While more Medicare Advantage (MA) plans are offering supplemental benefits to help seniors age in place, many beneficiaries aren’t using them. Paul Hain, M.D., chief medical officer for GoHealth, told McKnight’s Home Care Daily “there is certainly a knowledge gap.”
According to the Centers for Medicare and Medicaid Services, 57% of MA plans now offer meal supplements and 45% provide transportation. In 2019, CMS expanded the definition of health-related supplemental benefits covered under MA plans and allowed for an even broader array of benefits last year.
GoHealth is a virtual marketplace that helps seniors shop for Medicare plans. Hain said a growing number of plans are offering physician house calls and home care. But Hain said seniors often pick plans that don’t offer the benefits they need or don’t utilize the benefits that are being offered.
“If you are able to go to your physician, maybe you just need a ride to the physician. If you’re unable to leave your home, then it makes sense to have a plan with an at-home visit benefit,” Hain said.
Hain said supplemental benefits offered under MA can help address social determinants of health (SDOH) which can affect up to 80% of an individual’s overall health outcome. SDOH includes neighborhood, educational level, economic stability and environment.
“Research is becoming more clear that the minority of a person’s health outcomes are due to truly medical things. The majority is due to genetics and social determinants of health. Addressing both are important to getting seniors healther,” Hain said.
Currently, about 40% of people 65 and older are covered by MA plans, but that number is expected to grow with the rising number of baby boomers. Overall Medicare enrollment is projected to increase from 64 million seniors to 78 million by 2030.