You may have heard of Medicare Advantage, an “all in one” alternative to the original Medicare program. Medicare Advantage may have a lower monthly premium but can mean more out-of-pocket costs for the senior. It typically has a fixed network of doctors, hospitals, and providers.
Over the last several years, the US Centers for Medicare and Medicaid Services (CMS) amended their policies for Medicare Advantage clients which now allows some payments to non-medical home care agencies.
Under Medicare Advantage, coverage was extended for “primarily health related” needs and for “special supplemental benefits for the chronically ill”, also known as SSBCI.
The “primarily health related” benefits can cover services such as in-home supportive services, support for caregivers, home-based palliative care, adult day care, and therapeutic massage.
SSBCI can include in-home support services, transportation help, nutrition assistance, and other services, all designed to help chronically ill people stay at home and out of the hospital.
But the vital part of Medicare Advantage programs is that the provider must be contracted with CMS; many home care companies including FootPrints are not contracted with CMS, based primarily on the increased workload to submit claims and the reimbursement rate paid.
Many in the field of elder care as well as political representatives advocate for Medicare to also allow payment to in-home care companies to offset the cost of private payment. And while it makes sense to help an elderly person with the activities of daily life, meal preparation, and housekeeping so that he or she can live at home and not in an institutionalized care facility, the Medicare system isn’t there yet.
At FootPrints Home Care, we’re happy to answer your questions about any home care topic for the elderly, and to provide dedicated, trained caregivers to help your family member remain safely at home for as long as possible.