Newly expanded supplemental benefits in Medicare Advantage grew 43% for 2022

November 24, 2021  by  Allzone MS   307

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Along with that growth, the number of plans offering more than one benefit increased 15%, from 175 to 202.

The findings show that under the Centers for Medicare and Medicaid Services’ reinterpretation of “primarily health-related” benefits, supplemental benefit offerings in Medicare Advantage – such as home-based palliative care, in-home support services, caregiver support and therapeutic massage – all increased for the upcoming year.

Along with the 43% jump in supplemental benefit offerings, the number of plans offering more than one benefit increased 15%, from 175 to 202.

The Biden Administration projects to enroll 29.5 million beneficiaries in Medicare Advantage over the coming year. The supplemental benefits are unavailable in fee-for-service Medicare.

Guidance issued in both 2018 and 2019 from CMS expanded the type of supplemental benefits that Medicare Advantage plans are permitted to offer.

WHAT’S THE IMPACT?

Medicare Advantage plans – private plans offering Medicare benefits – must cover all benefits covered by original Medicare at a level of cost sharing that is, in total, 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 were granted more flexibility regarding the benefits they were permitted to offer. This new flexibility expanded the types of supplemental benefits that could be provided to all enrollees (called “‘primarily health related’ for supplemental benefits”), and also allowed plans to offer different cost-sharing or additional benefits to specific subsets of their enrollees.

In spring 2019, CMS further expanded the flexibility of these benefits by allowing MA plans to offer special supplemental benefits for the chronically ill.

In-home support services had the largest growth in prevalence among these plan benefits, especially from 2020 to 2022. The prevalence of support for caregivers of enrollees almost doubled from 2020 to 2022, bringing it up to a similar level to home-based palliative care and therapeutic massage, both of which had small increases from 2021 and 2022.

With the exception of therapeutic massage from 2020 to 2021 and adult day health services from 2021 to 2022, all of the identified benefits have increased in plan prevalence each year.

THE LARGER TREND

Insurers are expanding their Medicare Advantage offerings at a decent clip, with Humana announcing in October that it would debut a new Medicare Advantage PPO plan in 37 rural counties in North Carolina in response to market demand in the eastern part of the state.

Around the same time, UnitedHealthcare, which already has significant market control with its MA plans, said it will strengthen its foothold in the space by expanding its MA plans in 2022, adding a potential 3.1 million members and reaching 94% of Medicare-eligible consumers in the U.S.

For the third straight year, health insurer Cigna is expanding its Medicare Advantage plans, growing into 108 new counties and three new states – Connecticut, Oregon and Washington. The move will increase its geographic presence by nearly 30%.

Centene is also getting in on the act, expanding MA into 327 new counties and three new states –Massachusetts, Nebraska and Oklahoma. In all, this represents a 26% expansion of Centene’s MA footprint, with the offering available to a potential 48 million beneficiaries across 36 states.

The Centers for Medicare and Medicaid Services said in late September that the average premium for Medicare Advantage plans will be lower in 2022 at $19 per month, compared with $21.22 in 2021. However, Part D coverage is rising to $33 per month, compared with $31.47 in 2021.

Enrollment in MA continues to increase, CMS said. In 2022, it’s projected to reach 29.5 million people, compared with 26.9 million enrolled in a Medicare Advantage plan in 2021.

For More Information: https://www.healthcarefinancenews.com/news/newly-expanded-supplemental-benefits-medicare-advantage-grew