Medicare Advantage Plan Growth in Rural America: Availability of Supplemental Benefits


The 2018 CHRONIC Care Act influenced the growth rate in Medicare Advantage (MA) plan enrollment by allowing plans to offer more options extending the types of benefits available to MA beneficiaries. The Act gave MA plans the flexibility to offer new supplemental benefits to address enrollees' broader health and social needs. Now, in addition to traditional primarily health-related benefits, MA plans can offer expanded health-related benefits (e.g., in-home support services, therapeutic massage, caregiver support, home-based palliative care, and adult day health services) and special supplemental benefits for the chronically ill (SSBCI) such as food and produce, meals, transportation, and pest control.

Key Findings:

  • MA plans providing any supplemental benefit were less commonly offered in noncore counties (87.2 percent of plans), followed by micropolitan counties (94.6 percent) and metropolitan counties (97.6 percent) in 2022. Only 10 to 20 percent of plans offered expanded supplemental benefits or SSBCI across all three geographies.
  • Plans with traditional primarily health-related supplemental benefits most frequently included vision (97.6 percent), hearing (95.2 percent), fitness (94.6 percent), and dental services (93.6 percent). Significantly fewer plans offered expanded supplemental benefits and SSBCI that address beneficiaries' broader health and social needs. Declining availability of all supplemental benefit types was seen as geography shifted from metropolitan to noncore counties.
  • Noncore counties in the West region were most likely to be "supplemental benefit deserts” (i.e., counties with no plans offering supplemental benefits) while counties in the Northeast region were the least likely.
RUPRI Center for Rural Health Policy Analysis
Edmer Lazaro, Dan Shane, Fred Ullrich, Keith Mueller