A guide for occupational therapy practitioners

Comparing supplemental benefits in two Medicare Advantage plans

Compiled by Madeline Garcia, OTD-S

This guide examines and assesses the supplemental benefits offered by two specific Medicare Advantage plans. It presents a list of key definitions, including the categorization of three main types of Medicare Advantage supplemental benefits. It's crucial to understand that the benefits discussed in this guide vary depending on the plan and eligibility criteria.

Key Definitions

I - Introduction

Medicare Advantage (MA), also known as Medicare Managed Care or Medicare Part C, is administered by private insurance companies but regulated and reimbursed by the federal government.

II - Understanding Supplemental Benefits

Supplemental benefits (SB) refer to certain items and services not covered under Traditional Medicare.

III - Overview of SCAN Health Medicare Advantage Plan (SCAN Connections (HMO D-SNP))

SCAN Health Plan is a not-for-profit healthcare organization based in Long Beach, CA. The organization was founded in 1977 by a group of seniors advocating to increase access to quality healthcare for older adults.18

IV - Overview of Humana Medicare Advantage Plan

Humana is a healthcare company founded in 1961 providing Medicare Advantage plans, group insurance plans, individual health insurance plans, and specialty health services. 21

V - Recommendations for OTPs

As MA enrollment and nonmedical benefits increase, OTPs must grasp how MA plan design can impact beneficiary health and well-being. Taking a more informed approach to addressing SDOH through nonmedical benefits can lead to more satisfying outcomes for both beneficiaries and OTPs in their daily work. Envisioning a future where practitioners are well-versed in SDOH and utilize their expertise to help coordinate and implement these benefits is essential.