Page 148 - Business Development Orientation Binder

4/9/2019

Medicare vs Medicaid Home Care Eligibility

MEDICARE MEDICAID

1. Requires the patient to be 1. Patient does NOT need to be
homebound homebound

2. Requires the patient to 2. Requires the patient to have a
have a need for intermittent, medical need for the services
skilled (RN, PT and/or SLP) ordered (the services DO NOT
services. have to be skilled).

Patients with United Health Care, Medicaid, and Medicare
insurances all require FFEs.

5

Skilled Needs

Intermittent Skilled Nursing Physical or Occupational
(<7d/wk, <8hrs/day) Therapy and Speech-
Language Pathology
 Teaching and Training
 Observation and Assessment  Teaching and Training
 Psychiatric Nurse Evaluation &  Observation and Assessment
Therapy  Restoration of Function Due
 Disease management to Illness or Injury
 Administration of Certain  Gait training
Medications  Safety assessment
 Tube Feedings  Home exercise program
 Wound, Catheter & Ostomy Care  Swallowing and speech
 Nasopharyngeal and evaluation
Tracheostomy Aspiration / Care  Fine motor skills assessment
and treatment

6

3