Medicare Advantage plans historically could not include items like wheelchair ramps or dehumidifiers as well as rides to places like the local grocery store as part of the benefits included with traditional coverage. Traditional coverage for hospitalization and physician services or drug coverage. Contracted with the federal government, Medicare Advantage plans help provide the extra benefits and services needed by seniors which include disease management or nurse help hotlines. Some will provide vision and dental care or wellness programs.
Reinterpretations for the standards regarding health-related supplemental benefits is being done by CMS (Centers for Medicare & Medicaid Services) to add additional services to be included in Medicare Advantage programs. These additional services will increase health, improve quality of life. This would be for non-skilled and in-home support, including assistive devices.
MA business health insurance companies such as Cigna, Aetna, UnitedHealth Group, Humana, and Blue Cross and Blue Shield plans could be opened to new possibilities for addressing social determinants of health and finding ways in keeping seniors from more expensive hospital settings. This allows new partnerships with insurers involved in Medicare Advantage businesses can then have with companies typically not involved in services for seniors that are health related.
Broadening the definition of “primary health related” for the Medicare Advantage program by Trumps administration’s CMS allows supplemental benefits when compensating for physical impairments or diminishes the impact of injuries and health conditions as well as reducing avoidable emergency room utilization.
Health insurers are happy in the direction CMS is taking whether it gets healthier food and nutrition or a way to purchase less expensive medical products for the elderly.
Submissions to the government by Health insurers in the Medicare Advantage business must be in by June 4 for health benefits in 2019. CMS would have to approve any additional services plans wish to offer.