On April 4, 2024, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that updates the Medicare Advantage Program for 2025.
In 2022, more than 99 percent of Medicare Advantage (MA) plans offered at least one supplemental benefit. The median was 23 supplemental benefits, and the most frequently offered benefits were hearing, vision, fitness, and dental.
CMS has held long-standing concerns that enrollee utilization of many supplemental benefits is low. To ensure the large federal investment of taxpayer dollars in supplemental benefits is actually making its way to enrollees, and is not primarily used to market benefits that individuals rarely use, the final rule requires Medicare Advantage plans to engage in outreach efforts so that enrollees are aware of the supplemental benefits available to them.
CMS finalized its proposal to require MA plans to send enrollees annual personalized notices regarding supplemental benefits they have not accessed in the first six months of the year. The notice will include “the scope of the benefit, cost-sharing, instructions on how to access the benefit, any network application information for each available benefit, and a customer service number to call if additional help is needed.”
Contract Year 2025 Medicare Advantage and Part D Final Rule (CMS-4205-F) | CMS
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