Medicare Advantage

Changes to Medicare Advantage in 2019

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We Explore Some Of The Changes Coming To Medicare Advantage Plans In 2019

If you’re a current Medicare Advantage subscriber or will be soon, then you may have heard about the big changes coming to Medicare in 2019. These changes are designed to streamline the program and increase benefits, adding value to plans that already give seniors affordable health insurance coverage during retirement. There are plenty of changes coming this year and next, but here’s a recap of some of the biggest improvements for the coming plan year. 

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Medicare And Extra Benefits For 2019

The Medicare Advantage program has proven successful in the last decade. Enrollment in the private portion of Medicare has doubled to more than 20 million since 2010. This means that enrollment has grown from a quarter of enrollees to more than a third. Satisfaction with the program also remains high.

Advantage plans have been largely popular among seniors because of the benefits available that aren’t offered in original Medicare plans. Many Advantage plans include dental and vision coverage, hearing aids, gym memberships, nurse advice hotlines and other perks that can help improve quality of life and give you more bang for your healthcare buck. Starting next year, there will be even more benefits to Advantage, including adult daycare facilities, home health aides and palliative care, and home safety devices.

Adult Daycare Facilities – 2019 

The Center for Medicare and Medicaid Services announced that Advantage plans can now provide coverage for adult day care programs. These structured programs are offered outside of the home to provide support and assistance for adults who need supervision. 

Home Health Aides and Palliative Care – 2019

Another area that will be included under Medicare Advantage is home health aide care. Aides can provide personal care for those who need assistance, including cleaning, cooking, bathing and running errands. Home-based palliative care will also be available for those who suffer from serious illness. 

Medicare And Home Safety Devices – 2019

Medicare Advantage will cover the installation of home safety devices and modifications, such as grab bars and wheelchair ramps. These devices may help prevent injuries and readmissions to the hospital. You may find plans that cover non-emergency trips to the doctor under new guidelines as well. 

These benefits may also help the insurance company spend less money on hospital care down the road. To be covered for these services, a medical provider will have to recommend them based on your health history and needs. 

Average Premiums Dropping For 2019

With so many options available from different companies, Medicare plans vary widely. What’s notable, though, is that MA premiums will decline while both benefits and plan choices expand in 2019. The average Advantage plan is expected to decrease by roughly 6 percent to $28 a month, down from an average of $29.81 in 2018. About 83 percent of all MA recipients will benefit from the same or a lower premium in 2019. Insurers have also added about 600 more plans to the market for next year, bringing the total to around 3,700 nationwide.

In addition to these new benefits, a new regulation has been put in place to allow Medicare Advantage enrollees to “test drive” the plan before they go all in. If you’re not satisfied with your current MA plan within three months of enrolling, you can switch to another Medicare Advantage plan or back to original Medicare. 

Medicare Part D In 2019

The opioid epidemic continues to grow each year, and the current administration along with lawmakers in Congress are taking steps to address the problem. Medicare Part D Plan has made this a top priority for Medicare in 2019. Drug management programs will be instituted to actively fight and prevent opioid addiction. These benefits will include therapeutic massage and alternative pain treatments. 

Is The Donut Hole Closing?

If you’re not familiar with the Part D “donut hole,” it’s a situation that some Medicare Part D subscribers experience when they spend a lot on prescriptions in a plan year. Once you hit the initial coverage cap of your plan, you’re stuck in the gap until you reach the other side, which is considered catastrophic coverage. There are thresholds for both the initial coverage cap and catastrophic breaking point, and they change each year. The Affordable Care Act included discounts for prescriptions when you’re stuck in the donut hole with the goal of closing that gap by 2020.

There’s good news for those who find themselves falling into the donut hole in 2019. Thanks to the Bipartisan Budget Act of 2018, beneficiaries won’t have to wait until 2020 for the gap to close on brand name drugs. You’ll pay just 25 percent of the cost of these drugs from when the plan starts until you hit your out-of-pocket spending threshold for the year (at which point, catastrophic coverage kicks in). That’s how Medicare Part D was designed. By 2020, the gap on generics will also close.

Medicare Part D isn’t part of Medicare Advantage, but the two share some common features. Both are private plans sold by individual companies, and they follow the same enrollment schedule. If you want to change your plan for next year – and shopping around is always recommended, even if you like your current coverage – you’ll have from October 15 to December 7 to shop and sign up. And if you’re new to Medicare, know that benefits keep improving each year while costs remain relatively low, especially for those with Medicare Advantage.

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