What Medicare Advantage offers for home care

Two years ago, COVID-19 disrupted communities and health systems. The constant fear of what could subject people, especially the elderly or vulnerable, to this deadly virus has led many people to turn to services that could be provided from the safety of their homes.

This was especially true for medical care, as 54% of consumers said fear of contracting COVID-19 was the main reason for delaying care, and 43% cited fear of going to hospital as the reason. , in a 2020 KaufmanHall survey. Fortunately, quality home care was available for these patients and is now part of the new normal that everyone is adjusting to. In fact, another 2020 survey by William Blair shows that 81% of physicians responsible for discharge planning now prefer to refer their patients to a home health agency rather than a skilled nursing facility, a figure up from compared to 54% before the pandemic.

People enrolled in a Medicare Advantage plan should know that they have access to a range of options for receiving home care, which can include primary care, emergency care, and even mail-order delivery from a pharmacy. . This approach provides the flexibility to receive medical care in the way that best suits them and reduces the risk of hospital stays.

Below are some of the home care options that Medicare Advantage beneficiaries may have, depending on their plan:

  • Urgent home care. It is possible to avoid a crowded emergency room in some situations and, instead, receive emergency care at home. In fact, many of the patients seen in the emergency department do not require the level and cost of care provided by the emergency room. As long as a client’s injury is not life or limb threatening, they may be able to schedule a home visit from a medical team who can treat a range of issues, from cuts requiring stitches to shingles and even food poisoning. Companies such as DispatchHealth can, depending on geography and health plan, be at a customer’s home quickly. Treating patients at home can benefit both patients and hospitals: it allows hospitals to provide ICU-level care to those who need it most, while allowing patients with milder illnesses to be treated in the comfort of their own homes at a much lower cost. Cost.
  • Primary home care. Telemedicine and even home visits by a physician may be options for Medicare Advantage members. From diabetes and high blood pressure treatment to physical exams and vaccinations, organizations like Heal provide primary care from the comfort of the customer’s living room in many communities. For Medicare beneficiaries, some healthcare providers may also offer a medication review, fall risk assessment, and home visits after a hospital stay. Many outside factors contribute to a patient’s health that are difficult to discover in the hospital or doctor’s office. By moving health services inside the home, physicians can identify and help address the challenges patients face in their daily lives, including transportation limitations, food and financial insecurity, living conditions unsanitary and inadequate housing. This arrangement can allow the provider to clarify health goals and expectations with the patient, family, and caregiver, which is very difficult to do in an acute care hospital.
  • Home delivery of prescription drugs. Prescription drug delivery by mail to Medicare Advantage members’ doorsteps combines the best of both worlds: more convenience and potentially lower costs. Many medications allow for a 90-day supply, which means fewer refills and more savings for you, and automatic refills ensure you never run out of medication. Most Medicare Advantage plans, including Humana, offer mail-order pharmacies for eligible prescriptions so there’s no waiting in line at the pharmacy or running out in bad weather to fill eligible prescriptions. .

An important benefit of treating patients in their own environment is that it provides a window into their daily lives and the factors that influence their health. Home care delivery provides direct visibility of the patient having enough healthy food in the refrigerator, whether their home temperature poses a hazard, furniture and carpets that could pose a safety risk, and better assessment of the patient’s mental health. This is especially important for those who live alone and may not be able to take care of themselves properly. Meeting these health-related social needs can be as important, if not more important, than medical treatment and has been a recent shift in thinking that is essential to preventative care.

Home care has a bright future because of the many factors that drive it: services often delivered more safely and affordably; a more complete view of the patient’s health being treated where they live; advances in tools and technology that enable an ever-widening range of home care; and the decrease in the rate of exposure to COVID-19. With the variety of services available, we hope individuals will take advantage of the at-home resources offered by their Medicare Advantage plans. They frequently improve the patient experience and meet patients where they want to be: at home.


Other pharmacies are available in the Humana network. Providers may also enter into contracts with other plan sponsors.

Humana is a Medicare Advantage HMO, HMO SNP, PPO, PPO SNP, and PFFS organization with a Medicare contract. Enrollment in any Humana plan is subject to contract renewal. Limits for telehealth services, also known as virtual visits or telemedicine, vary by state. These services do not replace emergency care and are not intended to replace your primary care provider or other providers in your network. Any description of when to use telehealth services is for informational purposes only and should not be construed as medical advice. Please see your proof of coverage for details on what your plan may cover or other rules that may apply.

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