Medicare and Continuing Care
Terms to Know
Here is a list of terms relating to continuing care options and Medicare.
This is the way that Original Medicare measures a person's use of hospital and skilled nursing facility (SNF) services. A benefit period begins the day the person goes to a hospital or skilled nursing facility. The benefit period ends when the person hasn't received any inpatient hospital care (or skilled care in a SNF) for 60 days in a row. If the person goes into a hospital or a skilled nursing facility after one benefit period has ended, a new benefit period begins. The person must pay the inpatient hospital deductible for each benefit period.
This is non-skilled, personal care, such as help with activities of daily living like bathing, dressing, eating, getting in and out of a bed or chair, moving around, and using the bathroom. It may also include care that most people do themselves, like using eye drops. In most cases, Medicare doesn't pay for custodial care.
Durable Power of Attorney
This is a legal document that enables someone to name another person, called the attorney-in-fact, to act on their behalf, in the event they become disabled or incapacitated.
(Watch the video to learn more about power-of-attorney and other advance directives. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)
Home Health Agency
This is an organization that gives home care services like skilled nursing care, physical therapy, occupational therapy, speech therapy, and personal care by home health aides.
Home Health Care
This includes limited part-time or intermittent skilled nursing care and home health aide services, physical therapy, occupational therapy, speech-language therapy, medical social services, durable medical equipment (such as wheelchairs, hospital beds, oxygen, and walkers), medical supplies, and other services.
A person who is homebound is normally unable to leave home unassisted. To be homebound means that leaving home takes considerable and taxing effort. A person may leave home for medical treatment or short, infrequent absences for non-medical reasons, such as a trip to the barber or to attend religious service. A need for adult day care doesn't keep someone from getting home health care.
This is a special way of caring for people who are terminally ill. Hospice care involves a team-oriented approach that addresses the medical, physical, social, emotional, and spiritual needs of the patient. Hospice also provides support to the patient's family or caregiver as well. Hospice care is covered under Medicare Part A (hospital insurance).
This is a legal document also known as a medical directive or advance directive. It states a person's wishes regarding life-support or other medical treatment in certain circumstances, usually when death is near.
This includes a variety of services that help people with health or personal needs and activities of daily living over a period of time. Long-term care can be provided at home, in the community, or in various types of facilities, including nursing homes and assisted living facilities. Most long-term care is custodial care. Medicare doesn't pay for this type of care if this is the only kind of care needed.
(Watch the video to learn about the range of long-term care service. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)
This is a facility that primarily provides skilled nursing care and related services for the rehabilitation of injured, disabled, or sick persons. A nursing facility may also, on a regular basis, provide health-related care services above the level of custodial care to individuals who are not mentally retarded.
Nursing homes serve as permanent residences for people who are too frail or sick to live at home because of physical, emotional, or mental problems. Nursing homes provide a wide range of personal care and health services, including helping people with dressing, bathing, and using the bathroom. Nursing home residents usually require daily assistance.
Power of Attorney
A medical power of attorney is a document that lets people appoint someone they trust to make decisions about their medical care. This type of advance directive also may be called a health care proxy, appointment of health care agent, or a durable power of attorney for health care.
Regional Home Health Intermediary
This is a private company that contracts with Medicare to check on the quality of home health care and pay home health and hospice bills.
Rehabilitative services are ordered by the doctor to help with recovery from an illness or injury. These services are given by nurses and physical, occupational, and speech therapists. Examples include physical therapy to help with walking and occupational therapy to provide help getting dressed.
This is temporary or periodic care provided in a nursing home, assisted living facility, or other type of long-term care program so that the usual caregiver can rest or take some time off.
Skilled Nursing Facility
This is a nursing facility that has the staff and equipment to give skilled nursing care and/or skilled rehabilitation services and other related health services.