In May, a final rule from the Centers for Medicare & Medicaid Services (CMS) opened the doors for Medicare Advantage (MA) insurers to offer long-term care benefits to members. About 7.5 percent of MA plan enrollees in 2019 may have access to in-home support services or extra benefits, according to CMS officials.
In a speech given at the Medicare Advantage and Prescription Drug Plan Spring Conference in May, CMS Administrator Seema Verma said, “For all of our beneficiaries, it is critical that we unleash the potential of Medicare Advantage and Part D.” Verma also stated she was “impressed by the level of private sector innovation and creativity” plans have brought to its beneficiaries. Read her full speech at the CMS site.
CMS officials have not confirmed how manys chronically ill enrollees could have access to these possible in-home and community supplemental services, but in Arizona, Anthem has stated they will begin to add more benefits with the new flexibility, according to an article by ThinkAdvisor.
Members of certain Anthem plans offered in Arizona and California will have access to the following:
- Three meals delivered per day for up to 42 days.
- Four four-hour shifts of in-home assistance with daily living activities.
- Forty hours of respite care for caregivers per year.
- One visit per week for adult day care center services.
- Healthcare appointment transportation services.
Check out ThinkAdvisor’s article for more on the possible long-term care benefits MA plans could offer.
Medicare Advantage plans are an alternative to traditional Medicare services that offer supplemental benefits to enrollees, and historically, federal rules have restricted Medicare from covering long-term benefits.
In Healthcare Dive you can read more about final rule that gave MA plans more flexibility in determining the types of supplemental benefits they can offer chronically ill enrollees, including nonmedical benefits.
Read this Hertel Report article for more background on MA plans and their flexibility opposed to traditional Medicare.