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Location: 4000 Executive Park Dr., Suite 225, Cincinnati, Ohio 45241

Office Hours: Mon.-Fri. 8:00 a.m. to 5:00 p.m.

Health Insurance

Questions & Answers

What is home health care?

Home health care is clinical medical care provided by a registered nurse, occupational therapist, physical therapist or speech therapist, and is often prescribed as part of a care plan following a hospitalization or facility discharge.  Home health care services include:

  • Nursing services
  • Teaching and training on chronic disease management
  • Instruction on medications, including injections
  • Medical tests that require instruction and monitoring to stabilize and transition to outpatient lab once managed 
  • Teaching and training on how to manage your health status
  • Wound care and teaching on how to manage and prevent wounds
  • Therapy services to help after changes from recent surgery or debility after illness as well as management of chronic conditions to maximize independence and remain at home. 

When should I think about getting home health care?

Situations in which home health is prescribed include:

  • Following an inpatient hospitalization, rehabilitation, or a stay at a skilled nursing facility – to help the transition back to independence
  • When you experience medication change, so you can monitor for side effects and teach a new medication and how to assess for effectiveness 
  • When you experience an overall decline in functioning – in order to help you to regain independence through therapy or learning new skills to compensate for your deficit

What are the requirements to qualify for home care?

Patient requirements for home health care include:

  • A need for skilled nursing care or therapy services (i.e., physical, occupational or speech therapy) on an intermittent basis
  • Restricted ability to leave home, which is certified by a physician

Specific home health care services are prescribed by a physician.

Some physical indicators that home care services can address include:

  • Conditions that limit mobility or the ability to leave home
  • Psychological challenges due to immobility
  • Wound care or wound infection
  • Chronic breathing problems or use of oxygen
  • Frequent physician visits or hospital admissions
  • Recent or upcoming surgery and anticipating discharge home
  • A history of or high risk of falls
  • Chronic or recurrent pain
  • Nutritional or fluid assessment needs

If you’re unsure whether a patient qualifies for home care, please contact us.

Is home health care covered by Medicare or my private insurance?

Medicare or private insurance often covers the cost of home health care services when ordered by a physician. Our staff will determine if your home care needs are covered and will complete all the necessary paperwork.

What can I expect on my first home care visit?

Our goal is to assist a patient’s return to their maximum level of functioning, as well as provide available services to help patients stay safely in their home.  A home care associate will call you to schedule a time to visit you in your home. During this first visit, a physical and environmental assessment will be performed, including a complete medication review so please have all your discharge paperwork and all medications you have ready to review with our staff. Once the assessment is complete, we will discuss the options available.  All patients and families have the right to decide which type of medical care is received and we will work with you and your physicians to develop the best plan of care to meet your individual needs.

How often will someone be in my home?

The number of home visits you will receive is based upon your specific skilled needs and typically ranges between 1-2 visits per discipline. After the initial assessment is completed in your home, your physician, your home care clinician, alongside both you and your family, will work together to develop a coordinated, individualized plan of care with you. This plan of care will guide us in providing the home health services that will support you in reaching your goals.

Can a family member or friend be present during home visits?

You don't have to do it alone! We encourage you to have your health care representative present at start of care to help with questions and to participate in the plan of care.  We also encourage other family and friends to actively participate in your care, well-being, and independence for long term support.  

What other services can you provide?

In addition to skilled clinical care, our key partner Stay Well Plus can provide in-home services such as homemaking, personal care, and respite care. One of the biggest benefits of home health care is companionship. We often find that having another person in the home to talk to a patient or give a caregiver a break is all that’s needed to improve a family’s well-being. 

How do I get started?

It's quite simple! All you have to do is call or contact us through our referral page and we'll do the rest. 

Medicare Information

Medicare Part A and/or Part B cover eligible home health services. To qualify for home care, a person with Medicare must meet all of the following:

  • Your doctor must decide that you need medical care at home and make a plan for your care at home.
  • You must need at least one of the following either part time or on and off: skilled nursing care, physical therapy, speech-language therapy, or occupational therapy.
  • You must be homebound and unable to leave the house without help. To be homebound means that leaving home takes a good deal of effort. But leaving home for medical treatment or short non-medical trips (such as for haircuts or religious services) do not usually disqualify you.

If you meet all the above, you may be eligible for care from a Medicare-certified home health agency. The Centers for Medicare and Medicaid Services has a lot more information about this. Call them toll-free at 1-800-633-4227 (1-800-MEDICARE) or visit www.cms.hhs.gov.

A Stay Well Home Health associate will coordinate the services your doctor orders for you.

Medicare doesn't pay for:

  • 24-hour-a-day care at home
  • Meals delivered to your home
  • Custodial or personal care (help bathing, dressing, and using the bathroom) when this is the only care you need
  • Homemaker services

You're not eligible for the home health benefit if you need more than part-time or "intermittent" skilled nursing care. For more information on qualifying for Medicare Home Health, visit www.cms.hhs.gov.

 

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Managed Care Plan information

Commerical Health Insurance

Most private insurance policies include some home care service for short-term needs, but benefits for long-term care vary from plan to plan. Be sure to contact your health care plan to get the details about your insurance coverage for home care.

Managed Health Care Plans

These group health plans sometimes cover home care services. Managed care organizations that have contracts with Medicare must provide the full range of Medicare-covered home health services available. Coverage may be limited to doctor-directed medical services and treatments, but your choice of agency is restricted. Be sure to ask about your plan’s coverage.

A Stay Well Home Health associate will assist in determining what coverage you have for the services required.

Self Pay information

If insurance coverage is not available or doesn’t cover all the care that you need, you and your family can hire providers and pay for services yourself. Keep in mind that you might be responsible for payroll taxes, Social Security, and unemployment insurance in some situations. (The IRS can tell you more.) It may help to shop around, as these services can cost a lot.

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Helpful Documents or links

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Stay Well Brochure

Download our brochure to share and for quick reference. 

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