A new data brief, examining offerings of both traditional supplemental benefits and Special Supplemental Benefits for the Chronically Ill (SSBCI) in Medicare Advantage from 2020 to 2021, shows that the number of health plans offering supplemental benefits is growing.
The brief, prepared by the actuarial consulting firm Milliman in conjunction with advocacy group Better Medicare Alliance, found that over the last year, the number of health plans offering supplemental benefits grew in 36 out of 41 categories measured, including 15 out of 17 traditional supplemental benefit categories, four out of five expanded supplemental benefit categories and 17 out of 19 SSBCI categories.
Benefits that are most widely offered in Medicare Advantage include vision (provided by 96% of plans), hearing (93%), fitness (92%) and dental care (87%).
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WHAT'S THE IMPACT
The supplemental benefits represent a wide range. This year, 57% of Medicare Advantage plans now provide a meal benefit, while 46% of plans offer transportation to and from physician appointments. Nearly a quarter of Medicare Advantage plans provide acupuncture as a covered supplemental benefit.
Among SSBCI, food and produce and meals (beyond a limited basis) were the most widely provided benefits, reaching more than 1.9 million and 1.5 million total beneficiaries, respectively.
The analysis also examines the clinical conditions for which Medicare Advantage plans most frequently offer supplemental benefits allowed under SSBCI, which requires the supplemental benefit to be targeted to chronically ill beneficiaries.
Beneficiaries with diabetes were the most targeted population for these extra benefits by a wide margin. For 2021, 293 Medicare Advantage plans offer reduced cost-sharing and/or additional benefits to support diabetic beneficiaries in managing their chronic condition in plans with nearly 1.5 million total covered beneficiaries.
Notably for 2021, use of SSBCI for behavioral health diagnoses – such as anxiety, depression or substance use disorder – also grew significantly, with 135 Medicare Advantage plans providing reduced cost-sharing and/or additional benefits in 2021, as compared with five plans the year prior. Congestive heart failure and COPD also ranked near the top of the most targeted disease groups.
In total, more than 500 Medicare Advantage plans provide reduced cost savings, expanded benefits or some combination thereof, the data showed.
THE LARGER TREND
Preliminary data at the end of Medicare open enrollment showed more consumers chose MA plans for 2021 due to their supplemental benefits, including telehealth and COVID-19 supplemental benefits.
A December 2020 study showed that, among those who decided on an MA plan because of supplemental benefits, 35% cited COVID-19 supplemental benefits specifically, while 27% cited telehealth benefits, the report said. Thirty-five percent are enrolled in an MA plan for 2021 because they've had it before and prefer it, 29% like the prescription drug coverage, 16% like the affordability, and 9% like the supplemental benefits.
In January, CMS issued a final rule that will require Part D plans to offer a real-time benefit-comparison tool starting Jan. 1, 2023. CMS said the rule is meant to strengthen and modernize the Medicare Advantage and Part D prescription drug programs so enrollees can obtain information about lower-cost alternative therapies under their prescription drug benefit plan. The agency said it expects the changes will result in an estimated $75.4 million in savings to the federal government over 10 years.
Despite the popularity of MA plans, North Shore Insurance Brokers managing partner Ina Goldberg takes issue with the plans, saying that as people age, more serious health problems begin and MA members start paying more out-of-pocket, which will often add up to more than all of those monthly supplemental payments they would have made for original Medicare.