AARP: New MA supplemental benefits for 2019 are not widespread

Medicare Advantage plans were allowed new flexibilities in 2019, but only a small number of plans will offer the additional supplemental benefits, according to AARP.

CMS announced the expanded benefits earlier this year with only a few months before MA plans had to submit their bids for the next year.

The expanded benefits include coverage for services such as transportation, additional in-home care, adult day care, housekeeping and help for family caregivers. Many of these benefits have been shown to reduce overall healthcare costs by keeping adults in their homes longer and out of higher-cost care settings, including emergency room departments.

The new benefits come at a time when MA already covers about one-third of all Medicare enrollees. In 2019, 22 million people are expected to be enrolled in an MA plan.

Aside from a new nicotine replacement therapy benefit, which is widely covered by MA plans in 2019, few will cover many of the other new benefits, according to AARP.

About half of plans in 2019 will cover the nicotine replacement therapy, but only 13 percent of plans will cover family caregiver support, which includes respite care, counseling and training courses. In-home care support will be covered by 3 percent of plans, including housekeeping and personal care services.

Out of six new benefits announced by CMS, four will be covered by less than 1 percent of MA plans, according to AARP.

Healthcare consulting firm Avalere Health also recently found that at least 40 percent of MA plans will offer new supplemental benefits, such as the nicotine replacement therapy.

The slow uptake in benefits isn’t surprising, according to AARP, as MA plans didn’t have enough time to adjust benefits to package for the next year. Supplemental benefits could be much more widespread across MA plans in 2020, “when insurers will also be implementing new rules for supplemental benefits that were written into the Bipartisan Budget Act of 2018,” AARP noted.

While the newest supplemental benefits won’t be widespread in 2019, more plans will offer coverage for services and devices that were already allowed, such as over-the-counter medicines and items that can be covered by insurers.

Amy Baxter

Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."

Around the web

The tirzepatide shortage that first began in 2022 has been resolved. Drug companies distributing compounded versions of the popular drug now have two to three more months to distribute their remaining supply.

The 24 members of the House Task Force on AI—12 reps from each party—have posted a 253-page report detailing their bipartisan vision for encouraging innovation while minimizing risks. 

Merck sent Hansoh Pharma, a Chinese biopharmaceutical company, an upfront payment of $112 million to license a new investigational GLP-1 receptor agonist. There could be many more payments to come if certain milestones are met.