Medicare at Home Act

The "Medicare at Home Act" proposes to amend the Social Security Act by establishing a new Medicare home care benefit under Part B. This benefit aims to provide essential support for eligible beneficiaries who require assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs) in their homes. The bill's findings highlight that millions of Medicare beneficiaries currently lack coverage for long-term personal care, leading to significant out-of-pocket costs and potential institutionalization. Under the proposed benefit, "home care services" would include help with tasks such as bathing, dressing, meal preparation, and medication reminders, furnished by a home care worker. Services would be capped at 20 hours per week per individual and would require a physician-certified plan of care, confirming the need for assistance with at least two ADLs, two IADLs, or one of each. Eligibility is restricted to Medicare Part A or B enrollees who are not receiving duplicative services through Medicaid. The legislation mandates the Secretary to establish a payment methodology for these services, ensuring a reasonable wage floor for home care workers . Financing for this new benefit would involve adjustments to Medicare Part B premiums, with the Chief Actuary of CMS required to provide an estimate of the per-beneficiary premium impact. Regulations for implementation, including standards for worker qualifications and agency enrollment, are to be promulgated within one year of enactment, with the benefit becoming effective more than two years later.