Home Care and Private Duty Services:
What to Expect and how it Works
If you find yourself in need of services once you leave a hospital, or if you’re caring for a parent in need of in-home services, home health care or private duty nursing may be just what you’re looking for. It’s important to realize though that each service option offers different levels of care.
Home health care requires a physician’s order and the person receiving the care must be home-bound. Home health care is as effective as the care you’d receive in a hospital or skilled nursing facility, but is less expensive and more convenient because it’s provided in the home. The care is provided by specialty-trained clinicians including nurses, physical therapists, occupational therapists and other professionals.
The primary goal of home health care is to treat an injury or illness so the person can be self-sufficient and regain their independence.
This is how the process works and what you should expect:
- A doctor’s order is required for home health care to start. Your doctor should provide you with a list of home health providers that serve your area or he/she will refer you for home care and choose a provider for you when services are limited. The home care agency will call you to schedule an appointment in your home to discuss your needs and to ask questions about your health
- The home care provider will talk to your doctor about your care and keep him/her updated
- Home care staff should see you as much as your doctor ordered (this is important)
How insurance works with home health care differs per insurance carriers and plans. Find out if your insurance covers these services, how long coverage is offered and if there will be any costs not covered. It pays to do your homework to ensure you don’t receive a surprise bill.
Private duty services are services that do not require medical care, such as bathing, meal preparation and light housekeeping. These services ensure that daily activities are carried out and the client is comfortable in his or her home. Private duty care is often long-term and a doctor’s order is not required.
How insurance works with private duty services differs per plan. Do your homework and find out if your insurance carrier covers these services. Find out how long they will cover services if they do offer coverage. When it comes to insurance, do your due diligence to ensure you know all the details. Insurance companies and original Medicare have customer service staff dedicated to answering your questions.
There are long-term insurance plans for skilled care and private duty care. Your local Area Agencies on Aging provide services that can help you choose long-term insurance, Medicare and Medicare Supplement insurance. They are a great resource and there is no cost for these services:
Alaska – http://dhss.alaska.gov/acoa/Pages/default.aspx
Hawaii – https://www.hcoahawaii.org/
Montana – http://dphhs.mt.gov/sltc/aging/areaagenciesonaging.aspx
Wyoming – https://health.wyo.gov/aging/
Providers: to help assess the risk when discharging patients please see Mountain-Pacific’s two tools below:
For more information on home health care and Medicare visit: