Everything to Know About Wellcare Home Care

As a leading healthcare service provider, Wellcare stands out as a valuable service for those needing medical care in the comfort of their own homes. In this comprehensive guide, we will explore everything you need to know about Wellcare home care services, from the benefits offered to eligibility criteria, benefits, and how to access these services.

What Are Home Care Services?

Home care services are designed to provide medical and personal care to individuals in their own homes.^[1] These services are particularly beneficial for those who are aging, recovering from medical procedures, dealing with chronic illnesses, or have mobility or cognitive impairments. Different types of home care services include:

• Doctor/nursing care
• Physical and occupational therapy
• Medical social services
• Home health aides
• Basic assistance care
• Home-delivered meals

The primary purpose of home care is to allow individuals to receive the necessary care in the comfort and familiarity of their home environment, promoting healing, independence, and a better quality of life. Home care can range from skilled nursing and therapy services to assistance with daily activities and personal care.

Does Wellcare Offer In-Home Care Services?

Yes, with the help of its network providers, Wellcare offers home care services through its Medicare Advantage plans.^[2] These plans can cover a variety of home health care services, including, nursing care, home health aides, therapists, and social services.

Additionally, some Wellcare Medicare Advantage plans may also cover home-delivered meals, home delivery of medications, fitness and wellness programs, a 24-hour nurse hotline, telehealth services, personal emergency medical response devices, a Wellcare utility flex card, and even a robotic companion.

DSNP Health Home Service Program

The Dual Eligible Special Needs Plan (DSNP) Health Home Service Program is a set of services offered by Wellcare to its members who meet certain eligibility criteria.^[3] This program is designed to cater to individuals who are part of the Medicaid Health Home Program, have both Medicaid and Medicare, and either have a serious chronic condition or are at risk for one. 

The DNSP is tailored for those with significant health issues that typically require coordination from multiple service providers. Key features of the DSNP Health Home Service Program include:

1. Comprehensive Care Management: This involves a holistic approach to managing a patient's healthcare needs, ensuring that all aspects of their health are addressed.
2. Care Coordination and Health Promotion: The program aims to coordinate various healthcare services the patient requires and promote overall health and wellness.
3. Transition Planning: This aspect helps in planning and facilitating transitions, for instance, from a hospital to a home setting, ensuring continuity of care.
4. Individual and Family Support: The program offers support not just to the individuals but also to their families, recognizing the crucial role families play in healthcare.
5. Referrals to Community and Social Support Services: It includes guiding patients to relevant community resources and social services that can aid in their health and wellbeing.

Types of Wellcare Home Care Services

Wellcare's in-home care services, particularly under its Medicare Advantage plans, encompass a wide range of healthcare and support services tailored to meet individual needs within the comfort of a patient's home. These services include:

1. Skilled Nursing Care: This encompasses a variety of nursing services performed by licensed nurses. It can include wound care, administering injections and IV drugs, tube feedings, medication management, and other medical treatments.
2. Home Health Aide Services: These services provide support for activities of daily living such as bathing, dressing, and personal care. Home health aides can also assist with transferring, turning, positioning, incontinence care, and mobility assistance.
3. Therapies: Disability home care covers various therapies when they are medically necessary and provided at home. This includes:
   • Physical Therapy: For restoring movement and strength.
   • Occupational Therapy: Aimed at improving the ability to perform daily activities.
   • Speech Therapy: To help with speech and language skills, cognitive skills, and swallowing.

4. Social Services: Medical social work services include counseling, assistance with finding community resources, coordination of services, and help with insurance claims and long-term care planning.
5. Diet Recommendations and Tube Feeding: Assistance with nutritional needs, including diet recommendations and support for tube feeding.
6. Pain Management: Services focused on managing and alleviating pain.
7. Cognitive/Cognition Assessments & Exercises: Evaluations and exercises designed to support cognitive health.
8. Additional Covered Services: Depending on the specific Wellcare Medicare Advantage plan, additional services might include home-delivered meals, medication delivery, telehealth services, 24-hour nurse hotline, and access to fitness programs.
9. Specialized Programs: Wellcare also offers specialized programs such as post-operative care for orthopedic patients, including care following various types of joint replacements and other orthopedic surgeries.
10. Support for Long-term Needs: In-home care is not only for short-term recovery but also supports patients with long-term needs, including those with chronic conditions or disabilities.

These services are designed to promote recovery, maintain independence, and enhance the quality of life for individuals in the comfort of their own homes.