About the New Flexible Medicare Supplemental Health Insurance

Medicare, News August 1, 2018 0
About The New Flexible Medicare Supplemental Health Insurance | Senior Market Advisors

About the New Flexible Medicare Supplemental Health Insurance

This post was originally published on May 23, 2018; updated 8/1/18

CMS is passing regulations that will allow Medicare Advantage plans to offer more unique benefits. The goal is to make it easier for seniors and Medicare eligibles to keep living at home. CMS administrator Seema Verma said, “Medicare Advantage beneficiaries will have more supplemental benefits, making it easier for them to lead healthier, more independent lives.”

Medicare Advantage Popularity

Even without any expansion, Medicare Advantage has been steadily growing in popularity over the past few years. It’s the most logical option for beneficiaries with chronic illnesses and disabilities because MA plans typically cover much more hospital costs and ancillary services than Original Medicare. Plus, beneficiaries need the prescription drug coverage that MA provides.

This year, 87% of Medicare beneficiaries have access to at least one Medicare Advantage plan. A total of 33% of all Medicare beneficiaries are enrolled in a Medicare Advantage plan, and studies suggest that the number will continue to rise.

New Medicare Advantage Benefits

Early this year, CMS released new changes regarding Medicare and Medicaid benefits. One of the biggest and newest changes is increased flexibility in what Medicare Advantage plans are allowed to offer as “supplemental” Medicare benefits.

Transportation and Medicare Advantage

Keeping up with modern technology and the popularity of ridesharing services, Medicare Advantage plans can now include more transportation options to help beneficiaries get to and from doctor’s appointments. Meal delivery services for those who have a hard time shopping for groceries or cooking for themselves are also allowed – and we are already seeing plans add these to their list of benefits.


Durable Medical Equipment and Medicare Advantage

New Durable Medical Equipment laws will also allow Medicare Advantage plans to allow home modifications, like wheelchair ramps for homes with stairs or air conditioners for those with asthma. Plans will also likely allow for more home health care to help with dressing, eating, etc, as well as more access to telehealth for those who have trouble accessing doctors.

Medicare Advantage Opioid Control

Opioid misuse grows every year; it’s impossible for CMS to ignore it. In 2019, CMS is asking Part D sponsors to limit opioid prescription refills and allow no more than a seven-day supply at one time. Additionally, CMS is expanding the Overutilization Monitoring System (OMS) to help identify beneficiaries who are using high levels of opioids from multiple pharmacies and with multiple prescriptions. When those beneficiaries are found, Part D sponsors must perform case management and can limit prescriptions.

Sponsors are also expected to implement safety alerts when chronic opioid users submit a prescription. CMS will start urging Part D sponsors and MAPD plans to set certain expectations for opioid prescriptions. Otherwise, beneficiaries will likely be stopped at the point-of-sale.

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Anastasia Iliou
Anastasia Iliou
Senior Content Manager at Senior Market Advisors
Anastasia graduated from Belmont University with a Bachelor's degree in Songwriting. When she's not writing, she's on a mission to visit all 50 states in the U.S (and to date has reached 36). Anastasia loves writing music, hiking, and playing with her pets (hedgehog, cat, and dog). She loves animals (but not so much bugs) and spends her free time volunteering for The Elephant Sanctuary in Tennesee.