Will My Insurance Pay For In-Home Care?

Most insurance plans provide some coverage for home care services. But plans, deductibles and out-of-pocket expenses will vary. Also, not all providers are in network with all insurance plans. It is best to contact your home care provider of choice prior to your surgery to see if it is in-network with your insurance company. You will also want to contact your insurance company to determine if any pre-authorization is required for home care services.

Original Medicare Part A typically covers home care services at 100 percent, provided the services are ordered by your surgeon, are performed by skilled professionals and are medically necessary. In addition, the patient must be essentially “home-bound,” meaning that it is difficult for the patient to perform activities outside the home, except to go to doctor’s appointments.

What Can I Expect From In-Home Care?

Within 24 hours of returning home, you can expect a call and a visit from your home health provider. Depending on the type of surgery and your surgeon’s preferences, you may receive visits from skilled nurses, a physical therapist and/or an occupational therapist. If you need assistance with personal care such as bathing, a home health aide can also be provided.

What If I Live Alone?

It is best to make arrangements with family members or friends who can stop by and spend some time with you each day. They can assist you with meal preparation, laundry and other daily activities that you will be unable to perform when you first return home. They can also help by running errands for you as it will be quite an effort for you to go out initially.

Before you leave the hospital, physical and occupational therapists will assess your functional level, ask questions about your home environment and support and make recommendations to the discharge planner and your surgeon about your rehabilitation needs. They may suggest a short stay in a rehabilitation facility if they feel you are unable to safely return directly to your home.