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FAQs

Get your frequently asked questions answered here. If you don't see the answer to your specific question, please feel free to contact our staff at 281-372-6963. We are happy to help!

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Find more information about home health care by clicking here.

Find more information about hospice care here.

Home Health Care FAQs

1 

What is Home Health Care?

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2

What is the Goal of Home Health Care?

In general, the goal of home health care is to treat an illness or injury. Home health care may help you:

Recover

Regain your independence

Become more self-sufficient

Maintain your current condition or level of function

Slow decline

3

What does Home Health Care Include?

Skilled Nursing

Physical Therapy

Occupational Therapy

Speech Therapy

Home Health Aide

Medical Social Worker

4

What Services are Included in Home Health?

  • Wound care for pressure sores or a surgical wound

  • Patient and caregiver education

  • Intravenous or nutrition therapy

  • Injections

  • Monitoring serious illness and unstable health status

5

What Do I Need to Start Care?

Doctor or other health care providers orders are needed to start care. Once your doctor or other health care provider refers you for home health services, the home health agency will schedule an appointment and come to your home to talk to you about your needs and ask you some questions about your health.


A doctor or other health care provider (like a nurse practitioner) must have a face-to-face visit with you before certifying that you need home health services. A doctor or other health care provider must order your care, and a Medicare-certified home health agency must provide it.

 

The home health agency staff will also talk to your doctor or other health care provider about your care and keep your them updated on your progress. It’s important that home health staff see you as often as the doctor or other health care provider
ordered.

6

What is a Plan of Care?

The agency will work with you and your doctor or allowed provider (including a nurse practitioner, a clinical nurse specialist, and physician assistant) to create your plan of care listing:

  • What services you need

  • Which health care professionals should give these services

  • How often you’ll need the services

  • The medical equipment you need

  • What results your doctor or allowed provider expects from your treatment.

 

Agency staff will teach you (and family or friends who may be helping you) to continue any care you may need, including:

  • Wound care

  • Therapy

  • How to manage your condition

 

Learn to recognize problems like infection or shortness of breath, and what to do or who to contact if they happen.

7

Who Pays for Healthcare?

  • Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) covers 100% of eligible home health services as long as you need part-time or intermittent skilled services and as long as you’re

  • “homebound,” which means:

  • You have trouble leaving your home without help (like using a cane, wheelchair, walker, or crutches; special transportation; or help from another person) because of an illness or injury.

  • Leaving your home isn’t recommended because of your condition.

  • You’re normally unable to leave your home because it’s a major effort.

8

What Home Health Services are Covered?

  • Medically necessary part-time or intermittent skilled nursing care

  • Physical therapy

  • Occupational therapy

  • Speech-language pathology services

  • Medical social services

  • Part-time or intermittent home health aide care (only if you’re also getting skilled nursing care at the same time)

  • Injectable osteoporosis drugs for women

  • Durable medical equipment

  • Medical supplies for use at home

9

What Does Part-Time or Intermittent Mean?

In most cases, "part-time or intermittent" means you may be able to get skilled nursing care and home health aide services up to 8 hours a day, with a maximum of 28 hours per week. You may be able to get more frequent care for a short time if your doctor or other health care provider determines necessary.

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You're not eligible for the home health benefit if you need more than part-time or "intermittent" skilled nursing care. You may leave home for medical treatment or short, infrequent absences for non-medical reasons, like attending religious services. You can still get home health care if you attend adult day care.

10

What Does Medicare NOT Pay For?

  • Medicare doesn't pay for:

  • 24-hour-a-day care at your home

  • Meals delivered to your home

  • Homemaker services (like shopping and cleaning) that aren’t related to your care plan

  • Custodial or personal care that helps you with daily living activities (like bathing, dressing, or using the bathroom), when this is the only care you need.

11

What are my Costs in Original Medicare?

$0 for covered home health care services.

After you meet the Part B deductible, 20% of the for Medicare-covered medical equipment.

Before you start getting your home health care, the home health agency should tell you how much Medicare will pay. The agency should also tell you if any items or services they give you aren't covered by Medicare, and how much you'll have to pay for them. This should be explained by both talking with you and in writing. The home health agency should give you a notice called the Advance Beneficiary Notice (ABN) before giving you services and supplies that Medicare doesn't cover.

12

What Does Part-Time or Intermittent Mean?

  • In most cases, "part-time or intermittent" means you may be able to get skilled nursing care and home health aide services up to 8 hours a day, with a maximum of 28 hours per week. You may be able to get more frequent care for a short time if your doctor or other health care provider determines necessary.

Hospice Care FAQs

Hospice Care FAQs

1 

What is Hospice Care?

Hospice is an approach to care, so it is not tied to a specific place. It can be offered in two types of settings — at home or in a facility such as a nursing home, hospital, or even in a separate hospice center. Hospice care focuses on the care, comfort, and quality of life of a person with a serious illness who is approaching the end of life.


Hospice provides comprehensive comfort care as well as support for the family, but, in hospice, attempts to cure the person's illness are stopped. Hospice is provided for a person with a terminal illness whose doctor believes he or she has six months or less to live if the illness runs its natural course.

2

What is Hospice at Home?

The hospice benefit allows you and your family to stay together in the comfort of your home unless you need care in an inpatient facility. If your hospice team determines that you need inpatient care, they'll make the arrangements for your stay.

3

Who is Eligible for Hospice Care?

Hospice care is for people with a life expectancy of 6 months or less (if the illness runs its normal course). If you live longer than 6 months, you can still get hospice care, as long as the hospice medical director or other hospice doctor re-certifies that you’re terminally ill.

4

What Type of Providers are Included in Hospice?

You and your family members are the most important part of a team that may also include:

  • Doctors

  • Nurses or nurse practitioners

  • Counselors

  • Social workers

  • Dietitians

  • Physical and occupational therapists

  • Speech-language pathologists

  • Hospice aides

  • Homemakers

  • Volunteers

A hospice nurse and doctor are on-call 24 hours a day, 7 days a week, to give you and your family support and care when you need it.

5

Who Pays for Hospice?

Medicare covers your hospice care provided by a Medicare-approved hospice. If you're in a Medicare Advantage Plan (like an HMO or PPO) and need hospice care, you can stay in that plan, as long as you pay your plan’s premiums. 

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When you get hospice care, your Medicare Advantage Plan can still cover services that aren't a part of your terminal illness or any conditions related to your terminal illness.


If you qualify for hospice care, you and your family will work with your hospice team to set up a plan of care that meets your needs. Call us for more information to see if you or your loved one qualifies.

6

What is Covered?

Once your hospice benefit starts, Original Medicare will cover everything you need related to your terminal illness. Original Medicare will cover these services even if you choose to remain in a Medicare Advantage Plan or other Medicare health plan. After your hospice benefit starts, you can still get covered services for conditions not related to your terminal illness. Original Medicare will pay for covered services for any health problems that aren’t part of your terminal illness and related conditions. However, you must pay the deductible and coinsurance amounts for all Medicare-covered services you get to treat health problems that aren’t part of your terminal illness and related conditions. If you were in a Medicare Advantage Plan before starting hospice care, and you decide to stay in that plan:

 

  • You can get covered services for any health problems that aren’t part of your terminal illness and related conditions.

  • You can choose to get services not related to your terminal illness from either your plan or Original Medicare.

  • What you pay will depend on the plan and whether you follow the plan’s rules like seeing in-network providers. If your plan covers extra services that aren’t covered by Original Medicare (like dental and vision benefits), your plan will continue to cover these extra services as long as you continue to pay your plan’s premiums and other costs.

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