I live in Ny and get my caths thru Medicare @ 1K a month.  If I get nursing I get 2 caths.  At least what I've been told.  I have been paying out of pocket for PCA's
----- Original Message -----
To: Quad
Sent: Sunday, June 05, 2005 3:45 PM
Subject: Re: [QUAD-L] FOUND IT! - Medicare & Home Health Care

Lisa,
 
MediCARE recipients who have a skilled nursing need (indwelling catheter, wound, etc)
are fully eligible to receive HOME HEALTH AIDES (CNAs) while with that agency.
 
But since 1999 it's been like pulling teeth to get ONE visit a week let alone the 35 hours one can
be eligible for (hence links below).
 
Because in 1998-1999 our lovely government changed its payment system to agencies
and EVER SINCE they (agencies) get to keep the Medicare money that they'd otherwise half to "partially" use
to pay for the aide visits.  It's all about greed and screw the customers.
 
I've tried every avenue to get what I deserve and it's been hell.  The system is set up now
to protect the agencies rather than the patients.
 
I can't get much clearer than that.  And if I had a solution I wouldn't be writing this.  We've tried
everything in the last 6 yrs to fight for my rights.
 
Lori
 
-------Original Message-------
 
Date: 06/04/05 19:14:16
Subject: Re: [QUAD-L] FOUND IT! - Medicare & Home Health Care
 
Lori,
What's the deal with the Medicare the issue .
Lisa

Lori Michaelson <[EMAIL PROTECTED]> wrote:
Ok, Dave I see the "regular booklet" is vague on pages, 19, 25 and 41-42.  But is specified in another booklet.... read on ....
 
I know I'm not going crazy.  At one time I requested their booklet on "Home Health Care" and maybe it was in there.  FOUND IT!
 
I quoted it below in big purple letters.  I knew I wasn't crazy!  :-)
 
Ok..... as a start this info though .........
 
"Some home care can only be given by licensed health workers, such as if you need skilled nursing care and certain other health care services that you get in your home for the treatment of an illness or injury. Skilled nursing care includes services and care that can only be performed safely and correctly by a licensed nurse (either a registered nurse or a licensed practical nurse) or a licensed therapist. Remember, Medicare only pays for home care if you meet certain conditions. For more information, look at the Medicare booklet, Medicare and Home Health Care.

You can also hire a home health care agency for care in your home if Medicare doesn’t cover it. In this case, you will need to pay for this care on your own. Home care costs can vary depending on where you live, the type of care you need, and how often you need care. Usually home care is charged by the hour.

To locate home health agencies that provide services in your area, look at Home Health Compare on this website. You can also look at the National Association for Home Care website to get information about home care and hospice. This website includes information on how to find a home care or hospice agency and how to prepare for care.

The following home health services may be available in your community:

  • Skilled nursing care
  • Homemaker/Health aides
  • Personal care aides
  • Respite care
  • Medical equipment
  • Home repair and modification
  • Hospice "
I found at http://www.medicare.gov/LongTermCare/Static/HomeCare.asp  .  AT LEAST it DOES SAY Health Aides and PCAs.
 
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
 
The Medicare and Home Health Care booklet is clickable above.  When AT it note that page 9 says what your agency must provide and guides you to pages 19-20.
 
The 4 criteria to get home health is stated on page 11.  I meet all four as I have a foley cath as my "skilled nursing need."
Page 11 begins describing number of hours as well.
 
PAGE 12 says home health aides or nurses LESS THAN 8 HRS A DAY!  And 28 or fewer hours each week.
 
"Based on your need for care, on a case-by-case basis, the weekly total may be increased to up to 35 hours."
 
 
My needs remain the same and I'm only asking for 10 hours a week.  My Dr writes the orders and they should be followed.
 
Lori
One who refuses to let these well-paid services I NEED and AM ELIGIBLE FOR be taken care of!  People doing their job ... imagine that!!!
 
 
 
 
 
 

Reply via email to