Medicare Advantage Added Benefits Worth $2,000

Medicare Advantage Added Benefits: In 2022, the average MA plan enrollee had access to nearly $2,000 in extra benefits such as dental and vision.  Medicare payments for MA extra benefits have increased by 53% since 2019. Here are the percentage of all Medicare Advantage enrollees in plans that cover specified added benefits

• Vision (99%)
• Hearing (98%)
• Fitness (98%)
• Dental (96%)
• Over-the-counter (84%)
• Remote access technologies (72%)
• Meal benefits (71%)
• Acupuncture (45%)
• Transportation (39%)
• In-Home Support (12%)
• Part B Rebate (7%)
• Caregiver Support (4%)

How Does Medicare Pay Private Medicare Advantage Plans?

Medicare Advantage plans are private plans typically provided by insurance companies. They are different from the traditional ‘fee for service’ Medicare program.

In simplified terms, Medicare pays these private plans a predetermined rate per enrollee. This is rather than a per service rate. Payment rates are determined by the MA plan bid. For example, UnitedHealthcare bids the amount it projects will cover the Medicare Part A and Part B benefit package for a beneficiary of average health status.

If a plan includes Part D prescription drug coverage, Medicare pays for this as well through the Part D bidding process. Plans with higher quality ratings are rewarded with a higher benchmark.

Then the MA plan must manage the care it provides based on the projected (bid) amount.

$2,000 in MA Plan Added Benefits

In 2022, rebates for Medicare Advantage plans (excluding employer plans and SNPs) average $164 per enrollee per month. That’s nearly $2,000 annually per enrollee.

This represents the highest in the program’s history and accounts for 15 percent of plan payment. Plans can use the rebate (which includes plan allocations for administrative costs and profit) to lower cost sharing, lower premiums, or to cover supplemental benefits.

The average total rebates are 17 percent higher than in 2021 ($24 higher per enrollee per month) (Table 12-5, p. 426). MA rebates have increased by 53 percent since 2019.

According to the report, the average MA plan enrollee had access to nearly $2,000 in extra benefits annually that Medicare FFS enrollees cannot access without purchasing additional health insurance coverage.

Medicare payments for MA extra benefits have increased by 53 percent since 2019. The authors indicate that payments to MA plans have increasingly been used to provide an indirect subsidy to offer expanded benefits for MA enrollees.

Plans project that $36 per enrollee per month (22 percent) of rebates will be used for non-Medicare-covered supplemental benefits. The Medicare Payment Advisory Commission recently reported that while these benefits often include coverage for vision, hearing, or dental services, the non-Medicare supplemental benefits that plans most commonly offer appear to be tailored toward relatively healthy beneficiaries.

Association’s Free Directory Helps You Find Local Medicare Agents

Medicare is a national program. But your choices are local. Plans available in your area may not be available elsewhere. And calling Call Centers (the ones advertised on TV) may limit your choices.

Use the Association’s free (and private) directory to find Medicare Advantage agents near you.

Click the banner to find Medicare insurance agents in your Zip Code

Additional Medicare Information You May Find Of Value

Please click on any of the links (below) to read other recent news stories or reports containing information we believe you may find of value.

What Medicare Supplement Is The Most Popular Medigap?

Home Care Services Increasingly Covered By Medicare Advantage

Key 2023 Medicare Advantage Data For Consumers

The Illinois Birthday Rule For Medicare Supplement Insurance

5 Tips To Find Your 2023 Medicare Prescription Drug Plan