How Medicare and Medicaid Assist with Food Insecurity

Exploring the Roles of Federal Healthcare Programs in Addressing Hunger Introduction Food insecurity-the lack of consistent access to enough food for an active, healthy life-remains a persistent challenge for millions across the United States. Vulnerable populations, including older adults, individuals with disabilities and low-income families, are disproportionately affected. While Medicare and Medicaid are fundamentally healthcare programs, each plays a unique and increasingly important role in addressing food insecurity through direct and indirect means.

Understanding Food Insecurity in the U.S.

Food insecurity is defined by the U.S. Department of Agriculture as a household-level economic and social condition of limited or uncertain access to adequate food. In 2023, more than 44 million Americans experienced food insecurity at some point during the year. The health consequences of hunger are profound, ranging from poor nutrition and developmental delays in children to exacerbated chronic illnesses in adults and increased healthcare costs.

The Role of Medicare in Addressing Food Insecurity Medicare is a federal health insurance program primarily for people age 65 and older, as well as those under 65 with certain disabilities. While Medicare does not directly provide food assistance, it increasingly recognizes food insecurity as a key determinant of health and responds in several innovative ways.

Medicare Advantage Plans and Supplemental Benefits Medicare Advantage (MA), also known as Part C, allows private insurers to offer additional benefits beyond what traditional Medicare covers. In recent years, federal policy has expanded the definition of "supplemental benefits" to include services that address social determinants of health, such as food and nutrition.

Meal Delivery Programs: Many MA plans offer home-delivered, medically tailored meals for enrollees recently discharged from hospitals or managing chronic conditions such as diabetes or heart disease. These programs help improve recovery, adherence to medical regimens, and overall health.

Nutrition Counseling: Some MA plans include access to registered dietitians who can help beneficiaries create meal plans suited to their medical needs and economic circumstances.

Grocery Assistance: Select plans are piloting grocery benefit cards or vouchers, enabling members to purchase healthy food at local stores and farmers markets.

Florida DSNP Medicare Advantage Plans In Florida, Dual Special Needs Plans (DSNP) offered by major providers such as UnitedHealthcare, Humana and Devoted Health integrate medical coverage with additional non-medical supports, including food assistance. These plans serve individuals eligible for both Medicare and Medicaid, addressing food insecurity as part of their holistic approach to health, and include UnitedHealthcare, Humana and Devoted Health.

Screening and Referrals Medicare now encourages providers to routinely screen older adults for food insecurity during clinical visits. When a need is identified, healthcare staff can refer patients to federal nutrition programs (such as SNAP), community food pantries or local Meals on Wheels programs. Integration with community organizations such as NCCOA and Barnabas collaborate with community-based organizations that specialize in food access. For example, NCCOA provides trained counselors to navigate food assistance applications with SNAP; Barnabas offers food pantry assistance in Fernandina Beach and Callahan, working with church initiatives and strategic partners to serve residents of all ages.

The Role of Medicaid in Addressing Food Insecurity Medicaid, the joint federal and state health insurance program for low-income individuals and families, is central to the fight against food insecurity. Because Medicaid serves the most economically vulnerable Americans, its policies and waivers can be designed to address their specific social needs.

Waivers and State Innovation States administer Medicaid and can apply for waivers to test new approaches to care and coverage. Many states use Section 1115 waivers to fund pilot projects and programs that address food insecurity as a health-related social need.

Screening and Referral Programs: Medicaid managed care organizations often screen for food insecurity and partner with local agencies to provide food resources to members.

Collaborative Models and Community Linkages Medicaid supports integrated care models that address both healthcare and social needs. Accountable Care Organizations (ACOs) and Health Homes may include food access as part of their wraparound services. These models use care coordinators to help enrollees access SNAP (Supplemental Nutrition Assistance Program), WIC (Women, Infants, and Children), food banks and community gardens.

Nutrition as Prevention Medicaid programs increasingly recognize the preventive power of nutrition. Medicaid invests in food access for high-risk groups to lower hospital and emergency room costs.

Federal Nutrition Programs: Linkages with Medicare and Medicaid While Medicare and Medicaid themselves do not directly provide food, they serve as gateways to federal nutrition programs.

Supplemental Nutrition Assistance Program (SNAP) Many Medicaid recipients are automatically eligible for SNAP, which provides monthly benefits to purchase groceries. Healthcare providers and care coordinators assist patients in enrolling and navigating the application process.

Meals on Wheels Provided by NCCOA in Nassau County, Meals on Wheels deliver nutritious meals to older adults living independently, supporting both Medicare and dual MedicareMedicaid beneficiaries. NCCOA also provides nutritious meals to seniors in need, including those who are homebound due to isolation, disability or illness. This program provides more than just meals; it also provides nutrition education through visits from volunteers who also conduct wellness checks.

Challenges and Limitations Despite progress, significant barriers remain:

Limited Scope: Food-related benefits are not universally available to all Medicare or Medicaid enrollees. However, Medicare Advantage Plans fill in the gaps with healthy food benefits, depending on Medicaid level and qualification based on assets and income.

Funding and Sustainability: Pilot programs often depend on grants or temporary waivers, making longterm viability uncertain.

Awareness and Access: Some beneficiaries are unaware of available food resources or struggle with the application process. Coordination: Effective collaboration between healthcare providers and food assistance organizations is still evolving.

Looking Forward: Opportunities for Expansion Experts advocate for greater integration of food access into the fabric of healthcare, including:

Universal Screening: Ensuring every beneficiary is screened for food insecurity at regular intervals.

Expanded Food Benefits: Encouraging federal and state policymakers to authorize broader food assistance through Medicare and Medicaid.

Technology and Data Sharing: Using electronic health records to flag at-risk individuals and connect them with local resources.

Community Partnerships: Deepening collaboration with food banks, pantries and meal delivery services.

Conclusion Medicare and Medicaid increasingly recognize the vital connection between food insecurity and health. Through innovative benefits, community linkages and pilot projects, these programs help millions of Americans access the nutrition they need to thrive. While challenges remain, continued policy evolution and collaborative effort with Medicare Advantage Dual Medicare and Medicaid Special Needs Healthy Food Cards promise a stronger, more integrated response to food insecurity in the years ahead.

For more information, contact NCCOA Case Management at 904261-0701.

Source - Kathleen E. DeAngelis, HIA, Benefits Specialist, Compass Group Insurance