Are Medicare Advantage plans ready for the high costs of long-term care?

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By Christopher J. Giese, Allen J. Schmitz | 12 June 2018
An April memo from the Centers for Medicare and Medicaid Services provided guidance for Medicare Advantage (MA) plans preparing their contract 2019 bids with respect to interpreting the scope of the “primarily health related” supplemental benefit definition. The guidance clarified that plans can provide certain long-term care (LTC) benefits as a supplemental benefit for individuals who need assistance with activities of daily living (ADLs) or instrumental ADLs. Many concerns exist in offering LTC benefits as part of an MA plan. This article highlights a number of factors that may influence how MA plans offer and price new LTC benefits.