CMS adds new items to be covered under Medicare Advantage plans

Apr 12, 2019
The Bottom Line

In a press release dated April 1, 2019, CMS announced finalized updates to items that Medicare Advantage (MA) plans will cover for 2020, a change that the agency says will “[give] chronically ill patients with Medicare Advantage the possibility of accessing a broader range of supplemental benefits that are not necessarily health-related but have a reasonable expectation of improving or maintaining the health or overall function of the enrollees.”

Beneficiaries enrolled in a MA plan could, for example, receive coverage for the following:

  • Meal delivery in more circumstances
  • Transportation for non-medical needs like grocery shopping
  • Home environment services in order to improve their health or overall function as it relates to their chronic illness
  • For patients with asthma, home air cleaners and carpet shampooing to reduce irritants that may trigger asthma attacks
  • For someone with heart disease, a plan could provide heart healthy food or produce
  • For someone with diabetes, a plan could provide transportation to a doctor’s appointment, diabetes education program or to see a nutritionist

The agency says that these benefits can address social determinants of health for beneficiaries with chronic disease, and also help combat the nation’s opioid crisis.

For 2019, CMS expanded the definition of health related supplemental benefits to encourage daily maintenance of health. This means MA plans can offer supplemental benefits that are not covered under Medicare Parts A or B, such as adult day health services and/or in-home support services.

Read the press release here.

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