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If you don?t get the benefit of group medical insurance from your employer, or the insurance offered is extremely limited, you can select an individual policy and can get fee-for-service, Health Maintenance Organization (HMO), or PPO protection. But you should keep in mind that individual plans may not offer benefits as broad as those in-group plans. If you?ve a non-cancelable policy, you can keep it as long as you keep paying the monthly premium. The insurance provider can raise the cost, but can?t cancel your policy. Before picking a medical insurance policy, be confirmed what it will pay for and what it won?t. To know about individual medical insurance plans, you can call insurance corporations, HMOs, and PPOs in your community, or consult an agent.

In North Carolina, high quality health care is available all across the state. But it comes at a price, as physician visits, laboratory work and hospital stays are expensive. Individual medical insurance can solve this problem providing a financial life belt to needy individuals so that they can pay their medical bills.

Apart from medical care, individual medical insurance plans also cover some related types of insurance, especially when you are single: individual health care, individual long and short term disability, temporary medical insurance, long term care and dental insurance. These plans can help you in different situations when you badly need them.

Individual medical insurance gives you a sense of security and peace of mind. If you?ve a health care policy, you can sleep in peace with the knowledge that if something unfortunate happens, you won?t need to worry about financial help.

In North Carolina, a lot of licensed medical insurance corporations offer a wide variety of insurance policies for individuals and you can find one designed to meet your needs and budget. The plans are affordable because you select your coverage options from a menu.

The price of your health care policy depends on a number of factors, but it?s you who are in control of the premium by your choice of coverage options, deductibles and co-pays.

I hope you all had a wonderful Thanksgiving. Now that that’s over, Congress is back in session, and the Senate is tackling the health care reform issue.

One of the things that is being discussed in reforming our health insurance system is allowing people to buy insurance plans from other states where they might be able to find less expensive plans. I’m not sure how this is supposed to work, and here’s why.

One reason the cost of plans is lower in some states than is others is the number of mandated services a health plan is required to cover. The more a plan is required to cover, the higher the cost of coverage. For example, California has 56 required services that each plan must cover.? By contrast, Idaho has 13 state mandates. We aren’t at the top of the list by any means; Virginia has 60 mandates and Maryland has 66. Want to check out what kinds of things are mandated, click here.

Another area that needs to be addressed is how physicians and others are paid. HMO plans in California tend to be more expensive than PPO plans in the individual market, but you have lower out of pocket costs when obtaining care on an HMO plan. (The opposite is usually true in group health insurance.) The reason this can be is through very specific networks of contracted doctors. Most people know that you don’t have coverage if you go outside the HMO network unless it’s an emergency. So maybe you just don’t offer HMOs between states.? But PPOs have networks too. If you see a contracted doctor you are covered at a higher level than non-contracted doctors. So if you are in California and buy a plan from Kansas, would you always be covered at the lower reimbursement rates?? Larger carriers like United Healthcare and Aetna have networks in most states, but what about the smaller, regional carriers without networks in other states? How would that work?

Another aspect of provider payment that affects premiums is how much providers are paid. Care in some states is less expensive than others, so how do you pay providers in the ‘expensive’ states versus the less expensive, and what will that do to the cost of insurance in those states where lower costs of care are factored into the cost of insurance? You could still end up with the problem of some people being ‘under insured’ depending on how reimbursement is worked out.

So be careful what you ask for, you may gt it. The more you want covered in a plan, the more it’s going to cost. Just remember the old marketing adage, if it sounds too good to be true, it usually is.

Republican governors are not alone in being concerned about what the proposed health care legislation might mean for their already overstrained budgets: Democrats share the same worries.???????? ?We?ve got concerns,? Gov. Jack Markell of Delaware said in an interview Wednesday, hours before getting elected as the chairman of the Democratic Governors Association. ?And we?re doing our best to communicate them. We understand the need to get something done, and we?re supportive of getting something done. But we want to make sure it?s done in a way that state budgets are not negatively impacted.?

