What’s Considered Medically Appropriate for Insurance to Be Expanded

Healthy groceries, home-delivered meals, air conditioners and grab bars in the bathroom may soon be some of the “medically appropriate” benefits covered by insurance.

The Centers for Medicare & Medicaid Services expanded the definition of “primarily health-related” benefits insurers can include in their Medicare Advantage policies. Beginning in 2019, insurers can provide retirees care and devices to prevent or treat illness and injuries or reduce emergency medical care. The type of benefits offered can vary according to the beneficiaries’ place of residence.

Experts believe these benefits will reduce costs and advance beneficiaries’ health. Observers are hopeful insurers for individual and employer-sponsored health insurance soon will follow suit if studies indicate that food-related and care interventions will lower costs and improve health outcomes.

For instance, the Institute on Aging, a California nonprofit that offers services for seniors and adults with disabilities, reduced health care costs 30 percent by taking a more integrated approach to addressing participants’ social and health needs. A Health Affairs study showed a 16 percent decrease in overall medical spending for participants in a medically-tailored meal program.

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