Medicare Guidelines for Home Care Social Work

In 1965, the federal government enacted the Medicare program. It was created as a health insurance program for people 65 years old or older. Medicare Part B helps pay costs for medication and outpatient services, including home care social work.

Definition

• Home care social workers connect patients with community-based programs.

  Medicare defines the role of a home social worker as a person who "under the direction of a doctor helps you with social and emotional concerns related to your illness." Their role also includes linking patients and family with community support services.

Guidelines

• Home social workers help patients adjust to life changes resulting from illness.

  The agency administering home social services must be Medicare approved to be covered. Patients must also have a diagnosis that meets Medicare criteria for approval of specific home health care services.

Credentials

• Home care social workers must have the proper credentials for reimbursement.

  The social worker providing home services must have the required state license, education and certification in order to be eligible for Medicare reimbursement.

Considerations

• Social work assessment skills help determine the end point for home treatment.

  Medicare pays for a percentage of home health care costs; ask your agency about your out-of-pocket costs. Under Medicare guidelines, the home health care team continues to do evaluations on patient progress. When the patient stabilizes, the social worker and other home care staff must terminate services.