How I Got Home Visits for Physical and Occupational Therapy

Art: Robin Mead

Medicaid, Medicare, and some private insurance will pay for home therapies under the right circumstances. Azalea did some smart research and planning, and was able to arrange for six home visits per week from speech therapists, occupational therapists, and physical therapists. She was kind enough to share everything she learned along the way.

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How Azalea Got Home Therapies

When it became clear that I wasn’t able to cope with all the appointments I needed to keep up with outside of my home, this is everything I did:

🌷 I started by researching local home care agencies, and settled on what seemed like the best option. I found agencies by using Google, and also by asking my case manager through my Medicaid plan.

🌷 The agency I chose offered everything I needed and might need. This is important because most insurance plans will only allow you to have one home care agency, regardless of whether they offer all the services you need.

🌷 Then I asked my therapists to discharge me with a note saying that the discharge was due to my inability to attend appointments outside of my home. I specifically asked that it used this language and did not state that I had met my therapy goals.

🌷 In researching the program, I discovered that the key piece of qualifying was showing that I’m homebound. That doesn’t have to mean you literally never leave the house. For most home health programs, homebound means:

• “You need the help of another person or medical equipment such as crutches, a walker, or a wheelchair to leave your home, or your doctor believes that your health or illness could get worse if you leave your home”
• “It is difficult for you to leave your home and you typically cannot do so”

🌷 I made sure this was documented both by my previous therapists and by my primary care doctor.

🌷 Next my primary care doctor sent orders to the home health agency.

🌷 Then the agency sent a nurse to do an intake interview. She toured my home, made suggestions for safety modifications (like a shower seat and grab bars).

🌷 The nurse set me up for two appointments each week with physical therapy, occupational therapy, and speech therapy. A total of six appointments. So much fun.

How Did Things Turn Out?

The physical therapist was great.

The speech therapist mostly focused on getting my meds set up in a way that I’d remember to carry out, which was helpful,

The occupational therapist was ridiculously bad. His suggestion for my safety issues in the kitchen was to set up cameras so that my caregiver could watch me while I wore a “Pavlok” watch that he could use to literally shock me if I was about to do something wrong.

We thought he was joking so we said, “Maybe we could put the feed online so anyone could shock me!” The occupational therapist thought this was a great idea and kept asking if I was making progress to figure out how to do it.

Next Steps & Ongoing Plans

While the therapies were going on, I had my caregiver attend as many of these sessions as possible. The intention was for my therapists to set up programs that I could carry out without them there. So, in addition to getting therapy, we also learned how to do the exercises independently.

After a month, I was discharged from their services and, we decided that the best plan would be for me to get a month of speech and physical therapy quarterly. Now I have one month of therapies, followed by two months of carrying out the programs on our own, and so on.

All these services were covered by both my private insurance and by my managed care Medicaid plan.

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Thanks for Reading

🌸 This page is part of the free online guide: How to Be Homebound

🌸 If you live in HUD or Section 8, home therapies can also be part of a request for an additional bedroom: Epic Master List of Disability Accommodation Letters

🌸 Art on this page by Robin Mead and Elizabeth D’Angelo.

🌸 Page Updated: 10/1/19

🌸 To get daily updates on helpful disability services, and low income programs, follow us on Facebook: The Sleepy Girl Guide.

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