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Medicare Advantage new expanded allowances, presenting a potential alternative

October 24, 2018

Medicare Advantage Plans Mull Covering Aging in Place Upgrades for Seniors

Medicare Advantage new expanded allowances, presenting a potential alternative

Aging-in-place upgrades — like grab bars and wheelchair ramps — and basic in-home assistance may soon be widely covered by insurance plans under Medicare Advantage new expanded allowances, presenting a potential alternative to reverse mortgages for some older homeowners.

The Centers for Medicare & Medicaid Services (CMS) announced in April that it would allow these services and items to be offered through its affiliated Medicare Advantage health plans.

Under the Medicare Advantage program, insurance providers — the largest being UnitedHealthCare and Humana —  can offer basic Medicare benefits along with some supplemental upgrades. These public-private partnerships have seen rising adoption among older Americans, with about a third of all Medicare beneficiaries enrolled in some kind of Medicare Advantage plan in 2017. The Congressional Budget Office predicts that penetration will grow by about 4% each year, but some industry experts believe that the real growth rate could be closer to 6% to 7%.

The plans have also seen broad support under the Trump administration, with CMS administrator Seema Verma trumpeting Medicare Advantage progress in a recent statement.

“The steps that the Trump administration has taken to improve and drive competition in Medicare Advantage means more savings, more benefits, and lower costs for seniors,” Verma said. “The popularity of programs, such as Medicare Advantage, and with the various new supplemental benefits and policy changes that have been adopted, we expect plan choices to be even more robust moving forward.”

The exact proportion of Medicare Advantage beneficiaries varies by region, with Minnesota easily leading the way at 58.4% penetration in the first quarter of 2018, according to a recent analysis by Excel Health. Residents of that state, along with California, Florida, Oregon, and Pennsylvania, account for about 40% of all enrollees nationwide, with more rural states like Alaska, Wyoming, and Vermont bringing up the rear — with 1.5%, 3.9%, and 10.2% uptake, respectively.

But the nationwide numbers are trending upwards, and expanded coverage of in-home services is indicative of the government’s overall public health philosophy.

“What has happened, in addition to dental and vision, you now can cover other services as long as they help to keep Medicare beneficiaries out of the hospital,” Fred Bentley, the vice president of Avalere Health, a Medicare Advantage consultant, told Reverse Mortgage Daily.

Just this week, major Medicare Advantage insurer Anthem announced a new package for next year that covers up to $500 for safety devices like temporary wheelchair ramps, reaching devices, and shower stools, as well as in-home aide care for some chores and light assistance. The package also covers some one-way transportation, food deliveries, and alternative medicine treatments, like acupuncture.

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