Growing Number of Seniors Have Access to ‘Expanded Primarily Health-Related Benefits’

More than 1,400 Medicare Advantage plans will offer at least one Expanded Primarily Health-Related Benefit (EPHRB) in the 2023 plan year, according to a new report from ATI Advisory. CMS in 2019 reinterpreted the definition of what constitutes as a “primary health-related” benefit, which allowed plans to offer a wider range of supplemental benefits such as adult day health services, support for caregivers of enrollees and therapeutic massage. The most commonly offered EPHRB is in-home support services, which is available in at least one plan in the majority of U.S. counties, according to ATI’s analysis. Two EPHRBs — in-home support services and support for caregivers — saw significant uptake from 2022 to 2023, growing 50% and 83%, respectively. An earlier analysis from ATI found that more than 30% of MA members are currently enrolled in a plan that offers at least one type of supplemental benefit, which includes both EPHRBs and Special Supplemental Benefits for the Chronically Ill.

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