Original Medicare (Part A and B) rarely go through changes, but the Advantage plans also known as Part C often experience changes each year. Insurers anticipate the same for 2019, but the aspect that will remain the same is their function as an alternate comprehensive cover for most seniors.
When seniors become eligible to enroll in the government-funded health program, they automatically receive Part A and B of Medicare. It serves as the primary form of health care for senior citizens, and as such it often falls short in some regard. That is where the Advantage plan steps in and offers additional coverage.
With the open enrollment period for starting on the 15th of October, it is natural that most seniors want to know what are the best Medicare Advantage plans for 2019.
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Medicare Advantage Changes In 2019
Updates on Advantage changes often come up during the Annual Election Period (AEP), but the Centers for Medicare & Medicaid Services (CMS) have already publicized several of them. For 2019, the CMS expanded benefits to include coverage for services and items that may not precisely fall under medical treatment. However, these items provide care, treat injuries/illnesses, are devices that could possibly prevent diseases, and compensate for physical impairments.
The coverage also extends to addressing the effects of psychological illnesses and items that have a hand in reducing emergency medical care. Also, Medicare beneficiaries will not require a physician’s prescription/order, but the items must be deemed medically appropriate and recommended by licensed health providers.
Advantage benefits are also envisioned to extend to better food options and modifications made to the homes of beneficiaries. They include simple things like installing grab bars and contracting aides to offer assistance with daily activities. In-home care from a non-skilled provider is also for the first time covered as a supplemental benefit.
In general, MA premiums also often go through modest increases while in some cases benefits decrease too.
2019 Medicare Advantage Premiums
Along with the changes in the scope of coverage, the premiums on Medicare Advantage plans in 2019 will also increase. Insurers are yet to release the changed rates, but the anticipated increase in cost is likely to be about 5%. The plans that will also likely be the most affected are the prescriptions drug Part D and Advantage plans without the prescriptions coverage. Seniors will likely continue to search for $0 premium MA plans.
Another significant change is the scraping of the disenrollment period. Beneficiaries will instead have a chance to make changes to their Medicare plans during the open enrollment period. However, during the extended enrollment period, enrollees can only make one plan switch.
Different Medicare Advantage Plans in 2019
MA plans work on a network-based system where providers have a hand in controlling costs. Part A and B do not operate under networks, and it is often confusing for seniors in the beginning when switching over to Advantage plans.
MA plans typically fall under HMO and PPO networks. HMO plans require that beneficiaries seek almost all Medicare-approved health services from in-network providers. Enrollees must also have a primary care physician who can give referrals for specialized medical care. It means that you might have to settle for one of the doctor’s within the insurer’s network if your physician is not on their list.
PPO plans on the other hand charge higher premiums but allows beneficiaries to obtain out-of-network services. The out-of-pocket costs tend to be higher, but enrollees can significantly keep them on the lower end by seeing in-network medical providers.
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Choosing The Best Medicare Advantage Plan For 2019
Each individual has differing health care needs, and that also has a hand in determining which MA plan suits them best. Often, most find that a Medicare Advantage Prescriptions Drug (MAPD) plan works sufficiently for their needs. It is because these plans often bundle up Part D with other medical benefits.
However, of equal importance when joining a plan with Part D is to note that every insurer has their own prescription drugs tiers. That means that they cover different drugs at varying benefit levels. In essence, it means paying more for brand names compared to generic medicine. One of the other changes that the MA plans will go through in 2019 is the closure of the “Donut Hole.” In short, it means that beneficiaries will spend significantly less on their prescriptions.
It is also a little early to tell which plans seniors will favor most next year but recent enrollment statistics can give an indication. For instance, last year saw an increase in the uptake of MA plans and the trend is likely to continue this year. Nearly 63% of Advantage enrollees chose to go with HMO plans while about 33% preferred the PPOs.
Enrolling in Medicare Advantage 2019
The Open enrollment period kicks off on the 15th of October running through to the 7th of December 2018. That is the best time to sign up for an Advantage plan or switch over to a different one. While a late enrollment period will run from January to March of 2019, it is wiser to enroll this year to avoid incurring penalties.
Worth noting is that only individuals who already have Original Medicare (Part A and B) can switch over to Advantage plans. Seniors suffering from End Stage Renal Disease (ESRD) cannot, unfortunately, sign up for the Part C plans. MA plans also cover special needs to cater to chronic illnesses.
Once signed up for an MA plan, the insurer issues the enrollee a new ID card that takes care of all billings including the Part A and B plans.
It can be a complicated process navigating around the different Medicare Advantage plans available as well as the different insurers offering them. The most significant take home is that enrollees have to stick with their chosen plan until fall of 2019 to make any changes or revert back to the Original Medicare.
Get doubt out of the process by letting us help you figure out what are the best Medicare Advantage plans for 2019 that suit you best.