December 7, 2018

Review of Contract Year 2019 Medicare Advantage supplemental health care benefit offerings

In April 2018, the Centers for Medicare & Medicaid Services (CMS) expanded the types of supplemental benefits that Medicare Advantage organizations can offer to their enrollees.

Medicare Advantage (MA) plans, private plans offering Medicare benefits, must cover all benefits covered by original Medicare at a level of cost sharing that is, in aggregate, no greater than original Medicare. MA plans may offer additional (supplemental) benefits such as dental, vision, and fitness. Under new CMS guidelines, these plans will have more flexibility in 2019 with regard to the benefits they are permitted to offer. Milliman reviewed the number of MA plans that are taking advantage of this new flexibility by offering new types of benefits in 2019. This flexibility expands the types of  supplemental benefits that can be provided to all enrollees (“‘primarily health related’ for supplemental benefits”) and allows plans to offer different cost-sharing or additional benefits to specific subsets of their enrollees (“uniformity requirement”).

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