Before the Senate adjourns for its annual summer recess, momentum was building at press time for what would be one of the most significant changes to the Medicare program since the addition of Part D. That would be the expansion of fee-for-service (FFS) Medicare benefits to include dental, vision and hearing, and although details of any such legislative proposal are scarce, industry observers say the potential change could drive more Medicare Advantage plans to innovate.
Along with prescription drug pricing measures, the expanded Medicare benefits were included in a discussion draft of the $3.5 trillion spending package that Senate Democrats aim to pass via budget reconciliation, which requires a simple majority rather than 60 votes typically needed to pass bills in the Senate. That is separate from the Infrastructure Investment and Jobs Act, the Senate’s $1.2 trillion infrastructure proposal that the chamber aims to pass this week and includes delaying the implementation of the controversial Trump-era rebate rule to 2026 — a move that has been discussed as a way to fund enhancements to the Medicare program.
“Having dental, vision and hearing benefits added to original Medicare will deprive MA plans of a key differentiator that has helped win members from FFS,” suggests Michael Adelberg, principal with Faegre Drinker Consulting. But, he notes, MA plans will receive additional funds for covering these benefits. “This should create the opportunity to leverage a new set of differentiators like food, transport, OTC [over the counter] and other benefits emerging as the new ‘table stakes.’”
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