Every year Medicare makes changes to the nationalized program in one way or another. Typically, at the first of the year, premium and cost-sharing changes are implemented. The most common changes to expect from Medicare are new premiums, deductibles, and co-pay amounts each year.
In 2019, we will see changes to Medicare that go beyond the usual cost changes. This year, Medicare has allowed new benefits, discontinued plans, and modernized the way beneficiaries can connect and interact with their resources.
Let’s take a look at the main changes to Medicare you should know about this year.
1. Open Enrollment Period Returns
Running from January 1st to March 31st, Medicare has reinstated its “try before you buy” program for Medicare Advantage (MA) plans. This means if you selected a Medicare Advantage plan during the 2018 Annual Election Period (AEP) and it just isn’t working for you, you can use this time to get out of it.
Previously, Medicare beneficiaries who chose a Medicare Advantage plan during the AEP were stuck with that plan until the following year unless they used the Medicare Advantage Disenrollment Period to change back to Original Medicare in the first six weeks of the year. Now beneficiaries have a longer 3- month window to either change back to Original Medicare OR make a one-time switch to a different Medicare Advantage plan.
The Open Enrollment Period eliminates the major issues that accompany choosing the wrong plan. Don’t love your MA plan? Be sure to use this time to get out of it.
2. Cost Plans Are No More
Years ago, Medicare created Cost Plans as an option for beneficiaries who lived in rural counties where there were not at least two competing Medicare Advantage plans. Since that time, Medicare Advantage plans have expanded into nearly every corner of the country.
This was a change that took legislators a long time to pass but as of 2019, Cost Plans are no longer widely available to Medicare beneficiaries.
Many beneficiaries who previously had a Cost Plan were given the option to return to Original Medicare and choose a Medigap plan and a Part D drug plan or they could enroll in one of the Medicare Advantage plan options in their county. If they did not choose one of these options, they were auto-enrolled into a Medicare Advantage plan through their original carrier.
Sometimes fewer choices can be a good thing as too many choices can be overwhelming for beneficiaries.
3. New Benefits with Medicare Advantage
As a standard, Medicare Advantage plans must offer coverage equal to or better than Original Medicare. To incentivize beneficiaries to choose their specific plans, Advantage carriers often add more benefits than Original Medicare does such as dental coverage, vision coverage, and other relevant perks.
As of 2019, Medicare Advantage plans are now allowed to include supplemental home healthcare benefits too. These services can include adult day-care, transportation to doctor appointments, meal delivery, and even home modification benefits.
Though these services are now permitted, it does not mean every Medicare Advantage plan will be offering them. With that said, if plans with these offers become popular with the public, more carriers will be likely to offer them in future plan designs.
4. Medicare Creates an App
A true sign of the times! Medicare now has a phone application that will give beneficiaries the ability to find information wherever they are.
One of the most misunderstood aspects of Medicare is what it covers. This app will let users search services and procedures to quickly see whether it is covered by Medicare.
As great as it will be to have this convenience, it will also clear up many unnecessary bills. Beneficiaries can easily see if a service or procedure will be covered before they agree to move forward.
5. Donut Hole Expenses Shrink
Last but certainly not least, the percentages that beneficiaries will be responsible for in the Part D donut hole will be lower in 2019.
The donut hole has never been popular with beneficiaries. They fear getting into it for what their out-of-pocket costs might be. However, it has been a necessary evil in that it helps encourage beneficiaries to use generic drugs and keep overall costs for Medicare down.
The good news for 2019 is that beneficiaries will pay less than ever for both generic and brand-name prescriptions. When they hit the gap, beneficiaries will only be responsible for paying 37% for generic prescriptions and 25% for brand-name prescriptions. The Part D plan covers the majority of the cost for both.
Until Next Year
And there you have it! Staying current on changes that impact your healthcare is more important than ever. These are the five major changes that you can expect to see from Medicare this year.