From the start, Republican governors have been more outspokenly critical about the health care legislation ? in particular, the bill proposed by Harry Reid of Nevada, the Senate majority leader ? which they said would saddle them with millions of dollars in additional Medicaid costs as insurance coverage is expanded. At their own meeting two weeks ago in Texas, Republican governors declared Democrats felt the same way as they did, but were less apt to say it out of loyalty to President Obama.

Asked about that, Mr. Markell responded: ?Perhaps we?ve expressed some of our concerns less publicly. But I believe all governors are certainly concerned about what the potential impact is of some of these bills.?

Mr. Markell said that there was no division between governors and the administration on the need to get some sort of health care bill through; he said that he was reminded of the need in conversations with small businesses struggling with health care costs and constituents who have been unable to get health care coverage. He said his concern was some of the bills being considered would do that by shifting some of the costs to the state ? but said he remained confident, after conversations with the White House, that would not be the case.

Whatever the outcome of the health care deliberations, Mr. Markell said he did not believe it would affect the electoral outcome for governors in 2010, a year in which 19 gubernatorial seats currently held by Democrats are on the ballot. The key issues, the governor said, were jobs and the economy.

And to that regard, Mr. Markell said that he was hopeful that the White House and Congress would dispose of the health care deliberations and move on to discussing some sort of jobs creation legislation.

?Right now I believe we need to be focused really significantly on the state level on jobs and on the economic climate overall,? he said. Asked if Mr. Markell thought Mr. Obama and Congress were spending too much time on health care at the expense of the economy, he responded: ?Well I feel it would be terrific if they could finish health care and move on.?

????? What is Home Health?

Home Health Care is skilled nursing care and certain other health care services that you receive in your home for the treatment of an illness or injury. This could also include physical, occupational, and speech therapy. Medicare Part A will cover home health expenses at 100%. Private duty home care is not covered by Medicare and is paid for by the individual receiving the service. This type of service usually includes housekeeping and other routine personal care services (cooking, laundry, and shopping, and live in care givers.).
This could also include physical, occupational, and speech therapy. Medicare Part A will cover home health expenses at 100%. Private duty home care is not covered by Medicare and is paid for by the individual receiving the service. This type of service usually includes housekeeping and other routine personal care services (cooking, laundry, and shopping, and live in care givers.).??

***FREE OF CHARGE***if Medicare approved

Call or email now to see if you are Medicare/Medicaid Qualified
If you or someone you know needs help with
1. Diabetes
2. High Blood Pressure
3. Wound Care
4. Arthritis/Joint Pain
5. Any Chronic Illness or Disease
We Also Provide:
1. Light House Keeping/Laundry Services
2. Senior Transportation
3. Meal Preparation
4. And Much More At No Charge to YOU!!

CLICK?LINK BELOW TO WATCH VIDEO ABOUT HOME CARE ?http://www.tahc.org/associations/1626/files/TAHC new VO.wmv

II. How to get Medicare Home Health Care:?

? Your doctor must determine you need medical care in your home.

?? You will need at least one of the following services: skilled nursing care, physical or speech therapy.?

? You must be homebound. Homebound means that leaving your home is a considerable and taxing effort

III. What qualifies as Skilled Home Care Services?

? Wound Care for pressure ulcers or surgical wounds?

? Physical Therapy (fall prevention, recent fractures, recent stroke, TIA’s, endurance issues, or transfer training)?

? Occupational Therapy (recent strokes, ADL training-such as dressing, grooming, and bathing)

? Speech Therapy (swallowing issues, aspiration, recent stroke, pneumonia)

?? Patient and Caregiver education

? IV Therapy

? Injections (diabetes, B-12)

? Medication Management

IV. Home Health vs. Hospitalization:

? In many cases home health care services may be appropriate to prevent an individual from being hospitalized.

? Most patients and their families prefer to stay at home rather than be placed in the hospital or skilled nursing facility when their condition allows them to remain at home.

? Home health care is usually less expensive and in some cases just as effective as care in a hospital or skilled nursing facility.?

