Here Is What’s Covered Under Medicare When You’re Hurt
Some meanings elude you until you are actually dealing with them. One of these is the difference between occupational therapy (referred to commonly as OT), physical therapy (known as PT) and home health care. Readers who have been following my columns lately would know that a recent personal experience gave me direct contact and interest in the subject.
One of the reasons it makes a difference is that Medicare guidelines can be very specific as to what is covered and when. When you leave a hospital for home the orders need to specify what you receive, under what circumstances (such as homebound). You also need to define for yourself what you want and what you need. More of this following. I always wondered what OT meant considering that recipients of occupational therapy often may be retired or homemakers or disabled such that they cannot work outside the home.
Here are some things you and your family need to know if you are rehabbing at home after hospitalization. I am, by the way, back in the office now.
• Homebound
If you are rehabbing under Medicare at home after hospitalization, you need to be considered homebound. Homebound is not absolute and should not be an intimidating factor for you.
Next, you need to know what to expect from different visitors.
• Skilled Nursing
If your orders include home visits by neighborhood nurses, then you can expect to have your vital signs taken such as blood pressure, heart and so on. Where appropriate, you may receive instructions on diet and medication and they may check on wound care or give injections. They do not venture outside of the medical area.
• Occupational Therapy
There appears to be some overlap between OT and home health aides. OT is intended to get you to do things on your own. Home health aides help you to do certain things. For activities like showering you may have both OT and home health. For some only one or the other can help. It is important to know what you want to be able to do since time is limited – generally 45 minutes or an hour.
I wanted to know how to write since the injury severely affected my right hand and fingers. Without writing and typing, I was unable to communicate except by phone, to draft correspondence or pleadings, or to access my computer to check emails and conduct business.
I asked specifically for this help and the occupational therapist gave me ideas using exercise and a heating pad. If there is anything you need to be able to do you should check with the occupational therapist and see whether it is within their guidelines.
• Home Health
I learned that home health can help with showers but cannot help fold laundry. OT can assist in teaching how to do laundry singlehanded. Home health assists with personal care.
You should make your list or have someone make it for you and ask what the individuals coming to your home can and cannot do under the guidelines so you are prepared to make the best use of your and their time.
About the Author Janet Colliton
Esquire, Colliton Law Associates, P.C. Janet Colliton has practiced law for over 38 years, 37 of them in Chester County, Pennsylvania, a suburb of Philadelphia. Her practice, Colliton Law Associates, PC, is limited to elder law, Medicaid, including advice, applications and appeals, and other benefits planning including Veterans benefits, life care and special needs planning, guardianships, retirement, and estate planning and administration.