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Will Home Health Care Get Pricier?


The Centers for Medicare & Medicaid Services announced yesterday that its payments to home health care agencies would decrease by more than 2% in 2012. The question for consumers who use home health care services is this: Will these decreased payments to agencies force consumers to pay more out-of-pocket costs for home health services?

Probably not right away, experts say. “Seniors may not feel the effects immediately through Medicare cost sharing, but the reduction might result in greater out-of-pocket costs for non-covered services as agencies increase other fees to make up for the loss in income,” says  Mary Johnson, a policy analyst at The Senior Citizens League, a nonpartisan seniors rights group.

If someone is  eligible for Medicare-covered home health care services, they  probably won’t immediately feel the impact of these reductions in payments, since they currently have no Medicare co-pays or cost sharing responsibilities for those services (as long as they have original Medicare and get services from a Medicare-certified home health agency), she says.  However, anyone who gets coverage through Medicare Advantage  should contact their plan to figure out the  co-pays.

That said, “there’s a considerable amount of home health care services, often the bulk of care, that Medicare does not cover,” she says. “Fees for those services might be impacted as agencies shift the cost to patients.” Examples include 24-hour-a-day care, homemaker services like cleaning and laundry, personal care provide by home health aides like bathing and dressing and assistance to the bathroom, she says. Often these non-covered services are “the single biggest cost of home care for any senior dependent on those services and their families,” she adds.

Seniors wanting to find home healthcare services or to learn more, should click here. For more information about how Medicare pays for home health care, see the Publication Medicare and Home Health Care.


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About Encore

  • Encore examines the changing nature of retirement, from new rules and guidelines for financial security to the shifting identities and priorities of today’s retirees. The blog also explores news that affects retirement, from the Wall Street Journal Digital Network and around the web. Lead bloggers are reporter Catey Hill and senior editor Jeremy Olshan. Other contributors include The Wall Street Journal’s retirement columnists Glenn Ruffenach and Anne Tergesen; the Director for the Center for Retirement Research at Boston College, Alicia Munnell; and the Director of Research for Pinnacle Advisory Group, Michael Kitces, CFP.