Understanding Medicare homebound status

Posted on: January 31st, 2011 by sdavis

No one wants to stay in the hospital longer than they need to. But many people on Medicare don’t realize that they don’t qualify for home care because of their mobility. Patients with Medicare insurance only qualify for home care services if they are considered homebound by their physician and home health agency.

According to the Medicare Home Health Provision, a patient is considered homebound if he or she has a condition, such as an illness or injury, that keeps them from being able to leave the home without the assistance of another person or the aid of a supportive device, like a walker. The patient doesn’t necessary have to be bedridden to be considered homebound, but his or her illness or injury should prevent them from having a normal ability to leave his or her house. For someone to be considered homebound, leaving the home will require considerable effort. Most people on oxygen qualify as homebound, for instance, because leaving the home is a difficult task.

Another aspect of homebound status patients don’t realize is that absences from the home need to be only to receive healthcare. This includes not only regular doctor visits, but also therapy, psychiatric evaluations, or treatment at an accredited adult day-care. Absences to attend religious services are also included in the Medicare Home Health Provision, as they are considered short in duration and infrequent. Other absences from the home won’t completely disqualify a person from being considered homebound, as long as they are just that: short in duration and infrequent. Leaving the house for a coffee date every morning typically means that you’re not homebound.

Unfortunately, while there are many common factors among homebound patients, there is no master checklist available to determine if a patient is homebound or not. The decision is ultimately left up to the nurses and doctors caring for a patient.

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