People are living longer. According to U.S. Census figures, Americans over age 80 are the fastest growing segment of our population and will triple to more than 26 million people with the next 40 years. Every eight seconds a baby boomer turns 50 and once boomers begin to retire, one in five Americans will be over 65. Advancements in medical care have extended our lives into the 80’s and beyond. As the trend continues toward longer life, so does the likelihood that many older people will receive medical care in their own homes.

Home health care started in the nineteenth century with public health nurses visiting people with infections and teaching family members how to assist in the care of their loved ones. Today many health needs can be addressed at home.

The National Association for Home Care estimates that more than 8 million Americans currently receive home care for acute and chronic needs. After surgery, visiting nurses provide wound care and intravenous medications reducing the need to stay in a hospital. Physical therapists help patients recover from strokes or injuries. Occupational therapists help improve manual skills and speech therapists can address problems associated with talking and swallowing after a stroke. Today, these healthcare workers often provide services in the homes of their patients.

Home health aides are available for assistance in bathing and dressing. Medical devices, such as, wheelchairs, oxygen, hospital beds can be purchased or leased as needed from agencies or medical equipment firms. Today, home health care is available to anyone, but it’s not quite as simple as it sounds. Families must make proper arrangements to secure quality, affordable care in the home.

First, a doctor must order it and provide a plan of care. Most of the time, this process begins in the hospital to ensure that home care is available on the day of a patient’s discharge. Even if the patient was not hospitalized, home health agency services are available.

Who pays? Most insurance companies cover home health care. Medicare pays for 60 percent of home health care in the United States, spending almost $18 billion on 4 million recipients in 1997. At roughly $88 per day for an average home care visit, compared to $454 for nursing homes and over $2000 per day in a hospital, home care is a bargain.[1]

A word of caution, however: home care is not free. Medicare pays 80 percent of the allowed fee. The beneficiary pays 20 percent. A Medicare supplemental insurance policy may pick up that part—but not always. Make sure you know what the policy says. A patient must be homebound to qualify—by definition that means the patient leaves home only with great difficulty and only for doctor visits and religious services.

Medicare covers many things, but it does not cover everything used in home health such as 24 hour nursing, prescription medications, meal delivery, homemaker. While Medicare will cover equipment such as wheelchairs and lifts, you must meet certain criteria. It’s not enough to say your doctor ordered it or you think it would help. Before you buy, learn about the requirements.

Finally, be careful of fraud. Unfortunately, the elderly and the critically ill are often prime targets for scams. Be wary of vendors who offer to supply something at little or no cost to you. If Medicare denies payment you may be left with the bill. If you are solicited by telephone or door-to-door, be suspicious. Medicare fraud exceeds $24 billion annually, a large part of it from improper billing for home health services.

For further information on Medicare and home health coverage, go to http://www.medicare.gov/Publications/Pubs/NonPdf/hhpre.asp