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MA Enrollees Can Access COVID-19 Supplemental Benefits in 2021

Summary

Medicare Advantage (MA) plans continue expanding coverage of supplemental benefits, including services related to the pandemic.

New analysis from Avalere finds that, as in years past, MA plans will continue to increase their supplemental benefit offerings in 2021. More plans will offer primarily health-related benefits, such as meals and transportation. In addition, 1 in 3 MA plans will start offering new types of supplemental benefits specifically related to the pandemic, such as no cost-sharing for COVID-19 testing and care packages.

Supplemental benefits are additional services offered by MA plans that are not covered under Medicare Part A, Part B, or Part D, including transportation to physician visits, coverage of over-the-counter (OTC) drugs, meals, and other supplemental services that promote beneficiary health and wellness. Beginning in the 2019 plan year, the Centers for Medicare & Medicaid Services (CMS) added new flexibilities for MA plans by expanding the definition and scope of primarily health-related supplemental benefits.

The supplemental benefits that have been increasingly offered by plans from 2018 to 2021 include meals, transportation, in-home support services, and OTC benefits, among others (Table 1). For example, a majority of MA plans will offer an OTC benefit in 2021, and nearly half will offer a transportation benefit.

Table 1. Supplemental Benefit Offerings in 2018–2021
Percent of MA Plans Offering the Benefit
Most Prevalent Supplemental Benefits 2018 2019 2020 2021
Acupuncture 13% 18% 21% 23%
Dental 79% 84% 88% 91%
Fitness 86% 90% 91% 92%
Hearing 83% 89% 92% 94%
Home Modifications 5% 7% 9% 11%
In-Home Support Services 11% 19% 21% 27%
Meals 23% 42% 50% 57%
Nutrition/Wellness 18% 18% 20% 19%
OTC Benefit 50% 64% 73% 79%
Telehealth 7% 7% 7% 7%
Transportation 32% 39% 46% 47%
Vision 95% 97% 98% 98%
Total Number of MA Plans 2,888 3,440 3,992 4,494

The big 3 supplemental benefits (vision, hearing, and dental) are now almost universally available (98%, 94%, and 91%, respectively). Notably, telehealth supplemental benefits have been offered at a low rate over the years. Beginning in 2020, however, MA plans were able to include additional telehealth services as a basic Medicare benefit in their bid submissions to be paid for by Medicare. In 2020, 59% of plans have additional telehealth benefits available for Medicare-covered Part B services, but in 2021 this number will jump to 94%.

In addition, one-third of MA plans (34%) will offer an array of supplemental benefits related to the COVID-19 pandemic in 2021, including care/relief packages, waived or reduced cost-sharing for COVID-19 treatment, and personal protective equipment (Table 2).

Table 2. COVID-Related Supplemental Benefit Offerings in 2021
COVID-19 Benefit Percent of MA Plans Offering Benefit in 2021
Care Package 27%
Reduced Cost-Sharing 1%
Testing 1%
Personal Protective Equipment <1%
Other/Unspecified 3%
Total Number of MA Plans 1,423

Most of those 1,400 plans (83%) are already on the market, and they currently enroll 5.7 million beneficiaries. Access to COVID-related supplemental benefits will vary across the country (see the map below). In certain states, such as West Virginia, South Dakota, and North Dakota, upward of 80% of MA beneficiaries are enrolled in plans that will offer COVID-related benefits in 2021, while in smaller states such as Maryland and Rhode Island such enrollment makes up only 5% or less of MA beneficiaries.

“MA plans are quickly adapting to the new reality by recognizing the needs of Medicare beneficiaries during the pandemic” said Joanna Young, Principal at Avalere. “They are offering specific supplemental benefits and enhancing the availability of telehealth options for commonly used services, such as doctor’s visits.”

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Methodology

Avalere analyzed MA plan benefits data in the Q1 2021, Q1 2020, Q4 2019 and Q4 2018 plan benefit package (PBP) files released by the CMS. Due to different naming conventions that plans use to describe their supplemental benefits—primarily those not associated with specific rubric/category in the PBP file structure—Avalere’s counts might be underestimating the actual availability of specific supplemental offerings. The analysis reflects MA plans (defined on the contract-plan-segment level) in the 50 states, DC, and the territories. Avalere excluded MA plans with no drug coverage, Employer Group Waiver, Program of All-inclusive Care for the Elderly, Cost, and Demo plans from the analysis. Avalere used plan and county-level MA enrollment from the September 2020 files.

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