Does Medicare Pay for This?

Does Medicare pay for this?  Well, the moment we all have been waiting for… CMS (The Center for Medicare and Medicaid) announced this past month that starting in 2019 – MEDICARE WILL INDEED START PAYING FOR IN-HOME CARE SERVICES!

Beginning in 2019, Medicare Advantage Plans will start offering non-skilled Home Care as a supplemental benefit to their policies! What an amazing change to the Medicare system, that previously would only provide rehabilitation and skilled services.

“CMS is expanding the definition of ‘primarily health related,’” the agency stated in its announcement. “Under the new definition, the agency will allow supplemental benefits, if they compensate for physical impairments, diminish the impact of injuries or health conditions, and/or reduce avoidable emergency room utilization.”

With an ever growing and aging population, this is a welcome change to prepare for the future of our seniors. Although we don’t know the specifics of what will be covered, how much care and how the program will work, any increase in services in this area will be a benefit to providing preventive care to our older adults, as a solution to keeping them in their homes and out of hospitals.

“What Humana, UnitedHealthcare, and Aetna have been saying for several years is that we’ve had a great relationship for skilled home health and hospice for quite a while,” Keith Myers, CEO of LHC Group (Nasdaq: LHCG), told HHCN. “In the last few years, they’re starting to focus more on a dual-eligible population and have needed us to have a bigger commitment in personal services.”

Home based care is the wave of the future. Telehealth, Home Health, Home Care and many other programs are being set up for bringing care back to the home where care belongs and out of hospitals.  For the past 30 years, we have seen a drastic decrease in length of hospital stays, and in the nature of patients, in acute care hospitals and in nursing homes.  More out patient services, shorter stays and more rehabilitative services are being offered.  Home is truly the wave of the future.  Who would have thought that “house calls” would come back?  But then again, skinny ties just keep coming back too.

Stay tuned.  We will update you as we know more from CMS as the year progresses!


Source: CMS Officially Adds Non-Skilled In-Home Care as Medicare Advantage Benefit