Home health care assists a person in their recovery from an illness, accident, surgery, or change in their medical condition. Professional health care and rehabilitation services are delivered in a person?s home environment under the direction of their personal physician.????????

Services offered include:?????

Skilled Nursing?

24/7 Availability?????

Physical Therapy?

Wound/Ostomy Care???

Occupational Therapy??

Infusion Therapy???

Speech Therapy?

PT/TNR results in home??

Home Care Aides?

Pain Management????

Medical Social Workers?

Rehabilitation?

Who pays for home health care?

If you are Medicare eligible and qualified for care, there is no out of pocket cost to you. Home care can also be paid for by many private insurances or a variety of public programs.

To qualify for Medicare home health services, there are five basic requirements:

1. Your physician must determine that you need home health care services

2. Your own physician must write the orders for home health services, and oversee your care

3. You must need skilled services that are provided by a nurse or therapist

4. Your physician must determine that you are homebound, requiring considerable effort and help to leave home

Because benefits and requirements can vary, we can help you check with payors about your specific benefits, even before beginning services, so you can have this information at the start of care.?

-Medicare pays 100% of the cost for home health care for individuals 65 years of age or over or permanently disabled.

-Private insurance will pay for home health care. Benefits vary per policy and verification of benefits is required.

-Medicaid pays 100%. Pre-authorization is required.

-Workers Compensation Insurance.-Private Pay.

We?can HELP you in a number of ways.??????

???????? Patient specific health data with observations by a professional nurse are reported to the physician.?

?Helping patients and their families to understand and follow physician’s orders regarding nutrition, special diets, medications, and general nursing care:

???????? Assisting with home management of catheters and feeding tubes.

???????Giving injections ordered by the physician and teaching patients and family the proper techniques for doing so.?

??????????Helping patients restore strength and independence through physical therapy exercises,?

Educating diabetic patients on how to manage diet, insulin, and other health related measures.? Enabling the patient with ostomy how to resume a full, active life.

????????? Assisting patients with bathing and personal grooming (ADLS).??

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Q: What is home health care?
A: Home health care is a service that permits patients to receive personalized health care, maintaining their quality of life in the privacy and comfort of their homes.

Q: Why home health care?
A: Home health care is a cost-effective option for receiving health care services. Returning to one?s home and family can quicken recovery and improve the quality of life for both patient and family or caregiver.

Q: Who pays for home health care?
A: Most health insurance companies, HMOs, PPOs and Workers Compensation cover home health care. In addition, Medicare and Medicaid pay for home care services. Some insurance providers do not cover all home health services. Our staff will verify health coverage for the patient.

Q: What criteria are required for Medicare to approve services?
A: The following criteria are used to meet Medicare requirements:
? The patient is a Medicare recipient.
? The patient must be homebound. This is defined by Medicare as ?normal inability to leave the home and that leaving the home requires considerable and taxing effort.?
? The skilled care must be medically necessary as determined by the physician.

Q: What if I have a problem at night or on the weekend?
A: We have registered nurses on call 24 hours a day, 7 days a week.

Q: Do I need a physician?s order for home health care?
A: Yes, all health care provided in the home occurs under direct order and supervision of the patient?s physician.

Q: What types of services can be provided at home?
A: Many medical conditions that previously required hospitalization can safely be treated in the home. Home care services may include but are not limited to:

Skilled Nursing:
? Observation and assessment of condition
? Patient and family education of disease process
? Management and evaluation of patient care plan
? Medication education and management
? Dressing changes
? Home safety education
? Wound care
? Catheter care
? Injections
? IV therapy
? Ostomy care
? Pain management
? Diabetic care
? Nutritional support

Assistance with Daily Living:
? Bathing/dressing
? Transfer/ambulation
? Light meal preparation
? Light housekeeping
? Grocery shopping
? Medication reminder
? Laundry
? Companionship/Conversation
? Reading/writing
? Pet sitting/walking
? Escort to appointments
? Live-ins
? Respite
? Exercise therapy assistance

Q: How does Paloma Home Health Care, Inc. ensure quality care in the home?
A: Providing continuous quality care to patients is paramount to all we do. All patients are given a patient satisfaction survey that is incorporated into our ongoing evaluation process to continually increase our patient satisfaction. New programs and processes are developed through our quality improvement team to promote favorable outcomes.

