Frequently Asked Questions

“How can I benefit from Texas Cardiac Care’s services?”

If you or a family member:

• Have been hospitalized two or more times in the past 12 months
• Have frequent medication changes
• Have more than one chronic disease process
• Have a history of poor medication compliance
• Have a medical necessity for home health care services
• Have received a new diagnosis of heart disease

“Am I eligible to receive Texas Cardiac Care’s services?”

For Medicare home health care benefits, you must meet all of the following conditions:

• Your doctor must decide that you need medical care at home, and make a plan for your care at home
• You must need at least one of the following: intermittent skilled nursing care, physical therapy, speech therapy, or occupational therapy
• The home health agency caring for you must be certified by Medicare
• You must be homebound,* or normally unable to leave home unassisted
  
  *as defined by the current Medicare definition

Eligibility is also based on the amount of services you need.

Medicare covers your home health care services for as long as you are eligible and your doctor says you need these services. Skilled nursing care and home health aide services are only covered on a part time or intermittent basis. Therapy services however, are not required to be part time or intermittent.

“What does part time or ‘intermittent’ skilled nursing care mean?”

Medicare defines part time or intermittent skilled nursing care as needed or given on fewer than seven days each week or less than eight hours each day over a period of 21 days (or less).

“What does "homebound" mean?”

A person is considered to be homebound if the following conditions exist:

He or she:

• Cannot drive
• Leaves home infrequently
• Leaving home requires a great deal of effort

“Is there a limit to how long I can have my nurse, therapist, or aide?”

No. As long as the services are necessary, and eligibility requirements are met, Texas Cardiac Care will provide for your care.

However, this does not mean that TCC will visit your home indefinitely. Our goal is to provide the necessary tools that will give you the ability to manage your condition independently or with family assistance.

“I am not homebound, but I don't understand my medications and forget to take them a lot.”

Your doctor may be able to provide information about the medications prescribed for you.
If forgetting to take your medication(s) results in a medical problem, your doctor can provide a referral for our services.

If there is no medical necessity or you are not homebound, we can see you on a fee-for-service basis until you understand your medications and can take them properly.

“What does ‘poor medication compliance’ mean?”

Poor medication compliance means that an individual does not take their medications as prescribed by their doctor. There are many factors that can contribute to this, including:

• Forgetfulness or confusion
• Poor understanding of medications
• Poor vision
• Frequent changes in medications
• Medications are too expensive
• No transportation to and from the pharmacy
• Dietary, lifestyle, or activity changes

“Does my insurance cover the entire cost of services?”

Yes. As long as the medical necessity and homebound criteria are met, we accept Medicare, other selected insurances, and private pay as payment in full for our services.

 “How will my doctor know how I'm doing?”

At TCC we believe that the communication between all health care professionals is imperative to a patient’s well being. We keep in contact with the referring doctor and the primary care doctor if the referring doctor is a specialist. We update your doctor(s) regularly and follow up with phone calls and faxes to provide condition reports on an as needed basis.