For some older adults, private Medicare Advantage plans next year will offer a host of new benefits, such as transportation to medical appointments, home-delivered meals, wheelchair ramps, bathroom grab bars or air conditioners for asthma sufferers.
But the new benefits will not be widely available, and they won’t be easy to find.
Of the 3,700 plans across the country next year, only 273 in 21 states will offer at least one. About 7 percent of Advantage members — 1.5 million people — will have access, Medicare officials estimate.
That means even for the savviest shoppers it will be a challenge to figure out which plans offer the new benefits and who qualifies for them.
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.”
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.
Medicare counselors from California to Maine say key details are not included on the government’s website.
Officials say the added benefits will help Advantage members prevent costly hospitalizations. Federal approval of additional benefits is “one of the most significant changes made to the Medicare program,” Seema Verma, the head of the Centers for Medicare & Medicaid Services, told an insurers’ meeting last month. She said she expects plans to expand services in coming years.
Medicare Advantage plans, an alternative to traditional Medicare, serve 21 million beneficiaries and limit their out-of-pocket expenses. They often offer benefits not available in traditional Medicare, such as dental and vision care, hearing aids and gym memberships. But they also restrict members to a network of medical providers.
Enrollment is underway for Medicare Advantage plans, as well as for people in traditional Medicare who want to buy a policy for drug coverage. The deadline for choosing either type of plan is Dec. 7.
Among the new benefits that some Medicare Advantage plans said they will offer are:
• Trips to the pharmacy or fitness center in addition to doctor’s appointments for plan members, depending on where they live or their health conditions.
• A monthly or quarterly allowance for over-the-counter pharmacy products.
• House calls, under certain conditions.
• A home health care aide for a limited number of hours to help with dressing, eating and other daily activities, possibly including light housekeeping.
However, plans offering these and other services will likely have only some of the options and will have different eligibility criteria and other limitations. The same services likely won’t be available in every county the plan serves.
Often the Medicare website will simply indicate that specific benefits are available and advise consumers to contact the plan for more information. A Medicare spokesperson confirmed that there is currently not an indicator on the plan finder for plans offering these expanded health-related supplemental benefits.