What is the difference between Home Health and Private Duty care?

Home Health services are “intermittent” visits to a patient’s home from a highly skilled  and specifically educated clinician who provides nursing or therapy services, typically one to three times per week for a 60-day episode under a specific plan of care that is overseen by the patient’s Primary Care Physician (PCP). Home Health is typically covered 100% by Medicare.

Private Duty services provide patient home visits by non-medical care by un-skilled aides who do light house-keeping, meal preparation and companion services. Some Private Duty providers may also provide private, skilled clinical care. Care is usually provided in blocks of time and paid directly by the patient or family members.

How much does Home Health care cost?

If the patient is Medicare insured then Home Health services are reimbursed 100% by Medicare with no deductibles and no lifetime maximums. If the patient has commercial health insurance then Home Health

services are reimbursed per the patient’s selected health plan. Some types of plans include Medicare  Replacement plans, HMOs and PPOs. Each plan has it’s own reimbursement guidelines.

All patients with commercial insurance plans must receive pre-authorization prior to receiving services. To find out of National Home Care takes your commercial insurance contact us (make contact us a link). If the patient has neither Medicare nor Commercial Health Insurance than services may still be provided on a Private Pay basis. For an estimate of costs contact us.

What are the primary reasons for Home Health services?
Home Health services are often prescribed by a patient’s Primary Care Physician (PCP) who needs additional clinical support at home. Many times patients have had a recent hospital stay where a condition was stabilized and now they are being discharged to their home where additional skilled services can be provided.

Common patient issues that may require home health include: Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), Pneumonia, Stroke, Hip Replacement, Knee Replacement, General Muscle Weakness, Infusion Therapy and many other therapies and treatments as deemed necessary by a patient’s PCP and best delivered at a patient’s home.