Improving Benefits in Medicare Advantage for Patients and Providers



The AMGA advocates for the expansion of Medicare Advantage benefits, citing potential advantages for patients, physicians, and the broader healthcare sector.

Approved policy and technical alterations for 2025 in Medicare Part C (also referred to as Medicare Advantage) and the Medicare Prescription Drug Benefit Program (Medicare Part D) have been proposed by the association. The U.S. Centers for Medicare & Medicaid Services concluded a public comment period by the end of 2023.


AMGA's President and CEO emphasizes the significance of addressing the comprehensive needs of chronically ill patients, encompassing social factors that impact their health outcomes, as pivotal to their overall wellness. Maximizing coverage and benefits relies on patients being well-informed about available services.


In addition to various other themes like Special Supplemental Benefits for the Chronically Ill (SSBCI) and social determinants of health, AMGA presented its recommendations.


AMGA proposed incorporating outpatient behavioral health providers into network adequacy assessments to enhance access to vital mental health services. Their suggestions encompassed inclusion of addiction treatment providers, marriage and family therapists, mental health counselors, and other behavioral health providers.


Furthermore, AMGA recommended that Medicare Advantage plans integrate in-person care within their networks to enhance access to behavioral health services. While telehealth remains significant, they underscored the importance of ensuring patients have access to in-person care.


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