Frequently Asked Questions

1. If I have a nurse coming to my home, will she give me a bath?
   
   Nurses provide skilled care; home health aides provide personal care services which include baths. Medicare coverage includes personal care such as baths, but there must be a need for skilled service (a nurse, physical therapist or speech therapist) for the services of a home health aide to be covered. Private insurance policies vary in coverage for personal care services. Bath services are available as a private pay option.
   
   
2. Can my home health aide clean my house? I'm a Medicare patient.
   
   If you have a home health aide through Medicare, the aide can clean your immediate surroundings to benefit your well being, e.g. change sheets, tidy up your bedroom. But cleaning your house is not a benefit.
   
   
3. Can an aide run errands for me?
   
   Personal care services reimbursed by Medicare, Medicaid and private insurance do not include running errands. Private duty aides that are paid by you can run errands.
   
   
4. At what times do home health aides provide services?
   
   The schedule for home health aides is designed to meet the needs of the patient. For example, one patient might need personal care at 7:30 a.m. while another requires service in the afternoon.
   
   
5. Does Medicare pay for supplies?
   
   Medicare will pay for supplies that are required when a skilled service is ordered by a physician. An example would be bandages and dressings used by a nurse to dress a surgical wound.
   
   
6. What does "skilled service" mean?
   
   A skilled service is defined by Medicare as a service that is provided by a nurse, physical therapist or speech therapist and is complex enough to require the expertise of a trained professional.
   
   
7. Is respite care covered by Medicare?
   
   Respite care is a service that relieves a family member or friend who is a caregiver. Medicare does not cover respite care which is usually provided in shifts of two, three or four hours. Medicaid has special programs for people with long term disability that cover some limited respite care. There are specific requirements in order for Medicaid patients to qualify for these programs.
   
   
8. Will my Medicare supplemental policy cover home respite services?
   
   Your Medicare supplement does not cover respite services.
   
   
9. I don't have a doctor. Can you send a nurse to my home?
   
   Medicare, Medicaid, private insurance and other third party payors require that you have a physician's order.
   
   
10. What are Medicare Replacements?
    
    A Medicare replacement is a health maintenance organization which usually charges less than the traditional Medicare premium. Home health coverage by a Medicare replacement is more limited than traditional Medicare; all services must be preauthorized by a case manager; and participants must use physicians on the provider list. Check with a case manager for your policy to determine home health benefits.

For further information, call (502) 581-8621 or (800) 346-4577.