4 Payers Share 2023 Medicare Open Enrollment Benefits, Inflation Drives Updates

October 03, 2022 - For the 2023 Medicare open enrollment period, payers are introducing new benefits and expanding old ones with the aim of lowering costs and reducing healthcare’s complexity.

One of the major drivers behind new benefits that a couple of the major payers mentioned was the rising inflation rate.

Nearly four in ten Americans restrict spending in other areas of their lives in order to cover healthcare costs. That includes limiting automobile activity and even food consumption.

Rising inflation has seriously constricted Medicare beneficiaries’ wallets and made healthcare’s high prices even more unaffordable. Around 20 percent of Medicare beneficiaries reported that they spend half or over half of their monthly income on healthcare costs. High prices leaves seniors with the impossible choice between covering their healthcare needs or covering their daily needs.

In response to these rising financial pressures, payers are expanding Medicare Advantage benefit for 2023.

Aetna

READ MORE: Few Seniors Have Changed Plans During 2022 Open Enrollment

For plan year 2023, Aetna expanded its Medicare Advantage plans into 141 counties. Around 55 million Medicare beneficiaries will have access to an Aetna Medicare Advantage plan in the new year.

The payer introduced new Medicare Advantage plans: the institutional special needs pan and the expanded Aetna Medicare Eagle plans for veterans. The new institutional special needs plan, called the Aetna Medicare Longevity Plan, is now available for members in nursing homes in Pennsylvania. It includes benefits specifically tailored for nursing home residents, including social and emotional supports.

The Aetna Medicare Eagle plan is a Medicare Advantage plan for veterans, which will now be available to over 6.1 million seniors. The option is a zero-dollar premium plan with zero-dollar copays for primary care services and labs. It includes dental, vision, and hearing care benefits along with an over-the counter allowance and access to the Silver Sneakers fitness program.

Aetna also brought its dual eligible special needs plans into new markets in South Carolina, South Dakota, and Utah and new preferred provider organization options in Georgia and South Dakota.

Individual Medicare Advantage plans will include new benefits such as the Aetna Medicare Extra Benefits Card, a preloaded debit card with an allowance for over-the-counter items, healthy foods, transportation, and more.

READ MORE: Trends in Medicare Advantage 2022 Open Enrollment Offerings

Memory Fitness is another new benefit that gives Individual Medicare Advantage members access to brain games to help them exercise their minds. The Fresh Food Boxes benefit will let members receive a box of produce on a regular basis.

The plan will also include more traditional Aetna benefits such as telehealth coverage, zero-dollar cost-shares on certain benefits, dental, vision, and hearing benefits, and more.

“To help lower their health care costs, we expanded our Aetna Medicare Solutions portfolio of products to include improved prescription drug coverage that will save members money, more essential benefits that make a meaningful difference in members’ lives and plans that fit their unique needs and budget,” added Christopher Ciano, president of Aetna Medicare.

Elevance Health

Elevance Health—formerly known as Anthem—will offer plans available for almost 33 million Medicare-eligible consumers. Elevance Health offers various Medicare Advantage plans, some of which still bear the Anthem name.

Elevance Health’s Medicare Advantage plans are available in 210 new counties serving another 6.7 million consumers in 24 states and Puerto Rico. The payer’s dual special needs plan will be available in 21 states, offering zero-dollar prescription copays and other extra benefits.

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The plan will offer a prepaid benefits card to cover multiple benefits. The goal is to streamline benefits coverage so that members do not have to tote multiple benefits cards, according to the press release.

Elevance Health will continue the partnership with Kroger, which allows members in Kentucky, Virginia, Ohio, and Georgia to receive a monthly grocery card benefit to help cover costs for nutritious foods and health and wellness products at over 200 Kroger stores. The partnership also gives members access to a Kroger dietitian and food deliveries from the grocery store.

The payer’s Medicare Advantage benefits include in-home social support and health-related transportation.

“With inflation higher than it’s been in decades, seniors and other Medicare eligible individuals are searching for a benefits plan that provides the greatest value,” Elena McFann, president of Medicare for Elevance Health.

“Three-quarters of our affiliated health plans for 2023 have a zero-dollar premium and no co-pay for visits to a primary care physician. In addition to their affordability, our Medicare Advantage plans take a holistic view of health and contain extra benefits designed to enhance our members’ quality of life.”

Humana

Humana will extend into 260 new counties in 2023. Additionally, the payer will introduce Medicare local preferred provider organization (LPPO) into 260 new counties—including entering California, Rhode Island, and Wyoming for the first time—and dual eligible special needs plans into 184 new counties.

In 2023, Humana will significantly boost the number of health maintenance organization (HMO) plans and LPPO plans with zero-dollar premiums.

Some HMO plans will also have an out-of-network dental benefit available. New allowances will be available to cover dental services like extractions and a certain number of cleanings, covering 100 percent of the service cost up to the allowance maximum. Members in PPOs can use the allowance at in-network and out-of-network dental providers.

In an effort to promote access to prescriptions, Humana will also remove preferred retail pharmacy pricing with over 60,000 pharmacies. The payer indicated that this move would establish a single retail network and enable access to low-cost drugs.

Humana also significantly extended its pair of hospital-at-home models—the provider-referred model and the facility-referred model. For some of the plans, members will have access to $0 cost-sharing.

“When you sum up what Humana is offering this year, it’s as simple as this: Our members spoke, and we listened,” said George Renaudin, Medicare president for Humana. “We conducted extensive research to ensure our changes align with consumer wants and needs. This research resulted in investments focused on what consumers want, like dental coverage, which is consistently a #1 priority in supplemental benefits for our members.”

UnitedHealthcare

UnitedHealthcare Medicare plans will be accessible for 95 percent of Medicare consumers in 2023. The payer noted that 99 percent of members in chronic special needs plans and standard plans will have 2023 premiums that match their 2022 premiums or are lower than the previous year’s premium costs.

Additionally, 97 percent of UnitedHealthcare Medicare members in a standard plan or chronic special needs plan will have a zero-dollar primary care copay.

Some Medicare plans will offer access to a new flex benefit for more extensive dental, vision, and hearing benefits, ranging from $150 to $750 of spending money for Medicare-approved items. Members can use the funds on services such as out-of-network dental charges or products like prescription sunglasses.

The Humana dual eligible special needs plans’ utilities credit will now have a home utilities benefit in addition to the typical food and utility benefits. The credit gives dual eligible beneficiaries extra spending credit of more than $2,200 to use on utilities that include heat, water, and home internet. Payers have been seeking to expand access to the internet in light of the virtual care and telehealth boom.

Dual eligible beneficiaries can also access a new home support services benefit through some dual eligible special needs plans. The new benefit will give members $150 to $225 in credit to use every quarter. The credit can be used on a variety of services, including but not limited to pest control, home modifications, and companion care.

“With financial pressures especially impacting older adults living on fixed incomes, we are committed to improving the benefits we offer and driving industry-leading innovations that make them easier to use for the people we serve,” said Tim Noel, chief executive officer of UnitedHealthcare Medicare & Retirement. “These investments and innovations will make a meaningful impact on the experience and value we provide to our members – in ways only UnitedHealthcare Medicare Advantage can.”

These expanded Medicare Advantage benefits come at a time when Medicare Advantage plans are coming under scrutiny for overpayment.