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Senior Spotlight – “Medicare” Home Health vs. “Private” Home Care – What’s the Difference?

Have you ever used home health care before? Do you know which type of home health you used – Medicare vs. private pay? Did you even know there is more than one type of home health? What is the difference?

Don’t worry, this was extremely confusing to me at first, and I had been working in the industry already. Below, I have identified 4 differences between “Medicare” Home Health and “Private” Home Care, which will help you make better-informed decisions.

  • Skilled vs. Non-Skilled Services – Medicare Home Health consists of skilled services by a licensed (RN, LPN, PT, OT, etc.) which include physical, occupational, speech therapy, or wound care after surgery or a recent fall. Private Home Care consists of non-skilled or personal care services by a (CNA, HHA, Caregiver, etc.) which include assistance with bathing, transferring, toileting, ambulating, eating, meal prep, transportation, med management or general safety and supervision.
  • Health Insurance vs. Private Pay – Medicare Home Health is typically covered by most Medicare and Medicare Advantage health insurance plans. Private Home Care is paid for out-of-pocket through savings, retirement income, or private long-term care insurance. In some cases, a Veteran and those who qualify for Medicaid may be able to receive assistance for private home care.
  • Short Term vs. Long Term – Medicare Home Health is typically a short-term solution for those leaving the hospital or rehab and may last 30-90 days, 2-3x per week, 45 min each visit depending on the individual’s progress and their insurance provider. Private Home Care is designed to help families long term with ongoing chronic care needs. The frequency and length of time care is needed is entirely up to the family to decide depending on what their individual needs are.
  • Physician Referral vs. Family Inquiry – Medicare Home Health will require a physician’s order since it is billed through your health insurance. However, even though your physician is required to write an order you still have patient choice and can select the home health agency you want to work with. Private Home Care does not require any physician order. In fact, Google is one of the most popular ways to find a private home care near you and the decision is completely up to the family regarding which company to use.

If you’d like to be more prepared whether you’re caring for your parents, spouse, or a loved one, attend the #1 Educational Event on Local Senior Resources. It is an all-day event on Saturday, March 14, 2020, at the Charlotte Harbor Event & Conference Center. Space is limited. To reserve your FREE tickets (lunch included), visit seniorsource.com or call (941) 677-7233.

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