A new midyear enrollee notification to Medicare Advantage policyholders reminding them about their plan’s unused supplemental benefits is coming.
The new rule requires Medicare Advantage (MA) plans to engage in outreach efforts so that enrollees are aware of the supplemental benefits available to them. CMS is requiring MA plans to issue a “Mid-Year Enrollee Notification of Unused Supplemental Benefits” annually between June 30 and July 31 of the plan year. This must be personalized for each enrollee and include a list of any supplemental benefits enrollees didn’t use during the first six months of the year. The notification will also include the scope of the benefit, cost-sharing, instructions on how to access the benefit, any network application information for each available benefit, and a customer service number to call if additional help is needed.
In 2022, over 99% of Medicare Advantage plans offered at least one supplemental benefit. The median was 23 supplemental benefits, and the most frequently offered benefits were vision, hearing, fitness, and dental. Some of these benefits address unmet social determinants of health needs, such as food insecurity or inadequate access to transportation. However, at the same time, some plans have indicated that enrollee utilization of many supplemental benefits is low. To ensure the large federal investment of taxpayer dollars in supplemental benefits is making its way to enrollees and is not primarily used to market benefits that individuals rarely use, the CMS Final Rule requires Medicare Advantage plans to engage in outreach efforts so that enrollees are aware of the supplemental benefits available to them.
Contract Year 2025 Medicare Advantage and Part D Final Rule (CMS-4205-F) Published: April 4, 2024 https://www.cms.gov/newsroom/fact-sheets/contract-year-2025-medicare-advantage-and-part-d-final-rule-cms-4205-f