Medicare Advantage Now Paying for Home Care

If you have ever tried to recover from surgery or a serious illness without assistance, you know how hard it can be just to manage your daily chores.

Having a home-care specialist arrive in your home a few times a week can make a tremendous difference in your recovery as well as reduce the stress and depression that can accompany an injury or serious illness.

For those who will be encountering these challenging situations, there’s good news. Many Medicare Advantage (MA) plans recently started paying for home services, also known as “custodial care.” This new benefit can include tasks like light housekeeping, shopping, getting dressed, medication reminders, and meal preparation.

Why the change?

Exploring possible cost savings, the Centers for Medicare and Medicaid (CMS) found that providing home care to sick and injured patients reduced CMS costs by preventing hospital readmissions. Research reported by HealthLeaders found that hospital readmissions declined 25 percent after the addition of home care services.

Since early 2019, CMS added in-home care as a MA benefit, hoping to reduce costs further. Before this change, Medicare covered home health care like skilled nursing, wound care, and similar skilled health services, but less-skilled services like home care were not covered. Patients had to pay these costs out of pocket.

In fact, this change in the law is so broad that MA plans may be able to provide other nonmedical services like respite care for family caregivers. With this important addition to Medicare benefits, MA plan administrators are already employing these strategies to keep their clients at home rather than in the hospital.

Over one-third of those receiving Medicare benefits also purchase an Advantage plan to defray the additional copays and other costs not covered by Medicare. Are you eligible for these benefits, including custodial care? If you currently do not have a Medicare Advantage plan, contact us to discuss the potential advantages of adding or switching supplemental plans.