posted by AHIP
on March 4, 2019
We know that healthy living means more than just the absence of disease. As people live longer lives, health insurance providers are looking for new ways to help them lead healthier and more active lives. This means addressing a range of factors that impact health and wellness among Medicare customers.
Under a new rule from the Centers for Medicare & Medicaid Services (CMS), Medicare Advantage (MA) plans can now take a more comprehensive approach to health by providing innovative benefits that directly focus on a member’s health care needs. MA plans now cover and target additional supplemental health-related benefits such as adult day care, caregiver support services, in-home support services, and more.
For example, Anthem expanded its Medicare Advantage offerings with “Essential Extras,” a suite of supplemental benefits that includes adult day care to reduce loneliness, personal home helpers, and even alternative medicine such as acupuncture or therapeutic massage. By addressing what they call “everyday health needs,” Anthem is aligning its MA plan benefits to the principles of patient-centered and value-based care, putting the emphasis on supporting good health rather than only treating illness.
In an op-ed, Ken Satrom, President of Amerigroup Texas Medicare (an Anthem affiliate), wrote: “Healthy living starts in our families, in our schools and workplaces, in our playgrounds and parks, and in the air we breathe.”
Another early adopter of the new standards, WellCare’s Medicare Advantage plan was developed with the knowledge that traditional health care only accounts for a portion of a person’s overall health. WellCare has added health-related supplemental benefits under current and new CMS rules that also help to address some of the social, economic, and environmental factors that commonly impact seniors, offering in-home support services, personal emergency response systems, transportation, and more.
These expanded benefits are being rolled out even as MA premiums are falling and enrollment is up—which is good news for plans and patients alike. In fact, CMS predicts that 22.6 million Medicare beneficiaries will be enrolled in MA plans in 2019, up 11.5 percent over 2018 enrollment. With new supplemental benefits, health insurance providers will continue to offer coverage options that best meets their members’ health and other related needs.