New Flexibilities and Expansions in Supplemental Benefits

Key Facts

• Recent changes in supplemental benefit policies, allow Medicare Advantage plans to offer an expanded array of new items and services not covered in Traditional FFS Medicare aimed at improving beneficiaries’ overall health. Unlike Traditional FFS Medicare, these benefits may be tailored to those with the highest’ need.
• CMS reinterpreted existing rules for 2019 around “primarily health-related” supplemental benefits to allow for the provision of items and services that have an expectation of maintaining or improving overall health. Benefits may be targeted to individuals with a specific clinical need, allowing plans to better tailor benefits to the highest-need enrollees.
• As of 2020, plans may offer a new category of benefits specifically for those with certain chronic conditions and these benefits may directly address non-medical needs.
• No additional payment is provided to plans to cover these new benefits.