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**For Facebook
Reviewers and 3rd Party Fact Checkers, these
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*Medicare
Advantage plans are funded by the federal
government through a process called
"capitation." Under this process, the
government pays a set amount of money to the
insurance company offering the Medicare
Advantage plan for each enrollee in the
plan. The amount of funding that the
insurance company receives is based on a
number of factors, including the health
status and demographic characteristics of
the enrollees in the plan, as well as the
location of the plan.
Healthy Options
Allowance. The new Healthy Options Allowance
offers members with D-SNPs, and other
qualifying members with chronic health
conditions on some Medicare Advantage plans,
the flexibility to spend their funds – up to
$3,300 a year depending on the plan – where
they need it most – whether that’s for
groceries, rent and utilities,
over-the-counter products, home supplies,
non-medical transport, pest control, pet
care supplies, disaster relief kits, and
more through spending cards that get funded
on a monthly basis.
The funding that
insurance companies receive for Medicare
Advantage plans comes from the Medicare
trust fund, which is funded by payroll
taxes, premiums paid by beneficiaries, and
general revenues. The amount of funding that
a Medicare Advantage plan receives from the
government is adjusted annually based on a
risk adjustment process, which is intended
to account for differences in the health
status of the plan's enrollees.
In addition to
the capitation payments, some Medicare
Advantage plans may also receive additional
funding from the government in the form of
quality bonuses or other incentives. These
bonuses are intended to reward plans that
provide high-quality care and achieve
certain performance metrics, such as
improving patient outcomes or reducing
healthcare costs.
