Nursing, Day Care and Home Services
Adult Day Health Care
Adult Day Health Care is a supervised nursing home-based program. Members receive any of the following medically necessary services:
- Nursing care
- Physical therapy, occupational therapy or speech therapy
- Nutritional counseling
- Therapeutic recreational activities
- Social work counseling
- Dental services
- Personal Care (such as bathing and grooming)
Note: This service is provided as a substitute for in-home personal care and/or when broad rehabilitation services are needed.
Home Health Aid (HHA) or Personal Care Services
Members can get help with medically necessary tasks under the supervision of a registered nurse. This service is to help members with:
- Going to the toilet
- Health-related tasks
Note: This does not include services for safety supervision, personal companionship or housekeeping service.
Home Health Care (For Members Eligible for Institutional Medicaid)
This service includes:
- Nursing services
- Occupational therapy
- Physical therapy
- Speech therapy
All services are provided in a member’s home by the staff of a licensed/certified home care or home health agency.
Nursing Home Care
Members may need short-term nursing home admissions after a hospital stay to promote recovery. Or they may require a long-term stay when the member, and his or her caregivers, physician and WellCare find that it is no longer safe for the member to remain in his or her home.
Note: This may be covered under Medicare. If a member does not have Medicare, we will cover short-term nursing home admission if medically necessary. Long-term stays will be covered when the member has institutional Medicaid.
Private Duty Nursing
Continuous skilled nursing care provided in a member’s home by a licensed registered professional or practical nurse, if medically necessary.
Social Day Care
A supervised community-based program. Physical activity and social interactions are promoted through:
- Socialization with others
- Participation in therapeutic recreational group activities
Members receive personal care services and a group meal. This service is allowed as a substitute for in-home personal care.