09/22/2025
Value-Based Insurance Design(VBID) was a project designed by CMS to help lower costs and tailor benefits to enrollees with chronic conditions and socioeconomic needs. In essence this allowed Medicare advantage plans to offer benefits, such as transportation, healthy food cards, money to pay for utilities, etc. It also allowed the insurance companies to offer lower costs for prescription drugs. However, this benefit will no longer be available in 2026 as CMS discovered that the costs were just too high.
This essentially means that if you happen to have a Medicare advantage plan that offered some of these benefits, they may no longer be available to you. Instead, there is a program called Special Supplemental Benefits for the Chronically Ill(SSBCI) that would allow an insurance company to continue some of these benefits under certain circumstances. Generally an insurance company may have one or more plans available that may offer benefits for healthy foods, utilities or transportation only if you qualify based on whether you have certain medical conditions. If you are not in one of the plans that offer these benefits, you would not have access to them. Or if you happen to be in a plan that offers some of these benefits, but do not have a qualifying medical diagnosis, you will not receive these benefits. For more specific details or if you are looking to make changes to your plan or want to know what else may be available during the Medicare Annual Enrollment Period starting in October, reach out to my office.
