When an aging loved one is discharged from the hospital, Medicare is often a primary provider of payment for home heath services. However, Medicare and Medicare Advantage plans have not typically provided coverage for in home care, and this has left many seniors who want to age in place struggling to find ways to pay for the services they need to remain safe and comfortable at home. For the first time in 2019, we are seeing this change.

Changes Announced by CMS

On April 12, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a final Call Letter announcing an expansion to supplemental services provided under Medicare Advantage plans to include non-skilled home care services. Beginning in 2019, supplemental services benefits were expanded to include non-skilled support. Examples of these services include:

  • Providing seniors with reliable transportation to doctor’s appointments
  • Assisting with shopping and running errands
  • Meal preparation
  • Providing long term support for certain activities of daily living

Supplemental Benefits with Medicare Advantage Plans

The new benefit is enveloped under the supplemental benefits provided by Medicare Advantage plans. The goal of this expansion in supplemental benefits is to offer more flexibility to seniors so that they can make informed healthcare choices. It encourages seniors to make the decisions that are best suited for their individual circumstances as they’re working to maintain and improve health and take a more proactive approach to remain safer, healthier and more comfortable in their homes.

Medicare Advantage Plans and In Home Care

At this time, only 3% of Medicare Advantage plans have chosen to offer in-home support services according to the AARP. About 13% of plans are covering respite care and other services geared toward supporting family caregivers. However, this number should increase by 2020 when more than 40% of plans are expected to offer new supplemental benefits. The pace of when various insurance providers begin to offer supplemental benefits is not expected to be uniform, so seniors in need of these services are encouraged to review their benefits summary statements regularly and contact their Medicare Advantage providers to express their opinions about which supplemental services are most important to them.

Financial Implications

The changes to Medicare Advantage plans will support aging in place. These changes also have the potential to help relieve the financial burdens that families face when planning to meet the care needs of senior loved ones. There are also cost benefits to the Medicare and Medicaid systems in taking this approach, as, based on a Genworth Cost of Care Survey, the average cost for nursing home care in California is $8,000 to $9,000 monthly versus a 2017 national average of $21 per hour for non-skilled in home care. If the supplemental benefits are effective in meeting the care needs of seniors at home, the need for long term institutional care may decrease over time as more seniors begin to feel empowered to safely age in place.

The Role of Home Care Providers

Salus Homecare and other home care companies will also take on a new role in strategizing and working more closely with Medicare Advantage providers. A more coordinated effort will provide opportunities for home care providers to flag concerns and drive more targeted interventions that keep seniors healthier, promote longevity and support aging in place. The Salus Homecare team is committed to working collaboratively with families and healthcare professionals, and many of our locations currently communicate with Medicare and Medicare Advantage providers when meeting our clients home health, palliative care and hospice care needs. We welcome the opportunity to expand on those collaborations to include non-skilled in home care services and further improve the way in which seniors age.

In looking toward the future and considering the needs of our aging population, it’s important to continuously evaluate programs. Part of this evaluation includes searching for cost effective ways to help seniors take control over their health, quality of life and longevity. This new expansion of supplemental services provided by Medicare Advantage plans is a step in the right direction. Salus Homecare is committed to continuing to monitor these changes, provide input and keep our clients informed so you can take full advantage of the services that will benefit your family most.