcomes with their ability to teach patients to care for themselves at home. A nurse may teach a diabetic how to use a glucose monitoring machine or teach a client about medication and how to better manage their side effects. Medicare will also cover for a nurse to teach you to inject insulin at home. But not to come to your home to give insulin injections.

You must be “homebound” to receive home care services in your home. Medicare defines homebound as taxing for you to leave your home. This does not mean you need to be in bed. But if you leave home it can only be for short durations or to receive medical treatments, such as chemotherapy.

Just as important as what Medicare benefits will pay, is what Medicare benefits will not cover. They will not cover aide services unless you have one of the skilled services discussed above. Medicare will only pay for the aide to assist with personal care, such as bathing. Medicare will not pay for housekeeping services.

Medicare benefits are there when you need them in the home. Saint Francis Home Care Services, Inc (Certified agency) can bill Medicare directly to cover needed services. Please feel free to call us (845-483-5550) about your Medicare benefits for home care services. You may also call your Medicare office for more information about home care benefits.