Insurer-Backed Bill Could Expand Access to Medicare Advantage Extras

Health insurers are welcoming a bill that could make access to Medicare Advantage plan supplemental benefits more flexible.

Rep. Gus Bilirakis, R-Fla., has introduced H.R. 5746, the Addressing Whole Health in Medicare Advantage Act.

The bill would let Medicare Advantage plan issuers offer supplemental coverage for items such as grocery discounts, respite care and homemaker help to any enrollee who has complex chronic conditions that significantly affect the enrollee’s health; has a high risk of hospitalization; requires intensive care coordination; has a low income; or meets other requirements set by the secretary of the U.S. Department of Health and Human Services.

Those types of supplemental benefits are relatively new. Today, plans can offer them only to enrollees who are classified as chronically ill.

America’s Health Insurance Plans, a group for health insurers, welcomed introduction of the bill. “By giving Medicare Advantage plans more flexibility, we can dramatically improve the well-being of seniors,” Sohini Gupta, an AHIP executive vice president, said in a statement.

What it means: Medicare Advantage plan issuers are trying to go into tough budget negotiations in Washington with the message that managed Medicare plans can offer Medicare enrollees attractive, important extra benefits, not just keep the monthly premiums low.

Medicare Advantage: Medicare is a federal program that provides health insurance for about 66 million Americans.

About 32 million of the enrollees have signed up for coverage through Medicare Advantage plans, or plans from private companies that provide what looks to the enrollee like a substitute for “Original Medicare.”