Medicare Advantage plans spent $38 billion on non-Medicare benefits in 2024, according to a Medicare Payment Advisory Commission report.
The group, which advises Congress on Medicare issues, held a meeting April 10. According to a presentation, MA plans received $83 billion in rebates from the federal government. Plans used these rebates to cover non-Medicare, or supplemental, benefits. These benefits include hearing, vision and dental care alongside fitness reimbursements, over-the-counter allowances and other benefits. These rebates are also used to reduce cost sharing and provide prescription drug benefits.
According to MedPAC, current data on supplemental benefit use in MA is inadequate to determine the value the funding is providing.
Here are five things to know:
- Conventional Medicare Advantage plans spend around 27% of the rebates they receive per-enrollee on non-Medicare services, while special needs plans spend 85% of per-enrollee rebates on services traditional Medicare does not cover.
- Of the share of rebates conventional MA plans put to non-Medicare benefits, 42% goes to dental benefits, the largest of any category.
- Policymakers are lacking enough information to assess the value of supplemental benefits, according to MedPAC. Insurers are not required to report how many enrollees use each benefit.
- In 2022, MA enrollees with dental coverage were slightly less likely to visit a dentist than fee-for-service recipients with no dental coverage, according to data from the Medicare Current Beneficiary Survey.
- In 2024, CMS implemented new policies requiring plans to report some information on how enrollees use non-Medicare services and spending, but this data is not yet available, according to MedPAC.
Read the full report here.