Q: How do I find out more about home health care?
A: Please call our office to learn more about how you can benefit more about the service, at 972 346 2013

Q: What services can Paloma Home Health Care, Inc. offer?
A: Our services include but are not limited to:
? Supportive Care Education of Disease Process
? Individual and Family Counseling
? Management and Evaluation of Patient Care
? Observation and Assessment
? Home Safety and Emergency Education
? Medication Education
? Assistance with ADLs
? Nutrition Education
? Restorative Therapy (Physical, Occupational and Speech)

Home health care helps seniors live independently for as long as possible, given the limits of their medical condition. It covers a wide range of services and can often delay the need for long-term nursing home care.

More specifically, home health care may include occupational and physical therapy, speech therapy, and even skilled nursing. It may involve helping the elderly with activities of daily living such as bathing, dressing, and eating. Or it may include assistance with cooking, cleaning, other housekeeping jobs, and monitoring one’s daily regimen of prescription and over-the-counter medications.

At this point, it is important to understand the difference between home health care and home care services. Although they sound the same (and home health care may include some home care services), home health care is more medically oriented. While home care typically includes chore and housecleaning services, home health care usually involves helping seniors recover from an illness or injury. That is why the people who provide home health care are often licensed practical nurses, therapists, or home health aides. Most work for home health agencies, hospitals, or public health departments that are licensed by the state.

How Do I Make Sure That Home Health Care Is Quality Care?
As with any important purchase, it is always a good idea to talk with friends, neighbors, and your local area agency on aging to learn more about the home health care agencies in your community.
In looking for a home health care agency, the following 20 questions can be used to help guide your search:

How long has the agency been serving this community? Does the agency have any printed brochures describing the services it offers and how much they cost? If so, get one. Is the agency an approved Medicare provider? Is the quality of care certified by a national accrediting body such as the Joint Commission for the Accreditation of Healthcare Organizations? Does the agency have a current license to practice (if required in the state where you live)? Does the agency offer seniors a ?Patients? Bill of Rights? that describes the rights and responsibilities of both the agency and the senior being cared for? Does the agency write a plan of care for the patient (with input from the patient, his or her doctor and family), and update the plan as necessary? Does the care plan outline the patient?s course of treatment, describing the specific tasks to be performed by each caregiver? How closely do supervisors oversee care to ensure quality? Will agency caregivers keep family members informed about the kind of care their loved one is getting? Are agency staff members available around the clock, seven days a week, if necessary? Does the agency have a nursing supervisor available to provide on-call assistance 24 hours a day? How does the agency ensure patient confidentiality? How are agency caregivers hired and trained? What is the procedure for resolving problems when they occur, and who can I call with questions or complaints? How does the agency handle billing? Is there a sliding fee schedule based on ability to pay, and is financial assistance available to pay for services? Will the agency provide a list of references for its caregivers? Who does the agency call if the home health care worker cannot come when scheduled? What type of employee screening is done?

When purchasing home health care directly from an individual provider (instead of through an agency), it is even more important to screen the person thoroughly. This should include an interview with the home health caregiver to make sure that he or she is qualified for the job. You should request references. Also, prepare for the interview by making a list if any special needs the senior might have. For example, you would want to note whether the elderly patient needs help getting into or out of a wheelchair. Clearly, if this is the case, the home health caregiver must be able to provide that assistance. The screening process will go easier if you have a better idea of what you are looking for first.

Another thing to remember is that it always helps to look ahead, anticipate changing needs, and have a backup plan for special situations. Since every employee occasionally needs time off (or a vacation), it is unrealistic to assume that one home health care worker will always be around to provide care. Seniors or family members who hire home health workers directly may want to consider interviewing a second part-time or on-call person who can be available when the primary caregiver cannot be. Calling an agency for temporary respite care also may help to solve this problem (see the Respite Care fact sheet for more information about these services).

