Medicare Advantage Supplemental Benefit Health Plans Draw Scrutiny

A recent article in The Hill identifies current issues with supplemental hearing, vision, and dental benefits offered by many Medicare Advantage plans. Many consumers are not fully aware of the extent and coverage related to these benefits and are still left with out-of-pocket costs. Part of the problem, experts say, is the lack of transparency and standardization about what supplemental benefits must cover, meaning benefits can vary between the thousands of Advantage plans on the market.

Medicare.gov’s plan finder tells people limits might apply to a plan’s supplemental benefits, but doesn’t go into specific details. Advantage plans don’t typically report information to the federal government about how often those benefits are used, what types of services are covered or how much beneficiaries pay out of pocket for that care. “That creates an information black hole about how useful those benefits are to beneficiaries, despite the fact that taxpayers are paying for it.” In 2022, rebates that plans got from the government to cover those benefits totaled $164 per enrollee per month, according to MedPAC.

To address some of these concerns, the Senate Finance Committee’s majority staff has recommended that Center for Medicare and Medicaid Services (CMS) provide model language for Medicare Advantage plan marketing to explain the out-of-pocket costs and network limitations for extra benefits such as dental, vision, and hearing.

Reference

Hellmann J. (2023) Medicare Advantage supplemental health plans draw scrutiny. Roll Call (accessed June 20, 2023).