Medicare is the primary insurer for roughly 48 million seniors, most of whom are very happy with their coverage. There are millions more on Medicare younger than 65 due to a disability. If you’re enrolled in Medicare already, or eligible for Medicare coverage in 2019, here are some changes to keep in mind.
Medicare Premiums and Deductibles are Going Up
The Part A deductible will increase to $1,364, up $24 from 2018, and the Part B deductible climbs $2 to $185. The standard Part B monthly premium for 2019 is set at $135.50, an increase of $1.50.
The income tables for those paying an income-related monthly adjustment amount have also changed, and top earners will pay about 7.5% more than in 2018.
|Individual Filers||Joint Filers||Medicare Part B premium|
|Over $500,000||Over $750,000||$460.50|
You can find out more about Medicare costs in 2019 here.
A New Open Enrollment Period for Medicare Advantage
Between January 1 and March 31 each year, you’ll now have the opportunity to switch from one Medicare Advantage plan to another or drop Medicare Advantage and enroll in Original Medicare (Part A and Part B).
This new open enrollment period is different from the Medicare Open Enrollment period that runs from October 15 to December 7 each year. (This is why here at Boomer Benefits, we like to refer to the fall period as Annual Election Period.)
The real bonus about this new open enrollment period is that makes Medicare Advantage plans in 2019 feel less risky. You can take it for a test drive. Let’s say you enroll in a Medicare Advantage plan during the Annual Election Period. If you don’t like it, you can change to another plan or return to Original Medicare and Part D during the OEP that runs from January 1st – March 31st. Keep in mind, however, that buying a Medigap plan to go alongside the Original Medicare may require health questions. Check with your broker to find your options.
Related Article: Part D Donut Hole in 2019
Lifestyle support coverage under Medicare Advantage
As of 2019, Medicare Advantage plans will now be able to cover more in-home services, including meal delivery, safety equipment such as handrails and wheelchair ramps, and even home health aides for help with activities of daily living.
Transportation to and from medical appointments may also be covered if recommended by a doctor.
This new change was designed to help seniors with chronic illnesses benefit from preventive care and home health care services that may help to prevent hospitalization. Advantage plan carriers were a little slow to incorporate the changes into the 2019 Medicare Advantage plans, but we are hopeful that we’ll see more plans incorporating these new benefits into their coverage outlines in 2020.
Donut Hole Changes for Part D
Medicare’s standard model for Part D drug plans states that patients in the Initial Coverage Level stage of their drug plan can be charged no more than 25% of the cost of their brand name drugs.
In the past, when beneficiaries reached the donut hole, this percentage could increase. (Back in 2006, you would pay 100% of the cost of brand name drugs in the gap)
As of 2019, there is no increase between the Initial Coverage Level and Coverage Gap (or Donut Hole). Plans must leave the maximum charge at 25%, even in the gap, for brand name drugs.
Telemedicine for End-stage Renal Disease and Stroke Patients
The FAST (Furthering Access to Stroke Telemedicine) Act was included in the 2018 budget deal, and provides Medicare reimbursement, regardless of location, for patients suffering from ESRD or stroke. In the past, services were typically covered at rural hospitals, where access to specialist care was limited. Now these services are covered even at urban and suburban hospitals.
While there are a number of stipulations, this new telemedicine feature is considered a good sign that Medicare is moving in the right direction when it comes to doctor visits for people in remote area.
Repeal of Therapy Cap
Congress repealed the spending limit on physical, occupational, and speech therapy services as of 2019. Historically, Medicare beneficiaries paid the full cost of therapy care past a certain annual dollar limit.
These caps are now gone; Medicare will pay 80% of costs for medically necessary therapy services after you meet your deductible.
This is incredibly important for seniors with illnesses in which physical therapy is important for maintaining function, mobility and independence. It used to be that Medicare would only pay for therapy that was creating improvement. For people with Parkinson’s Disease, for example, the ability to continue therapy that is simply helping to maintain the status quo is a huge plus.
All of these changes are for the better when it comes to Medicare coverage in 2019.