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NEW REPORT: MEDICARE ADVANTAGE PLANS SET TO OFFER NEW SUPPLEMENTAL BENEFITS IN 2019

Washington, D.C. A new report by the actuarial consulting firm Milliman reveals the latest accurate data and insights on new supplemental benefits Medicare Advantage enrollees will have access to next year.

 

Earlier this year, Centers for Medicare & Medicaid Services (CMS), the nation’s federal Medicare agency, expanded the types of supplemental benefits that Medicare Advantage organizations can offer to their enrollees beginning in 2019. Under the expanded definition, plans may offer several new types of supplemental benefits to enrollees, including home-based palliative care, non-skilled in-home support and services, and non-opioid pain management.

 

According to the report by Milliman, half of Medicare Advantage plans which will offer expanded benefits, due to the policy change, are adding in-home support services, such as personal care aides to assist individuals with disabilities and/or crippling medical conditions. Also, nearly 30% of these Medicare Advantage plans have chosen to offer home-based palliative care to diminish symptoms of terminally ill members with a life expectancy of greater than six months not covered by Medicare.

 

“Medicare Advantage plans are viewing 2019 as a year to test this new benefit flexibility. Experience will provide important evidence as to the impact of these benefits on care and outcomes for beneficiaries in Medicare Advantage. There is a lot of interest in care in the home and the opportunity it provides to meet patient needs, avoid hospitalizations, and address patients’ preference to remain in their homes. Which is why we see Medicare Advantage taking advantage of this expanded definition to offer these benefits.,” said Allyson Y. Schwartz, BMA President and CEO.

 

In total, Milliman identified 102 plans that are set to offer one or more of the new supplemental benefits in 2019. The report does not break down the number of plans who may be offering an expanded version of a previously allowed benefit, so the actual uptake of the new flexibilities is likely higher than it appears.

 

Summary of Expanded Supplemental Benefits in 2019

 

Benefit

Plans Offering Benefit

Home-Based Palliative Care

29

In-Home Support Services

51

Medically-Approved Non-Opioid Pain Management

22

Total (no plan offered more than 1 new benefit)

102

 

Medicare Advantage plans faced certain challenges when exploring offering the recently approved supplemental benefits including:

• The lack of clarity in CMS guidance as to what would be allowed and what restrictions would be in place;

• The compressed timeline between the issuance of the guidance and the deadline to submit 2019 bid and benefit packages; and

• Uncertainty around how to properly communicate new benefits to enrollees.

 

Medicare Advantage (MA) plans must provide coverage for all benefits that are covered by Traditional Fee-For-Service (FFS) Medicare. They may also offer extra, supplemental benefits that are not covered by FFS Medicare, such as dental coverage and hearing aids.

 

 

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