Cigna, Humana Expand MA Plans to Cover Social Determinants of Health
Expanding coverage to address common social determinants of health demonstrates Cigna and Humana's commitment to tackling members' risk factors outside of traditional medical care.
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By - Cigna and Humana announced their 2020 Medicare Advantage plans will now include coverage for social determinants of health.
These social determinants of health include the environment, economic, and social factors that impact an individual’s health. Research has shown that these factors influence a person’s health more than the medical care he receives.
It is no surprise, then, that payers are finding innovative ways to address these factors in their member populations. Cigna and Humana’s coverage for common social determinants of health in their 2020 Medicare Advantage plans demonstrates their commitment to addressing barriers impacting their members' health more broadly.
“Humana is committed to demonstrating more ways to care for our millions of Medicare members across the country by providing them new tools, technologies, and services that support their health and active aging,” President of Retail Segment at Humana, Alan Wheatley said in a press release. “For 2020, we’re offering more programs and benefits to address our members’ physical, social and medical needs and help them achieve their best health.”
The social determinants covered by Humana vary by region, but many will include support for caregivers, rides to medical appointments and the gym, acupuncture, home-delivered meals, and coverage for over-the-counter personal care items (e.g., pillboxes, vitamins).
Cigna’s coverage also varies by market, but highlighted benefits include air conditioners, fall prevention, acupuncture, and transportation to places of worship and grocery stores.
"We are excited about these pilots, and we're eager to learn from these programs and see where we can make a real, tangible difference in people's lives," Brian Evanko, president of Cigna's government business said in a press release.
Both payers are also introducing telehealth capabilities into their 2020 Medicare Advantage plans which will allow members to access routine care services via phone, tablet, or laptop. Humana’s plans will include limited telehealth capabilities for behavioral health and urgent care.
Expanding these benefits come as both payers are increasing their market saturation and hoping to grow their member populations.
Humana is expanding its PPO and HMO plans to 172 counties and 160 counties, respectively.
Cigna is expanding its plans to 80 counties across 17 states.
"This is an exciting year for Cigna as we roll out our biggest Medicare Advantage expansion to date with new geographies and new products," emphasized Evanko. “Even with this growth, our focus remains on providing customers with timely access to affordable care. One tangible example is the introduction this year of a $0 copay in some HMO plans for customers to see a specialist, lowering yet another barrier to people getting the care they need.”
In addition to offering a $0 copay for specialist visits, Cigna is introducing plans into every market with a $0 premium and nearly 90 percent of their plans will have no copay for primary care office visits. The organization is also offering plans with zero out-of-pocket costs for specialist care, to eliminate cost as a barrier to care.
Humana is leveraging wellness benefits to their members included at no additional cost. The offerings include SilverSneakers® fitness program, the wellness and rewards program Go365TM, and SmartSummary and SmartSummaryRx or personalized statements after a claim. Humana members who want to age in place will be offered the added benefit of personal care managers to help educate members about the resources available to them.
Both payers also plan to cover dental and vision care in their expanded plans
“We look forward to entering these markets with very attractive products from the start and growing our customer relationships deliberately over time,” continued Evanko. “We’ve chosen expansion markets very purposefully, selecting those areas where we are confident we can be successful because of our strong reputation and the strength of our relationships with doctors and hospitals.”
Increasing benefits and eliminating cost barriers demonstrates Cigna and Humana’s commitment to addressing the social determinants of health of their members and promoting healthier lifestyles.
