New Long-Term Care Medicare Benefit Proposed

A newly proposed Medicare benefit would extend services to eligible beneficiaries for long-term care. The proposal was within a discussion draft of a bill by Representative Frank Pallone (D-NJ), released at a Wednesday roundtable discussion with aging and disability advocates.

The proposal, The Medicare Long-Term Care Services and Supports Act of 2018, would establish a cash benefit within Medicare for beneficiaries that could be used toward all long-term services and supports, including nursing facility care, adult day care programs, home health aide services, personal care services, transportation and assistance provided by a family caregiver.

“The growing need for long-term care is one of the greatest threats to retirement security for American seniors, and the adult children who care for them,” Pallone said in a statement. “It’s time to expand Medicare to include a long-term care benefit so that millions of seniors and individuals with disabilities no longer have to face financial ruin before they get assistance. I’m hoping that this proposal will begin an important discussion, and look forward to getting feedback from interested stakeholders.”


The proposal, if introduced and enacted, would be the first new Medicare benefit since Part D, which was approved in 2003 and implemented in 2006.

The discussion draft of the bill aims to help families pay for long-term care, which can cost a senior an average of $140,000 out of pocket. More than 15% of seniors will incur costs in excess of $250,000, according to Pallone. Furthermore, more than 70% of seniors older than 65 will need some long-term care services and supports in their lifetime.

The reach would extend beyond the narrow limits of many Medicare services, including those of home health care, and it would incentivize people to seek care at home, “the setting where most people want to be,” according to Pallone.


Some senior care groups have already voiced their support for the proposal.

“We firmly believe that the nation’s current methods for financing LTSS are unsustainable, irrational, and unfair for individuals and families,” Katie Smith Sloan, president and CEO of LeadingAge, said in a statement. “It is estimated that about half of all older adults will lose the ability to care for themselves during their lifetimes, and will need help with everyday activities. We commend Representative Pallone for proposing a new Medicare long-term care benefit that addresses this critical issue.”

Written by Amy Baxter

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