Medicare advantage

Medicare Advantage lacking for mental health coverage

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Total buyer satisfaction with Medicare Benefit plans has elevated this 12 months, thanks largely to enhancements in billing and funds, value and supplier selection.

However in response to the brand new J.D. Energy 2022 U.S. Medicare Benefit Examine, some regarding developments are brewing beneath the floor of these optimistic numbers.

Most notably, a majority of Medicare Benefit plan members are saying they do not have sufficient protection for psychological well being and substance use dysfunction providers.

Information from the Commonwealth Fund and the Nationwide Library of Drugs reveals an estimated 1.7 million Medicare beneficiaries dwelling with a recognized substance use dysfunction, and about one in 4 beneficiaries dwelling with a psychological well being situation.

Older adults specifically, the research discovered, have been affected by the loneliness and isolation which have solely elevated all through the COVID-19 pandemic.

For some well being plans, protection will be improved, whereas others could have a possibility to coach prospects about psychological well being advantages, as many beneficiaries could also be unaware of the protection and medicines which might be obtainable.


Total, member satisfaction with Medicare Benefit plans is on the rise. Buyer satisfaction clocked in at 809 on a 1,000-point scale, which is up three factors from 2021 and up 15 factors throughout the previous 5 years.

Regardless of that, simply 38% of MA plan members say they’ve sufficient protection for psychological well being remedy, down from 39% a 12 months in the past. Simply 27% of members say they’ve sufficient protection for substance use dysfunction providers.

These numbers evaluate with 91% of members who say they’ve sufficient protection for routine diagnostics and 89% who say they’ve sufficient protection for preventive and wellness providers.

Telehealth utilization, in the meantime, is on the decline. Simply 24% of MA plan members used telehealth throughout the previous 12 months, down from 35% in 2021.

Amongst those that have used the expertise, nevertheless, 48% say they’re very seemingly to make use of it once more, a rise of 5 share factors from final 12 months.

Well being plan portals nonetheless present some promise, however breaking inertia is proving troublesome. A powerful majority (82%) of MA members are registered for his or her well being plan’s member portal – up 4 share factors from a 12 months in the past – however 14% have registered for the portal and by no means logged in.

Total buyer satisfaction scores are 72 factors larger (823) when prospects register and log in to the portal than once they do neither (751).

Kaiser Basis Well being Plan ranks highest in Medicare Benefit plan general satisfaction, with a rating of 844. Humana (824) ranks second and Highmark (811) ranks third.


The Facilities for Medicare and Medicaid Providers is in search of methods to make Medicare Benefit higher. The company launched a Request for Data in July searching for public touch upon the favored providing, and is searching for enter on methods to make it extra equitable, inexpensive and sustainable.

As enrollment within the Medicare Benefit program grows, so do considerations and uncertainty over the earnings suppliers are reaping and whether or not “overpayment” is a matter.

A report from the Brookings Establishment signifies the 5 main insurers – UnitedHealthcare, Humana, Aetna, Kaiser Permanente and Elevance Well being (previously Anthem) – are padding their backside traces by disguising earnings as prices.

The report factors out that insurers are in a position to do that as a result of earnings accrued by means of associated companies should not regulated by medical loss ratio necessities.

Medicare Benefit plan funds are anticipated to get an 8.5% income enhance for 2023. This is a rise over the 7.98% proposed within the February advance discover. The 2023 progress charge is ready at 4.88%.


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