• The days of needing help to fasten a corset are over, but many elderly need assistance in daily dressing.helping the bride image by Paul Retherford from Fotolia.com
  
  Medicare's Adult Home Care rules make it possible for eligible seniors to live in their choice of residence rather than moving into a nursing facility. Acceptance depends on the type of services the individual needs, as well as the duration of those services. Most patients heal faster in a home environment than in a hospital setting, where they can be exposed to infections. The rules provide a win-win situation for the patient, the family, the Medicare program and the supplemental insurance companies.
  
  

Eligibility Rules

• Infrequent trips for medical or religious purposes are allowed under the "homebound" rules.handicap image by silonos from Fotolia.com
  
  The patient must be under the care of a doctor who has written up a specific program relating to the patient's need, treatment and prognosis. This plan must undergo review and approval on a regular basis---usually monthly. The agency giving the care must be Medicare-certified.
  
  The patient must be homebound---defined as needing the help of a wheelchair, walker, or other person to go outside. The patient can use transportation provided by any of the Special Service Transports (SST) in many communities. Infrequent trips for medical appointments or religious services are permitted. The individual can attend adult day care, but the home health-care services must occur where the patient lives.
  
  

Skilled Nursing Rules

• Under the rules, an RN or LPN will give injections and train a patient's companion to take over when home care ends.nurse hand with syringe doing injection image by fotosergio from Fotolia.com
  
  Medicare covers "intermittent skilled nursing care" for any period less than "full-time skilled nursing care," defined as seven days a week, at least eight hours each day and covering a minimum of 21 days.
  
  In exceptional cases, Medicare may extend coverage for a longer period if the doctor is able to declare when the patient will no longer benefit from home care.
  
  The individual must receive care from a registered nurse (RN) employed by the certified agency or a licensed practical nurse (LPN) under regular supervision of the RN.
  
  This team is responsible for teaching family members or other caregivers how to treat the patient once Medicare's help ends. This responsibility includes nursing duties from dispensing prescription drugs and changing bandages to managing IVs, feeding tubes and giving shots.
  
  

Covered Therapy Rules

• A wheelchair-bound cook must learn to avoid scalding from spilled pots or reaching across hot burners.cooking image by feferoni from Fotolia.com
  
  Medicare covers speech-language pathology services when a patient needs help regaining the ability for vocal communication. This loss can have resulted from an operation or stroke.
  
  The program covers occupational therapy when a patient needs to learn shortcuts or safe methods to carry on regular home jobs, such as cooking, bathing or managing stairs.
  
  In all therapy, the patient's doctor receives regular reports and must determine whether the therapy is showing advancement. If the doctor sees a possibility of further progress, she will continue the orders; otherwise, the home health care will cease.
  
  

Cost Disclosure Rules

• Under Medicare rules, the agency must inform patients of any costs they will have to cover before care begins.Piggy bank with dollar bills and coins image by George Dolgikh from Fotolia.com
  
  Medicare does not cover adult homemaker services such as preparing meals, bathing, cleaning or marketing unless these services relate to the total care plan.
  
  Medicare-certified home health agencies are required to reveal each patient's costs before the program begins; Medicare covers 80 percent of approved costs. The balance is the responsibility of the patient who will use Medigap insurance, Medicaid or savings to cover the bills.