According to AARP, almost 90% of seniors express the desire to remain at home. Many feel they will be more comfortable there than moving into support care facilities. Not only do they prefer it but, in many cases it is cheaper on the individual as well as government programs to do so. In what may be a response to that, Medicare is implementing number of changes to better support the aging in place scenario.
Historically, Medicare has not covered or reimbursed for custodial care, meaning services provided by a nurse’s aide including assistance with activities of daily living. In most instances this kind of care would only be covered as a part of a temporary, skilled home health program with a physicians’ order, and not as a long term service. While this is helpful for those situations when someone is recovering from illness or injury, most seniors will eventually need day this type of care ongoing in order to age in place successfully (70 % according to the US Department of Health and Human Services).
So what type of services are now going to be covered? Well, under many Medicare Advantage plans benefits will now be offered to cover services such as transportation, home safety devices such as grab bars and wheelchair ramps, telehealth programs, and even home delivered meals. Medicare Advantage plans also will have the option to pay for assistance from home health aides, who can help beneficiaries with their daily activities including dressing, eating and care with hygiene. These benefits represent a revised and broader definition of the traditional requirement that Medicare services must be primarily health related.
Because these services are being covered under Medicare Advantage plans and not traditional Part A Medicare, some Medicare beneficiaries may want to try out a Medicare Advantage plan to see if it works out better for them. Fortunately, new regulations will let people try an Advantage plan for up to three months (a sort of “test run”) and if they aren’t satisfied, they can switch to another Medicare Advantage plan or choose to enroll in original Medicare. Congress required this flexibility in the 21st Century Cures Act in 2016, designed to accelerate innovation in health care.
More information on the upcoming changes to Medicare can be found on the AARP website.
About the Author: Pam Reynolds, CMC is the President and co-owner of Allegiance Aging Care Services. Pam has spent almost fifteen years working in senior care including long term care facilities and home health care. Her higher education is in Social Work, and she has been credentialed as both a certified Geriatric Care Manager and Licensed Assisted Living Administrator. Read more about Pam and her team of Aging Care Professionals here.