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Non-Medical Benefits That May be Covered Under Medicare Part C in 2020

Page Reviewed / Updated - November 28, 2019

Most seniors want to age in place, because there's no place they'd rather spend their twilight years than their current place of residence. Whether this is the home they've lived in their whole lives, a senior or retirement community, or an assisted living facility, if they consider the place their home, that's where three out of four adults aged 50 and over say they want to stay, according to an AARP survey. Liking where they currently live was the leading reason why 85% of seniors want to stay in their current homes, while 66% said it was because they had family and friends nearby and 50% didn't want to deal with moving.

Aging in place is more comfortable and comforting for many older adults who want to maintain their independence for as long as possible. Benefits include staying near family and friends; a strong social network is important to help prevent loneliness and depression. Staying in familiar surroundings with familiar routines maintains a stable environment, which can be especially beneficial for seniors struggling with memory loss. Overall, aging in place can improve a senior's quality of life, extending their physical and mental health.

To successfully age in place, older Americans need nonmedical benefits, such as nonmedical home care and home modifications to ensure their health and safety. Many seniors, especially those on a fixed income, can't afford the cost of these benefits, but Medicare may help. Previously, Medicare didn't cover many of the items a person needs to safely remain at home as they age. However, with new supplemental benefits added in 2019 and the anticipated expansion of nonmedical services and supports in 2020, Medicare Part C may cover many of the services seniors need.

This guide will cover nonmedical benefits offered through Medicare Part C that help seniors live independently longer. It will also cover the benefits first introduced in 2019 that were expanded and added to in 2020, and the importance of these benefits in the lives of seniors wishing to age in place. Information about eligibility requirements for Original Medicare versus Medicare Part C will also be discussed.

How Medicare Part C Coverage Is Changing

Medicare vs. Medicare Part C

Medicare is a federal program that provides health insurance for persons age 65 or older or disabled persons under the prerequisite age. About 2/3, or 66%, of Americans 65 years old and older depend on Medicare. Original Medicare includes:

  • Medicare Part A covers inpatient hospital stays, plus skilled nursing facility care, hospice care for patients with terminal illnesses and some home health care.
  • Medicare Part B covers medical costs, including doctor visits, outpatient care, diagnostic services, medical equipment and non-emergency medical care.
  • An optional Medicare Part D covers prescription drugs, but it must be purchased separately.

Medicare Part C, also called Medicare Advantage, is offered through private insurance companies approved by Medicare. Medicare C is a comprehensive alternative to Original Medicare that covers both Part A and Part B with the optional Part D usually available. Plus, it may cover extra benefits you won't get with traditional Medicare, such as dental, vision, hearing, health club and gym memberships, and a wealth of non-medical benefits that allow seniors to sustain their independence longer.

Changes in 2019

Starting in 2019, the Centers for Medicare & Medicaid Services (CMS) approved new supplemental health care benefits available through Medicare Part C plans that have never been offered before. Some plans may cover:

  • Transportation For Non-Emergency Medical Care
  • Home Modifications
  • Respite Care
  • Adult Day Care
  • Nonmedical Home Care

While home modifications help enhance the safety of the home, nonmedical home care is also important to ensure seniors can maintain their self-sufficiency for as long as possible. Nonmedical home care provides the support a senior needs to continue living in the comfort of their home and includes assisting with Activities of Daily Living, such as bathing, dressing, walking, transferring, eating and using the toilet.

Nonmedical home services also help ensure seniors eat healthy meals, maintain good personal hygiene and don't forget to take their medication or attend doctor's appointments. It really takes the stress off family members because they know their loved one is being cared for properly and benefiting from being able to stay in their own home. Another important aspect of nonmedical home care is the extra care seniors receive often lowers their need for emergency room visits, hospitalization and doctor's office visits, which saves money and increases their health and well-being.

Changes in 2020

Because supplemental health care benefits were new in 2019, they were somewhat limited. However, in 2020, benefits introduced in 2019 are expected to expand and new benefits added to offer a wider array of benefits. Besides all the previous benefits offered, new supplemental health care benefits may include:

  • Meal Delivery
  • Palliative Care
  • Safety Devices
  • Alternative Treatments, such as Therapeutic Massage and Acupuncture

One very important supplemental benefit being expanded in 2020 is home modifications, which include any physical changes to a person's home to accommodate the changing needs of an elderly or disabled person. As a person ages, their physical strength and mobility naturally diminish, making it more difficult to safely perform certain tasks.

Some home modifications that promote a safer environment include shower grips, walk-in tubs, grab bars and rails, stair lifts, traction and non-skid strips, transfer benches and other safety devices designed to prevent falls. Other modifications may ease the challenges of aging, which may include installing:

  • Faucet handle levers in place of knobs
  • Easy to use fixtures
  • Wider doorways and hallways to accommodate mobility devices
  • Wheelchair ramps
  • Climate controls with larger digital displays
  • Push button door openers
  • Lighting for enhanced visibility and security
  • Personal emergency response systems

Nearly any modification that makes the home safer for the senior may qualify. As long as the modification provides "a reasonable expectation of improving or maintaining the health or overall function" of the person receiving the benefit, it will likely qualify. However, don't forget that Medicare C plans vary by state and the individual plans available within the state may also vary. A licensed insurance agent can assist you in finding 2020 Medicare Advantage plans available in your area with all the benefits you need.

Determining Eligibility

An occupational therapy assessment can establish your initial eligibility for home health and your continued eligibility. To be eligible for Medicare, you must be:

  • Age 65 or older
  • Under age 65 and permanently disabled or
  • Under age 65 and have Lou Gehrig's disease or end-stage renal disease

To qualify for Medicare Part C, you cannot have end-stage renal disease. Other eligibility requirements include:

  • Enrollment in Original Medicare Parts A and B
  • Access to a Medicare Part C plan in your area
  • Enrollment in a Medicare Part C plan through a private insurance company

You must enroll in or make changes to your Medicare Part C plan during pre-determined enrollment periods, unless your circumstances allow you to enroll during Special Enrollment Periods. Open Enrollment for Medicare Part C runs from October 15 to December 7 each year.

FAQs

What is Medicare Part C?

Medicare Part C is another name for Medicare Advantage and is administered through a private insurance company, not the federal government. Medicare Part C covers everything normally covered in Original Medicare Parts A and B. It also provides extra supplemental benefits like nonmedical home care and home modifications that enable seniors and disabled persons to be self-sufficient while aging in place.

Does Medicare cover home modifications for seniors?

Original Medicare doesn't cover home modifications for seniors, but Medicare Part C does cover a variety of modifications that make the home safer to prevent accidents and allow seniors to remain in their homes longer than they might have otherwise. Home modifications may include a wide array of improvements, from simple installations like exchanging faucet handle knobs for levers to large installations like wheelchair ramps or lift chairs.

Does Medicare pay for bathroom modifications?

Medicare Part C usually covers modifications in bathrooms that help make the area safer, including traction and non-skid strips, walk-in tubs, shower grips and grab bars and rails. Because these modifications increase safety in a room that's notorious for accidents among seniors, they help make it possible for a senior to stay in their home and retain independence.

Does Medicare cover stair lifts for the elderly?

Medicare Part C may cover stair lifts, but traditional Medicare usually doesn't. A stair lift assists with a senior's diminished ability to climb stairs and may be recommended by a healthcare professional. Because a stair lift would be a necessary modification to prevent injuries and the potential need for medical attention, it should qualify as an allowable supplemental health care benefit. While only some 2019 Medicare Part C plans paid for stair lifts in 2019, more plans should cover them in 2020.