Benefit Design

Benefit design in Medicare has important implications for which services are covered, how much beneficiaries pay out-of-pocket, and federal spending. Medicare Advantage (MA) plans combine traditional Medicare benefits with supplemental coverage to distinguish their offerings. MPI’s work on this topic examines how Medicare Advantage plans use federal rebate dollars to provide supplemental benefits (e.g. dental, vision, hearing coverage, and over-the-counter flex cards), and the value of these benefits to beneficiaries and taxpayers.

MPI’s work also focuses on other aspects of plan design in MA including the role of Medicare Special Needs Plans (e.g., C-SNPs and I-SNPs) and other models intended for beneficiaries with more complex health needs. Additional topics include benefit redesign in other parts of the Medicare program, including in traditional Medicare and Medicare Part D, and the effects coverage changes have on costs, plan design, and beneficiary access.

Explore policy proposals related to Supplemental benefits and rebates, Plan networks, provider payments, and benefits coverage, Employer group waiver plans, and MA and VA coverage in our Medicare Advantage Compendium.