This week we’re tackling a bit of a new subject for us – home healthcare. It’s a buzz word that’s been flying around a lot lately but it’s not always clear that we all mean the same thing when we say “home health”.
So let’s start with the basics. Home healthcare is defined by the Centers for Medicare and Medicaid Services as “a wide range of health care services that can be given in your home for an illness or injury.” Some common examples of home healthcare services include: wound care for pressure sores or a surgical wound, intravenous or nutrition therapy, injections, or monitoring serious illness and unstable health status.
The logic here is that will be cheaper and more effective if we can deliver this kind of care in your home, rather than forcing people to stay in a nursing home or skilled nursing facility. And in general, that’s about right.
But those of you that read our blogs regularly know that there is a “BUT” coming. And it’s true. So here it is: home health can be a wonderful service for many people BUT most people don’t quite understand how having a home health nurse impacts their other insurance benefits. The devil really is in the details.
Basically, your home health care is provided by an agency. This agency is a private, for profit corporation which is contracted by Medicare or your insurance provider to provide care. They get a fixed daily payment for providing care and are supposed to provide all the care you need and all the medical supplies you need out of that per diem.
As a private, for profit agency, home health companies want to provide the required care the cheapest way possible. The less they spend on you, the more they get to keep in profit. Sounds like a recipe for problems, right?!
So what does that have to with us here at Men’s Liberty? That’s complicated by the joys of Medicare billing but LONG story short – according to the Center for Medicare and Medicaid Services only one group or entity can bill Medicare at a time for the same service. So we get quite a few of you all calling in for Men’s Liberty only to discover that if you are on home health then the agency has to purchase your supplies for you. Legally, we can’t bill your insurance for them!
So that is why, when anyone reaches our Care Representatives, we always ask whether or not you have someone coming out to your home to provide any medical care or services. Does that make sense? I know it didn’t make a lot of sense to me at first, but once I understood, a lot of other little bits started making sense. That’s why I wanted to share this info with you all here today. Home healthcare can be a great service for people in need, but it’s not always a simple as they might like you to think.
Still confused? Have questions about your health insurance coverage for Men’s Liberty? Give us a call at (800) 373-7006 or just leave your question in the comments and we’ll answer you right away!