Medicare Advantage plans will offer new supplemental benefits for many enrollees in 2019, according to a recent analysis by Washington, D.C.-based consulting firm Avalere Health.
CMS expanded supplemental benefits to MA plans in early 2018 through the Bipartisan Budget Act of 2018. The new benefits enabled more care to take place in the home such as allowing meal delivery, and aimed at reducing utilization of higher-cost care settings. These supplemental benefits, which come at no extra cost to beneficiaries, are additional services provided by MA plans that can often differentiate them from competitors.
At least 40 percent of MA plans will offer new supplemental benefits, such as nicotine replacement therapy (NRT), according to Avalere. The additions could help lure in new enrollees at a time when about one-third of all Medicare beneficiaries are covered by MA plans. In 2019, MA enrollment is expected to top 22 million Americans.
“As a result of additional flexibilities granted to Medicare Advantage plans by CMS, Medicare beneficiaries will have access to new types of supplemental benefits through Medicare Advantage,” Joanna Young, senior director at Avalere, said in the analysis. “Our research finds that almost half of all Medicare Advantage plans will offer new types of supplemental benefits in 2019.”
Many of these new benefits, like transportation to physicians’ offices, adult day care services and coverage of over-the-counter medicines, are not typically covered under traditional Medicare. These new benefits are aimed at maintenance and wellness for older adults rather than just treating sickness.
About 10 percent of MA plans, or 429, will offer caregiver support services and one-third will cover NRT. More than 100 plans will cover in-home support and personal care services, which are covered by Medicaid in some circumstances.
In 2019, approximately 3,700 MA plans will be on the market, up from 3,100 in 2018, according to CMS.
Benefits that can enable enrollees to stay in their homes longer, like coverage for small home modifications and transportation to healthcare services, can reduce costs further down the road by preventing adverse health outcomes in higher-cost settings.
“Recent changes to the Medicare Advantage program are presenting plans with opportunities to meet the needs of beneficiaries with high-risk health conditions,” said Sean Creighton, a vice president at Avalere. “The trend of more Medicare Advantage plans covering more supplemental benefits to meet the needs of patients positions the program well for continued enrollment growth.”
Avalere analyzed 2018 and 2019 plan benefit packages released by CMS for the first quarter of each year to conduct its analysis.
Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."