FutureFocus November 14, 2018: MarketWatch: Medicare Advantage Contracting and Supplemental Benefits

Lisa Remington

In this FutureFocus, is our MarketWatch on Medicare Advantage contracting and supplemental benefits. We are learning that beneficiaries choosing MA plans are not advised on each plan’s supplemental benefits and benefits may be restricted on eligibility criteria. We discuss what providers should do about denials from Medicare Advantage plans, and the four ways MA plans manage post-acute providers.

Lisa Remington, President, Remington Health Strategy Group

The expansion of Medicare Advantage supplemental benefits will not be available, nor easy to find.  Medicare officials have touted the expansion as historic and an innovative way to keep seniors healthy and independent. Despite that enthusiasm, a full listing of the new services is not available on the web-based “Medicare Plan Finder,” the government tool used by beneficiaries, counselors and insurance agents to sort through dozens of plan options.

Even if people sign up for those plans, they won’t all be eligible for all the benefits. Advantage members will need a recommendation from a health care provider in the plan’s network. Then they may need to have a certain chronic health problem, a recent hospitalization or meet other eligibility requirements.

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