Celebrating 12 years as a Medicare Specialist, October 2020 |
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Hi there!
ANNOUNCEMENT: NOW LICENSED in Florida and NY.
If you are moving and relocating to Florida, I can help you find a new Medicare plan. Please give me a call and referrals to friends and family are always welcomed and appreciated!
I will be known in Florida as “Boomer Health Plans Made Simple, LLC”
(Florida would not let me keep the word “Medicare” in my business name).
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Home Health Care has become a big topic since most of our medical treating has become outpatient; and recently home based thanks to video telemedicine. Defined below is the definition for Homebound versus Skilled Care and the
requirements to become approved for coverage.
Also, SUGAR - ideas to reduce your intake and how much sugar is to much.
Keep reading!
Theresa Cangemi CSA, CLTC
"The Medicare Lady™"
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How To Qualify for the Home Health Care benefit Under Medicare |
Many of my clients have heard me talk about the Home Health Care benefit. This benefit sounds like it would provide for long term care coverage. Well, there might be some very short term coverage to rehabilitate you so you can continue your normal activities after an illness or injury or being discharged from the hospital.
Medicare was always intended for ACUTE care only. Acute being defined as going to emergency room or urgent care, getting fixed up, and returning home to heal or get better.
Home health care includes a wide range of health and social services delivered in your home to treat illness or injury. Medicare covers your home health care if:
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You are homebound, meaning it is extremely difficult for you to leave your home and you need help doing so. The homebound requirement can be met in additional ways during the coronavirus public health emergency (Click "coronavirus" link. Great article for more information). You can be considered homebound if your physician certifies that you cannot leave your home because you are at risk of medical complications if you go outside, or if you have a suspected or confirmed case of COVID-19.
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You need skilled nursing services and/or skilled therapy care on an intermittent basis. Intermittent means you need care at least once every 60 days and at most once a day for up to three weeks. This period can be longer if you need more care, but your care needs must be predictable and finite. Medicare defines skilled care as care that must be performed by a skilled professional, or under their supervision. Skilled therapy services refer to physical, speech, and occupational therapy. You cannot qualify for Medicare home health coverage if you only need occupational therapy. However, if you qualify for home health care on another basis, you can also get occupational therapy. When your other home health needs end, you can continue receiving Medicare-covered occupational therapy under the home health benefit if you need it.
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You have a face-to-face meeting with a doctor within the 90 days before you start home health care, or the 30 days after the first day you receive care. This can be an office visit, hospital visit, or in certain circumstances a face-to-face visit facilitated by technology (such as video conferencing).
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Your doctor signs a home health certification confirming that you are homebound and need intermittent skilled care. The certification must also state that your doctor has approved a plan of care for you and that the face-to-face meeting requirement was met. Your doctor should review and certify your home health plan every 60 days. A face-to-face meeting is not required for recertification.
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And, you receive care from a Medicare-certified home health agency (HHA).
Medicare should pay for these services regardless of whether your condition Is temporary or chronic.
If you meet all the requirements, Medicare should pay for skilled care in your home and/or home health aide services.
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How Much Sugar is To Much? |
I always try to reach for the natural sugars, for my oatmeal or coffee, like honey - yum! But, you would be surprised where sugar hides! Did you know there is a difference between added sugars and natural sugars?
“Beverages like soda, juice, and sports drinks make up the largest percentage of the added sugar we consume.”
Here are some tips to trade out sugar for better options and still be happy:
- Rather than top your oatmeal with brown sugar, mix in sliced dates, ripe banana slices, or stewed apples.
- Instead of eating super sugary cereal, add fresh fruit to low-sugar, multi-grain cereal.
- Buy plain low-fat or nonfat yogurt and blend in frozen mixed berries to avoid added sugars typically present in flavored and fruit-on-the-bottom yogurts.
- For a healthier PB&J sandwich, use multi-grain bread and swap out jelly or jam for sliced fresh strawberries.
- Cut sugar in half when baking homemade treats like blueberry muffins or a fresh peach cobbler. They’ll still be plenty sweet, and you may not notice much of a difference.
- Use spices like cinnamon, nutmeg, ginger, fennel, and allspice to add sweetness to food instead of honey or refined white sugar.
I loved the PB&J sandwich idea (above). I had to text this one to my daughter who likes her peanut butter!
Here is the full article:
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* This article is for information purposes only. I don’t recommend, support, or diagnose any featured writer or article. I am not a doctor. Your health is one of a kind. What works for one person may not for another, so the information in these articles should not take the place of an expert opinion. Before making significant lifestyle or diet changes, please consult your primary care physician or nutritionist. You and your doctor will know your own health best. |
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