The Medicare annual election period (AEP) for 2022 began on October 15, 2021. Until December 7, all Medicare beneficiaries can select a new Medicare Advantage (MA) or a standalone Part D plan (PDP) for 2022. Ahead of the AEP, the Centers for Medicare & Medicaid Services (CMS) publishes information on MA and PDP premiums, benefit offerings, and Star Ratings. Avalere analyzed these data to assess changes in the number of MA plans offering select types of non-medical supplemental benefits, many of which have become newly available to enrollees in recent years due to regulatory and legislative changes.

In this analysis, Avalere examined the relationship between premiums and the number of plan offerings for the following select non-medical supplemental benefits: meals, transportation, nutrition, and in-home support services. Meals refers to pre-made meals that may be delivered to a patient’s home, whereas nutrition refers to general education and nutrition counseling from a practitioner (e.g., dietician).

Avalere compared 2021 and 2022 plan offerings and premiums to determine if access to key non-medical services for a $0 premium is increasing. Finally, we assessed changes in benefit offerings by the plan’s Star Rating. The analysis includes MA plans with drug coverage. Avalere excluded Special Needs Plans, as these plans are only available to enrollees with specific characteristics (e.g., be dual eligible, require an institutional level of care, or have a specific type of chronic condition), and also excluded employer plans, as these are not available to enrollees not covered by an employer group.

Plan Benefit Offerings

As shown in Figure 1, in 2022, the most commonly offered benefit of the 4 that Avalere analyzed is meals (68%), followed by transportation (39%), nutrition (30%), and in-home support services (11%). The percentage of plans offering these types of benefits will increase from 2021 to 2022, with the largest increases for nutrition and in-home support. Smaller increases will occur in the percentage of plans offering meals and transportation.

Avalere also examined the distribution of plan offerings at different premium levels, as shown in Table 1. In 2022, the percentage of plans with a $0 premium will increase to 58% from 53% in 2021. In 2022, only 18% of plans will have a premium of more than $50, a slight decrease from 2021 in which 21% of plans had a premium of more than $50.

More plans will offer meals, nutrition, transportation, or in-home support services at a $0 premium in 2022. The percentage of all plans that offer meals as a supplemental benefit at a $0 premium will increase from 30% in 2021 to 40% in 2022. Notably, in 2022, the percentage of all plans offering nutrition at a $0 premium will more than double from 2021 (9% to 19%).

Beneficiary Access to Plan Benefit Offerings at $0 Premium

Avalere also analyzed the extent to which Medicare beneficiaries have access to at least 1 plan at a $0 premium that offers at least 1 of these 4 supplemental benefits. As shown in Figure 2, the availability of $0 premium plans will increase for all 4 of these benefit types. This increase is greatest for $0 premium plans offering nutrition (where availability will increase from 67% in 2021 to 89% in 2022) and in-home support services (up from 49% in 2021 to 62% in 2022).  Of note, nearly all beneficiaries will have access to at least 1 $0-premium plan offering meals as a supplemental benefit in 2022.

Plan Benefit Offerings by Star Rating

Finally, Avalere assessed the relationship between Star Ratings and supplemental benefit offerings (Figure 3). Because plans with 4 or more stars receive higher payments, they have more funding available to provide supplemental benefits or reduce cost-sharing, compared to plans with fewer stars. Avalere examined the relationship between Star Rating and benefit offerings to determine if plans with higher star ratings more frequently offer these 4 benefits than plans with lower star ratings.  In 2022, while plans with at least 4 stars are more likely to offer meals (70% vs. 62%) or transportation (40% vs. 32%), they are as likely to offer in-home support services (10%) and are less likely to offer nutrition (26% vs. 36%). Consistent with the trends shown in Figure 1, a higher percentage of plans with at least 4 stars will offer these 4 benefits in 2022 than in 2021. The same trend holds true for plans with less than 4 stars for 3 of the 4 benefits, while the percent of these plans offering in-home support services will decrease slightly from 12% in 2021 to 10% in 2022.

Conclusion

As the AEP begins, beneficiaries will see a wide range of plans offering services. This early look at the benefits shows that certain types of non-medical benefits—most notably meals—are widely available at a $0 premium, whereas other types of benefits—such as in-home support services—are offered less widely. The AEP represents an opportunity for Medicare beneficiaries to make an informed choice based on the plans available to them and with their individual needs in mind. Should Congress make changes to either MA payment or fee-for-service benefits during the current or future legislative debates, availability of these supplemental benefits may shift over time.

To learn more about MA plans, connect with us.

Methodology

Avalere analyzed MA plan benefits data in the 2021 Q1 and 2022 Q1 plan benefit package (PBP) files released by CMS and premium data from the 2021 and 2022 MA landscape file. 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. Avalere excluded MA plans with no drug coverage, Special Needs Plans, Employer Group Waiver Plans, Cost, PACE, and Demo plans from the analysis. The analysis includes MA plans in the 50 states, DC, and the territories. Avalere used county-level Medicare eligibles information from the September 2021 Penetration file published by CMS.