If you meet certain eligibility requirements, Medicare may pay for your covered home health care for as long as you’re eligible and your doctor certifies that you need it.

Additionally, your Medicaid program or your private insurance also may cover home health care, or some services that Medicare doesn’t cover. Check with your Medicaid program or insurance company to learn about their specific eligibility requirements.

Absolutely, and we’d be honored to care for you or your loved one. Federal law gives patients the freedom to choose their health care provider under Medicare.

Home health care provides medical treatment for an illness or injury, with the goal of helping you recover, regain your independence and become as self-sufficient as possible. More than just providing excellent care in your home, home health care also saves billions of dollars each year. There is no more cost-effective provider of health care in our country.

VERGE Home Care offers health care services such as skilled nursing, home health aides, physical therapy, occupational therapy, and speech therapy. We can also offer specialized chronic care programs that focus on actively involving you in your health care process, addressing conditions including:

• heart disease
• diabetes
• chronic obstructive pulmonary disease (COPD)
• pain management
• wound care
• infusion therapy
• oncology
• chronic kidney disease
• psychiatric services

Essentially, your condition should be such that there exists a normal inability to leave home and doing so would require considerable and taxing effort. Generally speaking, you would be considered homebound if you have a condition due to an illness or injury that restricts your ability to leave home without the aid of an assistive device (such as crutches, canes, walkers or wheelchairs), without the assistance of another person, or if leaving the home is medically inadvisable.

You can leave the home as often as you need for medical treatment that cannot be provided in the home. Further, you are allowed brief and infrequent absences from the home for some non-medical reasons, such as an occasional trip to the barber/beauty shop, to attend church, or for unique family events (like a graduation).

The frequency of home health care visits and the services provided are based on your doctor’s orders in your personal plan of care. Your doctor may change your plan of care, increasing or decreasing the number of visits or services provided, in order to provide you with the best home health care for your needs.

On the first visit, a nurse or therapist will conduct an initial evaluation. At VERGE, this thorough interview and evaluation is part of our coordinated approach to managing your overall health status. Our evaluation focuses on educating you in self-care management and partners with your doctor to promote disease prevention and proactive care – which includes the family or caregivers.

This team approach facilitates an easier transition for you from a hospital or nursing facility to your home, and actively engages you and your caregivers in your health care.

VERGE Home Care provides comprehensive support for patients with chronic diseases and post-acute care needs. Our Home Health Care team works closely with physicians to coordinate all aspects of patient care for chronic diseases including CHF, diabetes, kidney disease and COPD. We also have advanced home-based health care methods for treating wounds, managing behavioral health issues, stroke recovery, pain management and rehab therapy.

ALLSTATE Hospice team provides treatment and comfort for people facing a life-limiting illness. ALLSTATE Hospice offers a support system of medical, social, psychological and spiritual services that promote dignity and affirm quality of life. Our comprehensive and specialized care allows patients, family members, and other loved ones to make choices about what is important to them. 

There are several requirements for a patient receiving home health care:

• The patient must need either skilled nursing care on an intermittent basis or therapy services (i.e., physical/occupational/speech therapy).
• The patient must be restricted in their ability to leave home, and their homebound status must be certified by a physician.

A normal inability to leave home such that absences from home are infrequent and of relatively short duration.  Any absences should require a considerable and taxing effort.  Likewise, absence that require an assistive device or the aid of another person may also be permissible for the homebound patient.  Similarly, a person may leave home for medical treatment which cannot be provided in the home.

A patient’s residence is wherever she makes her home. This may be her house, an apartment, a relative’s home, a home for the aged, or some other type of institution. However, a hospital, skilled nursing facility (SNF) or intermediate care facility (ICF) is not considered the patient’s home.

In November 2010, the Centers for Medicare & Medicaid Services (CMS) issued their final rule regarding hospice and home health face-to-face encounter requirements for 2011. As has always been the case, hospice and home health care patients must be under the direct supervision of a physician at all times, a model which VERGE Home Care has always employed and supported.

The new CMS face-to-face regulation is designed to further ensure the physician’s active involvement in a patient’s plan of care. This regulation will have no financial impact on either the patients we care for or the physicians who refer them to us.

For hospice care patients, CMS has place the responsibility for face-to-face visits on the hospice agency. You are not expected, nor required, to make any adjustments to the care you provide to hospice patients under this rule. This new regulation will not have an impact on you, your referrals to ALLSTATE Hospice, or how you interact with our care center. If you serve as a patient’s attending physician, you will continue to serve in that capacity. However, you can expect that your patients will receive additional support and hands-on care from our team through these face-to-face encounters.

For home health care patients, CMS’s face-to-face regulations require additional visits and documentation, which we will work with you and our shared patients to manage. These requirements are only for the initial certification period, not for recertifications. For details, please review “Home Health Face-to-Face Encounter – A New Home Health Certification Requirement,” published by CMS.

• You must have a doctor prescribe home health care.
• You must need either skilled nursing care on an intermittent basis or therapy services (i.e., physical/occupational/speech therapy)
• You must be restricted in your ability to leave home (“homebound”), and your homebound status must be certified by a physician.
  This means that you require the help or supervision of another person, or you use a supportive device such as a cane or walker. You can leave the home as often as you need for medical treatment. You are allowed brief and infrequent absences from the home for some non-medical reasons, such as an occasional trip to the barber/beauty shop or a walk around the block.

More detailed information about eligibility is available in The Center for Medicare and Medicard Services guide, “Medicare and Home Health Care (PDF).”

ALLSTATE Primary Home Care performs household and personal care services, like preparing meals, cleaning, and helping with bathing or dressing. Allstate Primary Home Care offers all these services for qualified clients. Services are covered by Medicaid, some instances by Medicare or private pay for your loved ones.

VERGE Home Care provides medical treatment for an illness or injury, with the goal of helping you recover, regain your independence and become as self-sufficient as possible. Home health care can also help you live with a chronic condition, like heart disease, COPD, or diabetes. Additionally, home health care can include some personal care services, like help bathing and dressing, as part of the plan of care ordered by your doctor.

ALLSTATE Hospice is designed to provide non-curative treatment and comfort for those who are facing a life-limiting illness. It offers a support system of medical, social, psychological, and spiritual services that support a patient, their family, and other loved ones.