New Report Shows Expansion of Supplemental Benefits in Medicare Advantage Plans
Washington, D.C. – A new independent study by the actuarial consulting firm Milliman commissioned by the Better Medicare Alliance (BMA) highlights the continued expansion of supplemental benefits in Medicare Advantage plans for Contract Year 2020.
The report showed, under the Centers for Medicare and Medicaid Services’ (CMS) reinterpretation of “primarily health related” benefits, adult day care services are being offered by plans for the first time in 2020 while benefits such as non-opioid pain management (e.g., therapeutic massage) increased more than eight-fold – offered by 22 plans in 2019 as compared to 192 plans in 2020.
Guidance issued both last year and this year from the Centers for Medicare and Medicaid Services (CMS) expanded the type of supplemental benefits that Medicare Advantage plans are permitted to offer. Of a set of benefits including adult day care services, home-based palliative care, in-home support services, support for caregivers of enrollees, and therapeutic massage, Milliman research found that 116 plans offer more than one of these services in 2020, whereas none did in 2019.
“The growth in supplemental benefits across Medicare Advantage plans as compared to 2019 tells a remarkable story of how plans are finding new ways to care for the whole person and address social determinants of health,” said Allyson Y. Schwartz, President and CEO of the Better Medicare Alliance. “These benefits not available in Traditional Medicare help enrollees to safely remain in their own homes, avoid social isolation, and lead longer, healthier lives. We are committed to ensuring that the 24 million Americans expected to enroll in a MA plan next year – and those who will come behind them – have access to the low-cost, quality care and enhanced benefits that MA provides.”
The figure below, courtesy of Milliman, depicts how supplemental benefits have rapidly expanded for the year ahead:
Medicare Advantage must provide coverage for all benefits that are covered by Traditional Fee-for-Service (FFS) Medicare. Without additional funding, Medicare Advantage plans may offer other supplemental benefits not covered by FFS Medicare, such as reduced cost-sharing, dental, vision, and hearing.
This analysis does not include the full picture of benefits being offered in 2020, as CMS has not yet released the files related to the uniformity requirement reinterpretation and special supplemental benefits for the chronically ill changes.