Is Meals on Wheels Covered by Medicare?
- Although Original Medicare (Parts A and B) usually does not cover meal delivery, many Medicare Advantage (Part C) plans cover meal delivery as an optional supplemental benefit for those who qualify. Learn more about home meal delivery, nutrition education and other benefits that may be available with a Medicare Advantage plan.
Meals on Wheels, a nationwide network of community-based, non-profit programs, provides seniors with support to help them keep living in their own homes, where many aging adults prefer to remain as long as possible. This support, the organization says, includes “nutritious meals, a quick safety check and much-needed human connection to homebound seniors.”
Much of the funding for Meals on Wheels comes from government sources and private donations. Some funds may also come from insurance.
If you are a Medicare beneficiary, you may be able to find a Medicare Advantage (Medicare Part C) plan available where you live that covers Meals on Wheels or similar home meal delivery. While Original Medicare (Part A and Part B) doesn’t typically cover meal delivery, Medicare Advantage plans often offer extra benefits not covered by Original Medicare, such as prescription drug coverage, dental, vision and hearing.
In 2022, 67% of Medicare Advantage plans cover food benefits such as home meal delivery, cooking classes, nutrition education and more.
What Is Meals on Wheels?
Meals on Wheels provides food and safety checks on home-bound seniors. Some of these community-run programs also offer services like pet food delivery, senior center meal programs, home repair services and transportation. “Each local program works with its own community’s needs and resources to provide a community-specific solution,” the organization says.
Meals on Wheels serves more than 2.4 million seniors from age 60 to 100-plus each year who, because of physical or financial challenges, find it difficult to shop for or prepare meals for themselves. The live in both rural and urban communities. More than half a million of its clients (20%) are veterans, 64% are women and 40% live in poverty.
These services are vital for the 9 million seniors in America who struggle with hunger, 15 million who live in isolation and 18 million who live in or near poverty. The organization predicts that these challenges will almost certainly grow, because the senior population is projected to double by 2050.
Do I Qualify for Meals on Wheels?
Meals on Wheels eligibility can vary by community, but typically seniors must demonstrate physical or financial difficulties with eating healthy meals and moving easily about their communities. Meals on Wheels says that many areas do not have enough local resources to meet the need, and many programs have waiting lists of people trying to get these services.
Who Pays for Meals on Wheels Services?
Meals on Wheels is a partnership between the federal government and the public. The Older Americans Act provides about 33% of Meals on Wheels funding, and local communities and private resources provide the rest, through sources such as client payments, private donor contributions, foundations and state and local governments.
Local communities establish their own payment policies based on local needs and resources.
Clients themselves are not required to pay for services. However, their insurance coverage may help support Meals on Wheels or other food delivery programs.
When Does Medicare Pay for Meals on Wheels or Other Home Meal Delivery?
While Original Medicare (Part A and Part B) typically doesn’t pay for meal delivery service, Meals on Wheels does not deny services to anyone who qualifies based on financial difficulties.
Many Medicare Advantage (Medicare Part C) plans, however, do include services like meal delivery, transportation for grocery shopping and other non-medical needs.
In 2020, the Center for Medicare & Medicaid Services (CMS) expanded supplemental benefits in Medicare Advantage plans to allow them more flexibility in offering more services to their beneficiaries, including to those who struggle with hunger and isolation.
The new policy, CMS states, “gives chronically ill patients with Medicare Advantage the possibility of accessing a broader range of supplemental benefits that are not necessarily health-related but have a reasonable expectation of improving or maintaining the health or overall function of the enrollees. These benefits can address social determinants of health for beneficiaries with chronic disease. For example, beneficiaries enrolled in a Medicare Advantage plan could now receive meal delivery in more circumstances, transportation for non-medical needs like grocery shopping, and home environment services in order to improve their health or overall function as it relates to their chronic illness.”
What Are Medicare Optional Supplemental Benefits?
Expanded services like meal delivery that aren’t covered by Original Medicare but are covered by some Medicare Advantage plans are considered an “optional supplemental benefit.” This means that Medicare Advantage plans have the option to cover home-delivered meal services, or not to. Thus, not all plans or plan providers include meal delivery as a benefit.
In addition, these services typically are covered only for a limited time and require the individual to meet certain health conditions or situations, such as:
- Recent discharge from a hospital or skilled nursing facility
- Enrollment in a qualified chronic-condition plan
A physician may also need to document that the service is medically appropriate before coverage is approved.
For example, a Medicare Advantage policyholder who has been discharged from a hospital or skilled nursing facility may qualify to receive meals from an approved vendor. The number of meals provided depends on the plan’s specified benefits.
Those with a condition such as congestive heart failure, diabetes, end-stage renal disease and other diseases may qualify for a chronic condition meal program that may covers, for example, 20 meals that support the dietary requirement of that illness.
A discharge nurse or case manager may be involved in ordering meals for a qualified patient and supervising the meal deliver program with the approved vendor.
Check carefully with your plan provider to see if these services are covered.