Medicare Advantage Expanding Health Related Benefits

Medicare Advantage Expanding Health Related Benefits

Recently, the Centers for Medicare & Medicaid Services expanded how it defines “primarily health-related” benefits that insurers are allowed to include in their Medicare Advantage policies.

Of the 61 million enrolled in Medicare, currently, 20 million people have opted for Medicare Advantage, a privately run alternative to the traditional government program which limits members to a network of providers.


Many Medicare Advantage plans already offer some health benefits not covered by traditional Medicare, such as eyeglasses, hearing aids, dental care, and gym memberships. But the new rules could expand significantly to include items and services that may not be directly considered medical treatment.

Although insurers are still in the early stages of designing their 2019 policies, some companies are considering adding healthy groceries, home-delivered meals, simple home modifications, and aides to help with activities of daily living. According to the new rules, the new benefits, which are focused more on injury prevention, must be “medically appropriate” and recommended by a licensed health care provider.

Many view this proposed change as CMS’s way of providing a more personalized healthcare experience as well as promoting wellness and independence for healthy individuals; however, there is some concern that the majority of people enrolled in traditional Medicare are being neglected.

The details of the 2019 Medicare Advantage benefit packages must first be approved by CMS and will not be released until the fall of 2018 when the annual open enrollment begins. That being said, as with any Medicare proposed change, all benefits may not be available to all beneficiaries.

Information gathered from: Medicare Advantage Plans Will Soon Cover Things