Medicare expands access to in-home support

WASHINGTON (AP) — In a harbinger of potentially big changes for Medicare, seniors in many states will be able to get additional services like help with chores, safety devices and respite for caregivers next year through private “Medicare Advantage” insurance plans.

The shift reflects a growing recognition that simple help at home can have a meaningful impact on patients’ well-being — and reduce some costs for taxpayers. A couple of hundred dollars to install grab bars in the shower can prevent a fall leading to a broken hip, a life-changing injury.

The newly covered services are similar to what people might need if they required long-term care, said Howard Gleckman, a senior researcher at the nonpartisan Urban Institute think tank. “It begins to break down the wall between long-term care and Medicare, which with very few exceptions, has never paid for long-term care.”

Change is starting slowly. The services will be offered by some Medicare Advantage plans in about 20 states next year, expected to grow over time.

There has to be a health-related reason to qualify, and costs will vary among plans. In some plans, there’s no added cost. But limits do apply. For example, a plan may cover one day per week at an adult day care center.

Nearly 23 million Medicare beneficiaries, or more than 1 in 3, are expected to be covered by a Medicare Advantage plan next year. The private plans generally offer lower out-of-pocket costs in exchange for limits on choice of doctors and hospitals and other restrictions such as prior authorization for services. It’s a growing business for insurers.

Medicare Advantage open enrollment for 2019 ends Dec. 7. But it’s not easy to use Medicare’s online plan finder to search for plans with expanded benefits, so beneficiaries and their families will have to rely on promotional materials.

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