Why We Don’t Take Medicare

A question we get quite frequently here at Angels on Call Homecare is “do you take Medicare?” with the follow-up question of “why not?” in response to the answer of no. There are some misconceptions about what us choosing to opt-out of Medicare means for the patients and families we care for, so today, we’d like to take a moment to address this decision and how it actually benefits our patients, their family, and our staff.

First, a little background information about Medicare coverage and home health care.

Medicare covers a portion of home health care services for those who require skilled services — recovery, part-time or intermittent skilled nursing care, occupational therapy, physical therapy, speech therapy, social services, and a portion of medical supplies and durable medical equipment (DME) — which is just a small portion of what we offer our clients. For these therapies, however, patients do not qualify for a therapy service unless they qualify for skilled nursing and a therapy (or therapies) are an additional benefit. For instance, under Medicare coverage, you would not qualify to have in-home occupational therapy by itself. You would have to qualify for intermittent skilled nursing with occupational therapy. Medicare does not cover live-in home care, meals at home, homemaker or companion care services, or personal care services. For more information about what Medicare does and does not cover in regards to home healthcare services, visit the Medicare site online today.

At Angels on Call Homecare, we offer a wide variety of in-home care services that are not covered under Medicare including:

  • Companion care
  • Live-in care
  • Meal preparation
  • Housekeeping
  • Personal care
  • Transportation services
  • Private duty nursing
  • Hospice care

How Opting-Out Benefits Angels on Call Homecare Clients

We can pass the savings on to you.

Because Medicare only covers a portion of your care, when Medicare is used as an insurance for care, and because Medicare negotiates for a reduced payment, when any healthcare agency accepts Medicare, they find themselves losing money and are unable to keep up with conducting efficient business, and therefore pass the cost on to other services and patients. To avoid this increased overhead cost and keep all of our care affordable, we opt out of accepting Medicare.

Better patient care.

Medicare has very rigid rules that limit the care of patients to strictly what is medically necessary, without the inclusion of the human aspect of life. For instance, while Medicare does cover occupational therapy that will help a stroke victim rehabilitate their own hygiene capabilities over time, it does not cover personal care in the meantime. What this means is that if we followed Medicare guidelines, our occupational therapists could show you how to brush your teeth with limited movement in your dominant hand, our home health aides would not be able to perform oral hygiene while you are in recovery. Opting out allows our care providers to administer a full range of care to our clients, including personal care and those services that are aimed at comfort rather than medical recovery.

Another way that opting-out of Medicare allows our care providers to provide better care is a reduction in paperwork. Medicare requires nearly a half-hour of charting and forms to be filled out for every hour of care provided and then requires filing and submission of this paperwork. This requires care providers to limit the time of hands-on attentive care to fill and file the required documents, significantly impacting the quality of care administered. By keeping documentation simple, our care providers can spend much more time with you or your loved one.

As we mentioned earlier, Medicare only covers a portion of the cost, which means to compensate for these losses, care providers must spread their time and attention to more clients. For instance, where clients who cover the cost of business can have a devoted caretaker, when care is rendered for only a portion, more clients must be seen in the same amount of time for the care provider to break even, splitting time, attention, and quality care among more clients, taking away from all of them.

Affordable Care at Angels on Call Homecare

If you are looking for comprehensive, affordable home health care that includes everything you or your loved one needs to live a safe and productive life from the comfort of your own home, contact us. Our in-home care providers offer a wide range of services to clients in Putnam, Westchester, Bronx, Dutchess, Orange, Rockland, Ulster, and Sullivan Counties. If you are interested in skilled nursing, home health aides, companion care, memory care, in-home rehab, respite care, private nursing care, or hospice care visit us online for more information or contact us to enroll in our services.

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