As the aging population in the United States continues to increase, the topic of long-term care is one that touches most families as they discuss ways to prevent the need for long-term care and strategies for financing it when it becomes unavoidable. Many people are unaware of the diverse options accessible to support seniors requiring assistance but who are not yet at the point where nursing home care is necessary. One of those options is home health services. To help you decide if it’s a viable option for you or a loved one, the Indianapolis attorneys at Frank & Kraft discuss what you need to know about Indiana home health services.
Understanding Home Health Services
With approximately 3.6 million of the almost 40 million seniors in America classified as housebound and in need of home-based care, caregiving for seniors is a huge industry in the U.S. Many of the housebound seniors, however, don’t require the constant care provided by a nursing home and/or cannot afford the hefty expense (averaging over $100,000 in 2022) of nursing home care. That leaves significant motivation to explore caregiving alternatives that allow homebound seniors to remain in their residences. One alternative is home health services, also known as home health care. Delivered directly to a patient’s home by licensed medical professionals, including nurses, therapists, and aides, home health services provide skilled care that treats or manages illnesses, injuries, or medical conditions. It’s crucial to note that home health care and home care differ; the latter generally refers to unskilled care that helps with daily tasks of living.
Underutilization of Home Health Services
A 2023 study published in the Journal of American Medical Directors Association examined home-based clinical care and long-term services and supports (LTSS) among older Medicare beneficiaries to gauge the frequency of home health services utilization. Analyzing the Medicare claims of 974 beneficiaries, the study revealed that while homebound individuals did utilize these services, no group received high levels of all care types. Homebound seniors used LTSS services more frequently (80 percent) than home-based clinical care (30 percent), underscoring a significant gap between seniors who could benefit from home health services and those currently receiving them. The study identified three levels of home clinical care and LTSS usage among older adults:
- Low Care and Services (46.6 percent): The largest group received minimal home-based care, and these individuals tended to be younger with fewer chronic conditions and functional impairments.
- Home Health Only with LTSS (44.5 percent): This group utilized some home health services, such as assistance with activities of daily living (ADLs) but received little home-based clinical care.
- High Clinical with LTSS (8.9 percent): A small number received extensive home-based clinical care, and they were generally older, more likely to have dementia, and lived alone.
Medicare Coverage for Home Health Care
While Medicare doesn’t cover nursing home care, and Medicaid requires qualification for coverage, many people are unaware that Medicare may help cover the costs associated with home health services. Medicare Parts A and B may cover medically necessary part-time or intermittent skilled nursing care, health assistance, durable medical equipment, and medical supplies for use at home. Part A covers home health care for individuals following a hospital stay or a stint in a skilled nursing facility, while Part B provides home health care for homebound adults in need of skilled nursing care. Medicare deems an individual homebound if they have difficulty leaving their home due to illness or injury, their physician recommends staying at home, and leaving their residence requires significant effort, such as the use of a cane, wheelchair, walker, crutches, special transportation, or assistance from another person.
Do You Have Additional Questions about Home Health Services Indiana?
For more information, please join us for an upcoming FREE seminar. If you have additional questions about home health services in Indiana, contact the experienced Indianapolis elder law attorneys at Frank & Kraft by calling (317) 684-1100 to schedule an appointment.