Eligibility for Home Care

Home Care clinical services can be provided, if a skilled clinical need exists. The homecare services provided by the VNA of Rhode Island are provided on an intermittent basis. Clinicians will visit your home to provide a treatment of care or do an assessment. Usually the assessments would take an hour and a half; treatment visits take an average of an hour.

You must have a caregiver who can be available to you. If you have Medicare, you can use your home health benefits if you meet all the following conditions:

• Your doctor must decide that you need medical care at home, and make a plan for this care.
• You must need one or more of the following:
  • Intermittent skilled nursing care
  • Physical therapy
  • Speech-language pathology services
  • Continued occupational therapy
• Your doctor must certify that you are homebound. Homebound means that leaving home isn't recommended because of your condition, you need help from another person, or use a walker or wheelchair when you go out and it takes a considerable and taxing effort. A person who is homebound may leave for medical treatments or short infrequent absences for non-medical reasons - such as to attend religious services or get a haircut. You can still get home health if you attend adult day care, but you would need to get the home care services in your home.

Eligibility is also based on the amount of services you need

If you meet the conditions above, Medicare pays for your covered home health services for as long as you are eligible and your doctor says you need them. However, the skilled nursing care and home health aide services are only covered on a part-time or "intermittent" basis. This means there are limits on the number of hours per day or days per week that you can get skilled nursing or home health aide services. More information about Medicare's guidelines for home care is available at the following link.
http://www.medicare.gov/publications/pubs/pdf/10969.pdf