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In 2004, 5.3 million Medicare beneficiaries were enrolled in Medicare Advantage (MA) plans. As of 2021, however, that number has increased to 26 million.
The growth trajectory for Medicare Advantage sales only continues to improve – enrollments increased 9% from 2021 to 2022, and findings released earlier this year by MedPAC show 46% of beneficiaries in Parts A and B were enrolled in MA plans, and MedPAC analysts contend that figure will stretch past 50% in 2023.
If you’re a health insurance agent or broker selling to seniors, these are numbers you can’t afford to ignore, especially as the open enrollment season approaches. Most Medicare Advantage plans include hospital, outpatient, and prescription drug coverage, and while they are administered by private insurers, carriers are required to follow rules set down by Medicare.
The rapid expansion of Medicare Advantage among consumers is fueled at least in part by the richer array of options available to them. Insurers are certainly motivated to keep plans compliant and as low-cost as possible, and in addition, to offer extra benefits that are attractive to Medicare beneficiaries and which make them stand out among competitors.
With the Medicare OEP set to launch in October, now is a good time to brush up on what is and is not available for beneficiaries. Here are some of the different benefits your prospects will want to know about as they set about making healthcare coverage decisions for the coming calendar year:
Many plans include routine care – annual check-ups, cleanings, and X-rays – while some Medicare Advantage plans offer more comprehensive coverage for fillings, dentures, partials, crowns, implants, root canals, and more.
While it depends on the plan, routine exams are fairly standard, and some plans may also cover a portion of the costs for eyeglass frames and lenses, contacts, and prescription sunglasses. Some Medicare Advantage plans also cover LASIK procedures that are determined to be medically necessary.
Routine hearing care
Though network requirements and out-of-pockets costs may vary, hearing exams and hearing aids are covered by most Medicare Advantage plans.
Fitness programs designed for seniors and gym memberships are available through select Medicare Advantage plans. Programs like SilverSneakers include live and online class and workshop options.
Home safety devices
Medicare Advantage plans may include an allowance to help cover the cost of purchasing and installing such home safety devices as wheelchair ramps, stair rails, and grab bars.
Transportation costs for travel that is deemed medically necessary – including going to and from doctor’s offices, pharmacies, clinics, and other healthcare facilities – is a benefit available in some Medicare Advantage plans.
Over-the-counter (OTC) medications
According to a report from the Consumer Healthcare Products Association (CHPA), 80% of Medicare Advantage plans offer OTC allowances as one of their top five supplemental benefits, along with dental, hearing, fitness, and vision.
Adult day-care services
Intended as a resource for family caregivers, adult day care centers typically operate five days a week during normal business hours. Some centers focus primarily on social interaction while others provide medical care as well. Medicare Advantage plans that include this benefit typically cover a portion of the costs.
Pest control services
As bug and rodent infestations can certainly compromise the health of beneficiaries – particularly those who suffer from certain chronic conditions – some insurers now offer quarterly preventive pest control as an available benefit in select Medicare Advantage plans.
Service dog stipends
Owners of registered service dogs can recoup a portion of the out-of-pocket costs of food, leashes, vests, and other related items for Medicare Advantage plans that allow it.
In 2019, the Centers for Medicare & Medicaid Services (CMS) cleared the way for Medicare Advantage plans to cover certain supplemental benefits for chronically ill enrollees. Under the Indoor Air Quality Equipment and Services provision, “temporary or portable air conditioning units, humidifiers, dehumidifiers, High Efficiency Particulate Air filters, and carpet cleaning” are eligible to be covered. Installation and servicing of the equipment can be included as part of the benefit.
Meal delivery services
Though the specifics vary by provider, beneficiaries suffering from chronic conditions can receive nutrition education, healthy cooking classes, and select meal delivery plans as part of their available Medicare Advantage benefits. Meal deliveries must typically meet Medicare standards for nutrition and portion size; some may be related to chronic conditions, such as diabetes, while others are tied to recuperation periods following a prolonged illness, surgery, etc.
If you are planning to pitch Medicare Advantage plans to prospects and customers during the Medicare OEP, it will pay to have access to a broad spectrum of carriers and plans.
With more than 300 coast-to-coast carrier partners, Quotit will help you produce more quotes in less time, and with a greater variety of plans and benefits for your customers. Additionally, Quotit’s customized proposals are easily and quickly generated, and include a summary of available benefits for easy reference.
Of course, seeing is believing. Book a demo with one of our specialists today to see how Quotit can help you make the most of the coming open enrollment season!