Medicare would cover limited home care for eligible beneficiaries

Medicare would cover home care workers' help with personal care and daily household tasks. People entitled to Medicare Part A or enrolled in Part B would need help with at least two personal care or daily household tasks, in any combination. A doctor or another authorized clinician would need to establish and periodically review a care plan certifying the need for help. People could not receive Medicaid long-term care services that duplicate this care at the same time. Covered housekeeping would need to directly relate to the person's health and safety; this benefit would be separate from Medicare home health services. Coverage would apply to services provided on or after the first day of that plan year.

The health secretary would adjust monthly Medicare Part B premiums to account for the home care benefit's cost. The proposal does not specify a dollar amount for the premium adjustment. The adjustment would follow Part B's standard rules for the government's share of costs. Medicare's chief actuary would report the estimated premium effect to Congress within 180 days after enactment.

The health secretary would set payment rules that reflect a reasonable minimum pay level for home care workers. Payment rules would cover home care provided by agencies or individual providers enrolled in Medicare. The proposal does not specify a minimum pay amount. The health secretary would issue rules within one year after enactment. Payment amendments would apply to services provided on or after the first day of the first plan year beginning more than two years after enactment.