Due to advancements in nutrition science, medical research, and healthcare technology, people live longer than ever before. But for one reason or another, millions of seniors each year still require assistance to perform essential activities around their homes.

Although many older adults rely on friends and family to provide that care, others must pay for home care professional services out of their pocket. As someone who might eventually need an in-home caregiver, here’s why having a Medicare Advantage plan makes perfect sense.

1. Aging in Place is Cost-Effective

For many seniors and families, aging in place isn’t just about enjoying the safety and creature comforts of home, but it’s also the most financially feasible option. The U.S. Department of Health and Urban Development (HUD) points out that aging in place ultimately saves money, especially for retirees who own their homes outright. 

According to Genworth’s 2020 Cost of Care Survey, non-medical in-home caregiver services cost $4,481 per month on average. Notably, when paired with a monthly mortgage or rent payment, the cost of home care is burdensome for many seniors. In addition to paying out of pocket, some turn to long-term care (LTC) insurance, V.A. benefits, community programs, and other resources to help defer rising home care costs.   

2 Does Original Medicare Pay for Home Care?

Contrary to what you might think, Original Medicare (Part A and Part B) does not pay for non-medical in-home services like custodial care, companion care, meals, transportation, and homemaker services. 

Instead, Medicare Part A only covers “skilled” home healthcare services for a limited amount of time. Those in-home services must be ordered by a doctor and provided by a Medicare-certified medical professional like a registered nurse, physical therapist, occupational therapist, home health aide, speech therapist, or social worker. 

3. How Medicare Advantage Can Help?

Offered by private insurance companies, Medicare Advantage (Part C) plans – by law – must provide the same benefits of Medicare Part A and Part B. In addition, a Medicare Advantage (MA) plan might offer supplemental benefits that fill in some of the coverage gaps, for example, dental care or prescription drug coverage.

In October 2018, the Centers for Medicare and Medicaid Services (CMS) approved new Medicare Advantage guidelines that allowed greater flexibility for enhanced quality of life, including expanded coverage for home care. The purpose of these changes was to allow seniors to continue living at home for as long as possible. 

Depending on the MA plan they choose, seniors may now take advantage of benefits like:

  • Transportation to and from doctor’s appointments
  • Meal delivery services
  • Custodial care services (bathing, personal hygiene, toileting, etc.)
  • Homemaker services 
  • Home health aide services
  • Adult day care
  • Family caregiver support services
  • Professional house cleaning or carpet cleaning services for those with severe asthma or allergies

4. How to Choose a Medicare Advantage Plan?

The first step in obtaining home care coverage is to enroll in a Medicare Advantage (Part C) plan instead of the Original Medicare (Part A and Part B) plans. Unlike Original Medicare, Medicare-approved private health insurance companies administer and manage Medicare Advantage programs.

To qualify for Medicare Advantage, applicants must be eligible for Original Medicare and live within the service area of the plan they choose. A senior’s eligibility for MA depends on what plans are offered in their geographic area by various private health insurance companies. 

In most instances, except for lower-income seniors, enrollees pay the Medicare Part B monthly premium. Depending on the plan they choose, an enrollee may also pay an additional premium.  

More Than a Decade of Senior Home Care Excellence

Finding a home care provider that you can trust isn’t always easy. At New Wave Home Care, we’ve been helping families in Southern California keep aging loved ones safe and comfortable in their own homes for 10+ years now. As a licensed home care provider, we support clients and their families with personalized in-home solutions that include companionship care, personal care, transitional care, respite care, dementia and Alzheimer’s care, and hospice support. 

When you choose New Wave Home Care in Pasadena, you can rest assured that your loved one is getting the specialized care they need from a trusted, friendly caregiver. To learn more now or schedule a FREE in-home assessment for a senior in the greater Los Angeles area, please visit us at www.newwavehomecare.com.