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Question: My sister was complaining of a painful swollen calf, so we took her to the Emergency Room at the hospital. After a number of tests, she was diagnosed with deep vein thrombosis. They gave her some treatment to start addressing the swelling etc. and said she did not have to be admitted to the hospital. But now they tell me she is going to need daily injections, blood level monitoring and other testing. I can help her with things like groceries, but I have no medical background and I have no way to transport her to the hospital every day for these treatments. Am I going to have to admit her to the hospital? What are my options?

Answer: We are sorry to hear about your sister’s condition and the quickest response is, no you will not have to hospitalize her and yes, there are options. Starting on October 1, the Home Medical Services benefit will be available for insured patients. This new benefit will allow patients to be covered for defined medical procedures provided by professional skilled nurses in a home setting. These services will be covered as Standard Hospital Benefit (SHB) and will therefore be part of every insurance policy in Bermuda without co-pays. It includes things like IV therapy and wound care. Home Medical Services, however, do not include services that can be done by a non-medical person, such as meal preparation, personal care and home maker services. This benefit is being introduced to help patients and families just like yours, who need assistance with medical care at home for things like your sister’s injections, blood level monitoring and testing. To help further understand the benefit and how you might be able to use it, we have provided some FAQ’s below:

Question: Who is eligible for the service?

Answer: The Home Medical Services (HMS) coverage will be available to insured patients who have been referred by a physician to a BHeC- Approved HMS Agency. The service must be delivered by a registered nurse, needed for four hours or less of part-time intermittent care in any 24 hour period, required for 60 days or less and be listed on the BHeC Home Medical Services Fee Schedule. The fee schedule will be available on October 1 at: www.bhec.bm/for-professionals/fee-schedules/

Question: How do I find a BHeC-Approved HMS Agency?

Answer: All BHeC-Approved HMS Agencies are listed on the HMS fee schedule and your physician will also be able to assist in providing the names of the agencies when referring their patients.

Question: How do we pay for the services provided as part of HMS?

Answer: The HMS benefit is covered under your Standard Hospital Benefit (SHB), which is part of every insurance policy in Bermuda. An insured patient will not be billed for medical care they receive as part of HMS — co-pays or the service fee. The HMS Agency must submit their claims directly to the patient’s insurer.

Question: What services are covered under HMS?

Answer: There are a number of services included under the HMS benefit. A few of these include: IV antibiotic therapy, pain management, wound care, catheter changes, infusion therapy, nutrition therapy (TPN and tube feedings) and patient education and training. However, for a complete list of medical services available as HMS please refer to the Fee Schedule on BHeC’s website.

Question: What is not included in the HMS benefit?

Answer: The HMS coverage excludes home care services that can be performed by non-medical persons such as: home support services for daily living, meal preparation, personal care (bathing, grooming) and home maker services (housekeeping, shopping). On 1st October, for a full list of approved agencies, services and procedures, visit the Home Medical Services Fee Schedule at: www.bhec.bm/for-professionals/fee-schedules/

Answers supplied by Jennifer Attride-Stirling, CEO of the Bermuda Health Council

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