.The new Special Supplemental Benefits for the Chronically Ill (SSBCI) likely holds the most interest for long term services and supports, housing and home and community-based service providers but lacks the detail around the services that can be provided. In 2020, MA plans will have the new option to offer “non-primarily health-related” supplemental benefits to chronically ill enrollees. These benefits do not need to be uniform across a population (e.g. all diabetics) and can vary based on each individual enrollee’s specific medical condition and needs.

New Rules:  The passage of legislation in 2018, such as the Bipartisan Budget Act of 2018 which contained provisions of the CHRONIC Care Act, will lead to changes in the types of benefits Medicare Advantage (MA) plans may offer in 2020 and beyond and what is expected of both MA and Special Needs Plans (SNPs).  CMS closed 2018 with the publication of a series of proposed and final rules that will govern MA, SNPs, and Medicaid managed care plans for 2020 and beyond. 

The Profile has proven to be a very useful statistical summary and serves as a resource for all professionals with an interest in the changing demographics of the population age 65 and over, including 15 topical areas (such as population, income and poverty, living arrangements, education, health, and caregiving).

CMS’s new interpretation appears to recognize the importance of these services for certain MA plan enrollees while making clear that not every enrollee in an MA plan will be eligible to receive them without a designated need.  CMS identified the following list of specific services as allowable supplemental benefits meeting CMS’s new expanded definition of “primarily health related”:


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