In any event, whether you arrange for home health care through an agency or hire an independent home health care aide on an individual basis, it helps to spend some time preparing for the person who will be doing the work. Ideally, you could spend a day with him or her, before the job formally begins, to discuss what will be involved in the daily routine. If nothing else, tell the home health care provider (both verbally and in writing) the following things that he or she should know about the senior:

Illnesses/injuries, and signs of an emergency medical situation Likes and dislikes Medications, and how and when they should be taken Need for dentures, eyeglasses, canes, walkers, etc. Possible behavior problems and how best to deal with them Problems getting around (in or out of a wheelchair, for example, or trouble walking) Special diets or nutritional needs Therapeutic exercises.

In addition, you should give the home health care provider more information about:

Clothing the senior may need (if/when it gets too hot or too cold) How you can be contacted (and who else should be contacted in an emergency) How to find and use medical supplies and medications When to lock up the apartment/house and where to find the keys Where to find food, cooking utensils, and serving items Where to find cleaning supplies Where to find light bulbs and flash lights, and where the fuse box is located (in case of a power failure) Where to find the washer, dryer, and other household appliances (as well as instructions for how to use them).

A WORD OF CAUTION . . .
Although most states require that home health care agencies perform criminal background checks on their workers and carefully screen job applicants for these positions, the actual regulations will vary depending on where you live. Therefore, before contacting a home health care agency, you may want to call your local area agency on aging or department of public health to learn what laws apply in your state.

HOW CAN I PAY FOR HOME HEALTH CARE?
The cost of home health care varies across states and within states. In addition, costs will fluctuate depending on the type of health care professional required. Home care services can be paid for directly by the patient and his or her family members, or through a variety of public and private sources. Sources for home health care funding include Medicare, Medicaid, the Older Americans Act, the Veterans’ Administration, and private insurance.

Medicare is the largest single payer of home care services. The Medicare program will pay for home health care if all of the following conditions are met:

The patient must be homebound and under a doctor?s care; The patient must need skilled nursing care, or occupational, physical, or speech therapy, on at least an intermittent basis (that is, regularly but not continuously) The services provided must be under a doctor?s supervision and performed as part of a home health care plan written specifically for that patient The patient must be eligible for the Medicare program and the services ordered must be ?medically reasonable and necessary? The home health care agency providing the services must be certified by the Medicare program.

To get help with your Medicare questions, call 1-800-MEDICARE (1-800-633-4227, TTY/TDD: 1-877-486-2048 for the speech and hearing impaired) or look on the Internet at http://www.medicare.gov.

WHERE CAN I LEARN MORE ABOUT HOME HEALTH CARE?
There are several national organizations that can provide additional consumer information about home health care services. These include the following:

The National Association for Home Care, which can be reached at 202-547-7424 or by visiting its website at www.nahc.org. The postal address is: 228 7th St., SE; Washington, DC 20003. The Visiting Nurse Associations of America, which can be reached at 617-737-3200 or by visiting its website at http://www.vnaa.org. The postal addresses are: 99 Summer St., Suite 1700; Boston, MA 02110.

To find out more about home health care programs where you live, you will want to contact your local aging information and assistance provider or area agency on aging (AAA). The Eldercare Locator, a public service of the Administration on Aging (at 1-800-677-1116 or http://www.eldercare.gov ?can help connect you to these agencies.

Case Study

WHEN IS HOME HEALTH CARE APPROPRIATE?
Because it is not always clear to the average person when an ailing senior needs home health care and when he or she needs nursing home care, it is usually best to consult a medical professional for advice. The following case study describes one situation in which home health care proved to be the right choice.
Francis is 84 years old and recently had a stroke. She was hospitalized briefly and then discharged to continue recovering at home. To enable her to return home, her doctor called a home health care agency, and the agency gave Francis a complete home health care plan for six weeks. Since the doctor ordered the home care for Francis, Medicare paid for it.

