Many health care treatments that were once offered only in a hospital or doctor’s office can now be done in your home. Home health care is usually less expensive, more convenient, and just as effective as care you get in a hospital or skilled nursing facility. Home health care helps you get better, regain your independence, and become as self-sufficient as possible.
Home Health Care is skilled nursing care and certain other health care services that you get in your home for the treatment of an illness or injury.
If you have Medicaid, you can use your home health benefits if you meet all the following conditions:
Being homebound means it is difficult to leave home because of your condition. Medicaid may consider you homebound if you need a wheelchair or someone else’s help to leave home, or if leaving home means you may be in danger or at increased risk.
For example, a person with dementia may be in danger when leaving home because of memory loss or other cognitive impairment. However, you can still meet the homebound definition even if you sometimes leave your home. You can leave for medical treatment you cannot get at home. You also can leave for non-medical reasons, like if the trip is occasional and only for a short time. For instance, you can go to religious services or to get a haircut.
You also can be called homebound if you go to a medical adult day care program. This is because the medical day care programs are considered medical treatment. You cannot be called homebound if you go to a regular adult day care.
For you to get home health care, your doctor must say that you need either skilled rehabilitation therapy or skilled nursing care. This means you must need professionals with special training and knowledge to care for you safely and well. These may include registered nurses and licensed practical nurses.
If you’re eligible for Medicaid-covered home health care, Medicaid covers the following services if they’re reasonable and necessary for the treatment of your illness or injury:
If you qualify for Medicaid home health care coverage, you generally pay nothing. Medicaid usually does not charge deductibles or coinsurance for these services. When you request services from us, you will be informed of the following if you must pay any part of your bill or if Medicaid will not cover any of the services.
You can keep getting home health care services as long as your doctor says you need them. Your doctor must renew the order at least once every 60 days. Many Alzheimer’s patients need certain ongoing rehabilitation therapies that Medicare’s home health care benefit covers.
Below are some examples of what Medicare doesn’t pay for:
Your doctor has to write an order for home health care services. After we receive the order, we will set a schedule with you to visit you at your home and talk to you about your needs and health.
Our staff will work with you and your doctor to write your plan of care. This plan will include:
There are a number of reasons for choosing BG Healthcare Services, Inc.
Personal care services are non-medical services that are offered in your home. These services include help with Activities of Daily Living (ADLs), such as:
BG Healthcare Services charges both per hour and per visit rate depending on the services requested in your home. With hourly rates, there is a 4 hour minimum that will be billed. If you meet the eligibility criteria for Medicaid, you may also be eligible for personal care services paid for by Medicaid. BG Healthcare Services also offers Private Pay for Skilled Services (Nurses, Therapists, Certified Nursing Aides and Social Workers) which is billed depending on the services requested. If you have long-term care insurance, your policy may pay for personal care services. Check your policy to see what it covers.
To qualify for personal care or personal assistance services under Medicaid, you must first be eligible for Medicaid, or you must be using a Medicaid Waiver. You must also meet criteria for placement in a nursing facility or an Intermediate Care Facility for Individuals with Mental Retardation and Related Conditions. You will be seen by a Pre-Admission Screening Team. Your local health department and department of social services offer the screening. The screening can be requested by you, a family member, or a health care professional. Anyone who is concerned about you can ask for a screening. If you are 60 years of age or older, contact your local Area Agency on Aging. If you have a disability, contact your local Community Service Board or Center for Independent Living. These agencies may be able to provide assistance with personal care or assistance services.
To receive personal care or personal assistance services from Medicaid contact your local department of social services. If you do not have Medicaid, you can also contact your local department of social services to get help. If you are currently using a waiver, contact your support coordinator, case manager, or services facilitator.
To find more information about the Personal Care Services under the Virginia Medicaid Waiver Program, you can go to: