Is someone you love in need of home health care? Don’t let your reluctance to bring up money—a taboo subject in many households—get in the way of your family member getting better. "Although it may be a difficult conversation to have, it’s important to have a plan in place," says Paula Wilson, a Registered Nurse and Clinical Coordinator at VNSNY. What sort of insurance coverage does your family member have, and is it sufficient?

Private health insurance and long-term care policies may cover some services, but your family member may be eligible for government insurance programs such as Medicaid and Medicare.

Medicare is a federally-funded program available to people age 65 and older, those with End Stage Renal Disease, and in some cases to those under age 65 with certain disabilities. Medicare coverage is divided into four categories:

• Part A covers inpatient care, as well as home health care.
• Part B covers doctor visits, outpatient care, some preventative services and home health care.
• Part C refers to Medicare Advantage Plans, which are Medicare-approved health plans that are offered by private insurers. These plans include all Part A and Part B services, and may offer extra coverage such as vision, hearing, dental, or health and wellness programs. For more information about VNSNY's Medicare Advantage Plans, visit 2010.vnschoice.org/medicare-advantage-plans.
• Part D covers prescription drugs.

The billing process is simple. Once your family member's doctor orders services that are covered by Medicare, a VNSNY nurse manager will work with him or her to coordinate your family member's care. Before your home health care services begin, VNSNY will give you a written estimate of the costs, including a breakdown of which services and supplies are covered by Medicare, and the approximate costs of those that aren't. You won't need to worry about filing claims—VNSNY bills Medicare directly. (You should be aware that Medicare has some limits about the home health care services it covers and eligibility.) 

For more information about Medicare benefits and eligibiilty, call 1-800-MEDICARE or visit www.medicare.gov. For information about how VNSNY works with Medicare, contact VNSNY at 1-800-675-0391, or visit www.vnsny.org/our-services/payment-options/medicare.