Tag Archives: Chris Giese

CMS guidance presents Medicare Advantage plans with new LTC benefits considerations

In April, the Centers for Medicare and Medicaid Services (CMS) provided guidance for Medicare Advantage (MA) plans regarding the scope of the “primarily health related” supplemental benefit definition. The guidance clarified the types of long-term care (LTC) benefits that MA plans can provide as a supplemental benefit for individuals needing assistance with activities of daily living (ADLs) or instrumental ADLs (IADLs).

These plans face various challenges as they contemplate offering LTC coverage under the new CMS definition for primarily health related supplemental benefits. In this paper, Milliman’s Chris Giese and Al Schmitz examine some of these challenges and explain what MA plans must consider to make choices that benefit both plans and consumers.