Medicare Advantage is an alternative to traditional Medicare and is chosen by one third of Medicare beneficiaries. Offered by private insurance companies, Medicare Advantage covers (at a cost) “primarily health-related benefits.”
But what is the definition of “health-related”?
People with asthma benefit from the air filtering properties of air-conditioners, but does that mean that an air-conditioner is a health-related benefit? How about fruits and vegetables? A healthy diet certainly supports better health, but does it count as “health-related”?
This year, the Centers for Medicare and Medicaid Services (CMS) has decided to expand the definition of “health-related.” Because Medicare Advantage plans are offered by private insurance companies, they vary; however, many plans already offer benefits such as eyeglasses, dental care, hearing aids, and even gym memberships.
With the expansion of the definition of “health-related,” Medicare Advantage insurers are considering adding benefits that are more broadly preventive. These benefits might include transportation to medical visits, and incentivization of healthier food choices.
The new benefits will focus on preventing injury, and slowing the progression of existing health conditions.
In order to receive the new benefits, they must be recommended as “medically appropriate” by a licensed health care provider.
CMS administrator Seema Verma explained that the changes will make it “making it easier to lead healthier, more independent lives.”
As open enrollment season begins in the fall, it will be worthwhile to take a fresh look at Medicare Advantage plans, as the new benefits may be valuable for your situation.
For those who need more care, Tower Lodge Care Center, in Wall, NJ, provides everything a senior needs to be healthy and happy — comfortable accommodations in a scenic setting; caring doctors, nurses, therapists, and nutritionists; activity schedules that allow opportunities for enjoyment and socialization.
Contact us for a tour at 732-681-1400, or by clicking here.