For the first week after Francis went home, a nurse visited her every day. The nurse met with Francis?s family to discuss her special dietary needs and to arrange for exercise therapy to help Francis regain her strength. Once that was done, the nurse visited Francis twice a week to check on how well she was recovering. The home health care agency also sent a homemaker, a personal care attendant, and a physical therapist to visit Francis several times during the week. The homemaker would do the shopping and cook light meals. The personal care attendant would help Francis bathe, get dressed, and walk. The physical therapist would keep Francis moving and see to it that she got some exercise to aid in her recovery.

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I see a lot of posts on here saying that we have the best health care in the world and the evidence is that people come here from other countries to get care. I agree that we have the best health CARE in the world.
What is being discussed is health care coverage, not health care. That is, the way health care is paid for.
Do you understand the difference?

I have to make a power point about a health care problem for a statistics class and include a frequency table, which means I need actual numbers, not percentages as most statistic information is portrayed. Does anyone know what would be a good health-related topic where I could find actual numbers easily? Or any good websites for health-related data?

Funny thing pain, if you?ve never had a severe pain then the suggestion of taking simple analgesia and resting the affected area all seems quite reasonable. I was reminded of this when I read recently of a doctor?s advice to someone who was suffering from sciatica. Having personally experienced sciatica, it?s a condition I would not recommend to anyone who wishes to walk, sit, laugh, sleep, or to just simply pull up your trousers. It?s a bit like a dentist drilling your teeth without an anaesthetic, but it affects your whole leg. In other words the pain is consuming, exhausting and without respite. Clinical studies do show that in the majority of cases the pain will eventually subside and surgery may not be necessary, but in the meantime the patient has to deal with the pain or deal with the medication required to dull the pain. Remember, pain-killers are not selective to the area affected. They affect the whole of the nervous system and elsewhere so there may be significant side-effects from these medications.

Dealing with severe pain can be a complex issue, but I suggest that you have to treat this sort of pain fairly aggressively as acute severe pain is relatively easier to treat than chronic severe pain. In the early stages of an injury or insult to an area of the body, most of the pathological processes are happening at the site of the injury or insult. Throughout time the brain begins to modulate this pain and so no only do you have the injured area to deal with, but you also have complex neural pathways within the brain to deal with as well. This often means a far more complex management plan and a far more protracted recovery time. Specialists are very skilled at dealing with these issues but they do rely heavily on the stories their patients give them. That means being honest in answering their questions and not being heroic with a grin and bear it grimace! Often the use of a pain scale is helpful with zero being no pain at all and a 10 being the worse pain you have ever experienced.

Another health issue we commonly down play is influenza. Over the years I have frequently heard people say that they would not have the flu vaccine because either they never get the flu or that they had it last week for a couple of days and then it was all over! Influenza is a serious debilitating disease that will usually last from 10 days to two weeks and often leave you flat on your back exhausted. It?s not a happy 10 days either as patients do not have the energy to read a magazine or even watch a DVD. You will literally feel ancient with every movement being a real challenge and that doesn?t include the aching all over or the fevers and sleepless nights. The influenza virus is also extremely contagious and most people are unaware that if you spread it to someone who is more frail than yourself that you may actually be putting their life at risk.

With the ?flu the big challenge is to vaccinate as many people in the community as possible, including children, those employed and unemployed, the elderly and the infirm, to reduce the chance of an epidemic occurring. Recent research has also showed that vaccinating pregnant women in the last trimester of their pregnancy will help protect their new born infants born during the ?flu season.

Medicine has evolved over the last 40 years, but the change has been fairly slow with doctors by nature being very cautious and conservative people. But we can?t leave the doctors to take all the initiatives. As patients we need to be good listeners in our approach to health by heeding all the great health messages that keep being given to us about vaccinations, smoking, alcohol, exercise and healthy eating. We also need to be good communicators and tell our doctors how we are feeling with conditions such as pain. If the team treating you doesn?t have the best information then it may be that you will not end up getting the best treatment!

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