November 4, 2019

Review of Contract Year 2020 Medicare Advantage supplemental healthcare benefit offerings

Report from Milliman

The highlights of our findings are as follows:

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 CMS guidelines issued in spring 2018, plans now have more flexibility with regard to the benefits they are permitted to offer. Milliman reviewed the number of MA plans that are utilizing this new benefit flexibility in 2020, having had a full year to make strategic decisions. 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”). In spring 2019, CMS further expanded the flexibility of these benefits by allowing MA plans to offer special supplemental benefits for the chronically ill (SSBCI). It is important for Medicare beneficiaries who choose to enroll in Medicare Advantage plans to consider supplemental benefits in the context of all of their healthcare needs as well as any cost sharing and member premium.

Sign Up for Policy Alerts

Sign up to receive exclusive updates on Medicare Advantage policy.