There are more beneficiaries enrolled in a Medicare Advantage plan than ever before. It’s no surprise that this increase in enrollees has pushed providers to offer plans with a competitive edge. CMS has plans to help providers do just that, and has proposed an expansion in plan options to increase competitiveness in this lucrative market.
Bipartisan Budget Act of 2018
This act was signed in February 2018 and impacted several governmental budgets. In the healthcare sector specifically, it was responsible for making changes to Medicare programs and funding other health programs that support low-income adults and people with disabilities. This act is responsible for the Part D Medicare donut hole closing and several other changes in 2019 and 2020. This includes the authorization of Special Needs Plans, the Medicare therapy cap repeal, and Medicare Advantage plan changes.
Medicare Advantage Changes in 2019
Last year, CMS changed what Medicare Advantage plan could, or could not, offer. These changes allowed MA to offer new benefits like daily maintenance, transportation, telehealth, and durable medical equipment. Daily maintenance benefits include at-home care items, like wheelchair ramps and other home modifications, hospital beds, oxygen equipment, and blood sugar monitors, etc.
Other changes in 2019 allowed MA plans to provide non-emergency transportation coverage. Prior to the Bipartisan Budget Act of 2018, this service was only provided by Medicaid. This benefit allows beneficiaries to receive free or low-cost rides to medical appointments and pharmacies.
Medicare Advantage 2020
2020 will also be a year of change as CMS has proposed an increase of 1.59% to Medicare Advantage rates. This is well below the 2019 rate increase of 3.4%. Plus, CMS is proposing MA expansions to support chronically ill beneficiaries. Up until this point, MA plans only offered supplemental benefits to all of their enrollees. This uniformity did not allow different plan benefits for different conditions.
Thanks to the Bipartisan Budget Act of 2018, MA plans may be able to offer primarily health-related supplemental benefits to beneficiaries with chronic conditions. In order for an enrollee to qualify as chronically ill, they must have one or more medically complex chronic condition that is life-threatening or significantly limiting to health. Plus, they must have a high risk of being hospitalized and require intensive care coordination.
Those who qualify may receive supplemental benefits for chronic illness as long as the item or service maintains or improves their overall function in relation to the chronic disease.
Join the SMA Family
The future of Medicare Advantage is bright and the number of enrollees is expected to increase in the upcoming years. This means that selling Medicare Advantage plans just became that much easier. Ready to start selling? At Senior Market Advisors, we contract with all the major carriers in your state! Our lead management system, online sales training, custom quote engine, and top tier commissions help make sure our agents are set up for success. To start contracting fill out this form or give us a call at 844-452-5020.