What Is the Medicare Grocery Benefit?

What Is the Medicare Grocery Benefit

At any age, it’s important to eat a diet of healthy, nutritious foods to protect against many chronic condition and diseases. Eating healthy can help you live longer, support your muscles and bones, boost your immunity, and make it easier to perform day-to-day activities.

However, eating healthy foods can be a challenge, especially if you have a hard time getting to the grocery store or preparing meals to due to an illness, chronic condition, or mobility issues.

Original Medicare (Part A and Part B) does not cover meal or grocery delivery services, but there are other options available to you depending on your eligibility and needs.

Do Medicare Advantage plans cover groceries?

Also known as Medicare Part CMedicare Advantage plans cover everything Original Medicare Part A and Part B do. They aren’t limited to that coverage, though. Around 90% include Part D prescription drug coverage, routine vision and dental services, hearing, and more.

Even though Original Medicare doesn’t cover groceries, grocery delivery, or food delivery programs, some MA HMO and PPO plans offer benefits like meal delivery or grocery benefits. For example, you may find an MA plan in your service area that offers a grocery benefit as a monthly, quarterly, or annual allowance for eligible food and grocery items.

For example, things you can buy with your grocery benefit may include:

  • Fruits and vegetables (fresh, canned, or frozen)
  • Dairy products
  • Meat
  • Seafood
  • Beans and legumes
  • Healthy grains
  • Cereals
  • Frozen meals
  • Salad kits
  • Soups
  • Pantry staples (flour, sugar, spices, etc.)
  • Nutritional shakes and bars
  • Water

Typically, only healthy foods are covered. In most cases candy, chips, desserts, sodas, alcohol, and similar items are not included with this benefit. Additionally, not all grocery stores qualify. Participating stores can vary by state, so contact your plan to learn more. Some examples of stores that may be included are:

  • ACME
  • CVS
  • Food Lion
  • Kroger
  • Walgreens
  • Walmart

Finally, not all MA plans offer this benefit at all, so if it’s something that’s important to you, you’ll want to find plans in your service area that do offer it.

How does the grocery benefit work?

Every Advantage plan is different, so you’ll want to check with yours for specifics. However, generally speaking, if you qualify for the grocery benefit you can use the allowance on eligible over-the-counter (OTC) items and groceries. Most plans will send you a grocery benefits card that you’ll use at checkout to pay for your items. The balance on the card will be applied to approved items, and you’ll pay for the remaining items out-of-pocket.

In many cases, you can buy your groceries in the store or online.

How to qualify for the Medicare grocery benefit

Qualifications will vary by plan, but you typically must have a qualifying health condition to be eligible. Examples of health conditions that may qualify you include cancer, heart disease or heart failure, diabetes, kidney disease, end-stage renal disease (ESRD), obesity, arthritis, and autoimmune disorders.

Other food delivery programs

If your MA plan doesn’t offer a grocery benefit, it may cover meal delivery as a benefit. This is typically only temporary assistance for a set number of meals or for a limited time after you’re discharged from the hospital, a skilled nursing facility (SNF), or other inpatient facility. And, meals must be nutritious and in line with Medicare’s daily nutritional guidelines.

Meal delivery programs may also be covered by your MA plan if you have a chronic medical condition or other health condition that has you homebound. Research plans in your service area that offer this benefit or talk to your plan to learn about coverage and how to arrange for meal delivery.

There are also other programs available to seniors and beneficiaries depending on your specific needs and eligibility:

Meals on Wheels

Meals on Wheels is a federally-funded program that delivers meals and healthy food to seniors, people with disabilities, individuals recently released from the hospital, and others who may be facing hunger or difficulties purchasing or preparing their own meals.

The program serves more than 2.4 million people aged 60 and older each year, and while not covered by Medicare or other health insurance plans, it does serve older adults regardless of their ability to pay. For example, they may offer a sliding fee scale or take food stamps as payment.

Each program has different eligibility and levels of support, so find a provider near you to learn more.

Program of All-Inclusive Care for the Elderly (PACE)

PACE is funded by Medicare and Medicaid and serves people ages 55 and older. One benefit PACE offers is providing meals and nutritional counseling for those in need, including home-delivered meals, meals prepared in your home by a personal care assistant, or meals supplied through an outside organization (like Meals on Wheels).

To qualify for PACE, you must be 55 or older, live in the service area of a PACE organization, need a nursing home level of care, and be able to live safely in the community with help from PACE.

Medicaid

This state-run program helps those with low or limited income or who meet other eligibility requirements. While there are limitations, such as being homebound and/or unable to prepare meals on your own, Medicaid does partner with organizations to provide meals through home-delivery or meal preparation services.

Special Needs Plan (SNP)

Special Needs Plans are a type of Medicare Advantage plan whose membership is limited to beneficiaries with specific diseases or characteristics, such as living in a nursing home. The plan’s benefits, providers, and prescription drug formularies are tailored to meet the specific needs of the group it serves. Some individuals with chronic conditions or who meet other criteria may be eligible for meal benefits through their SNP.

Supplemental Nutrition Assistance Program (SNAP)

SNAP (formerly known as food stamps) is a federal program that helps people buy the food they need. The program provides supplemental funds that can be used to buy eligible items from grocery stores and other retailers that sell food, as well as participating farmer’s markets.

Benefits are loaded on to an Electronic Benefits Transfer (EBT) card that can be used like a debit card to purchase eligible items like fruits and vegetables, meats, fish, breads, dairy, snack foods, and others.

Each state has different eligibility criteria, but typically a certain threshold for household income must be met, and household assets must fall below a certain amount. In 2023, income limits are:

  • $1,473 in gross income and $1,133 in net income for an older adult living alone
  • $1,984 in gross income and $1,526 in net income for a two-person household

“Older adults” are considered those ages 60 and older.

While about 4.8 million older adults are currently enrolled in SNAP, it’s estimated there are another five million who are eligible. To learn if you’re eligible and apply, visit https://benefitscheckup.org and enter your zip code or select your state of residence.

Additionally, the Centers for Medicare & Medicaid Services (CMS) recently approved several grants ($250 million) that will go to organizations that provide meals to help eligible adults get meal services. These programs include PACE, Medicaid, the Administration for Community Living (ACL), Meals on Wheels, and others.

Additional reading

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