Your Medicare Advantage plans 2019 may have more benefits than ever before due to some legislative changes made last year. 2019 was also a good year for funding for Medicare Advantage plans, as the Centers for Medicare and Medicaid Services (CMS) have increased their funding for next year.
More than 20 million Medicare beneficiaries are currently enrolled in Medicare Advantage plans, making up about a third of all beneficiaries.
The Kaiser Family Foundation reported that there are over 2700 plans to choose from across the nation, giving the average beneficiary about 24 plan options in each county. CMS also announced that premiums will decline while benefits increase.
Let’s take a look at what you can expect from the 2019 Medicare Advantage Plans:
2019 Medicare Advantage Plan Types
Most Medicare Advantage plans in 2019 will operate either HMO or PPO networks. HMO Medicare Advantage Plans typically require beneficiaries to treat in the network except in cases of emergency. PPO Medicare Advantage plans offer more flexibility in that members can see providers outside the network at a higher cost to them.
Beneficiaries in urban areas typically have the most choices and will often gravitate towards plan with the lowest premiums. Although some Medicare Advantage plans have $0 premiums, it’s important to remember that choosing a plan that includes your important doctors in its network is an important part of plan satisfaction. Many plans with $0 premiums are HMO networks, which can be the most restrictive, often requiring members to see a primary care doctor first before they can get a referral to see a specialist.
New Benefits for Medicare Advantage Plans in 2019
Legislation has expanded the type of supplemental health-related benefits that Part C Medicare Advantage plans can now offer.
These benefits include adult day care services, in-home custodial care, transportation services, bathroom grab bars and other home modifications, home-based palliative care and even meal delivery. The help with daily living tasks may be one of the most important benefits as many older beneficiaries can remain in their own homes if they had some assistance with things like bathing and dressing.
While not all Medicare Advantage plans chose to incorporate these new benefits into the 2019 plans, it’s a good sign for the future that some 270 plans chose to include some of the new benefits. It’s likely that if these go well, additional plans may choose to incorporate more of the new allowed features in 2020.
Lower Cost for Brand-Name Drugs in the Coverage Gap
Many Medicare Advantage plans in 2019 will include Part D coverage that is rolled into the plan. Under the Bipartisan Budget Act, plans can now charge no more than 25% of the cost of brand-name drugs in the gap. This means that the difference in cost for these medications in the earlier stage of the plan and the coverage gap phase should be less of a jump than before.
Prior to 2019, plans could raise the cost of brand-name drugs in the gap to 35%. Large increases in the cost of medications between the initial coverage level stage of drug plans and the coverage gap stage have long been a complaint of many beneficiaries. The reduced maximum coinsurance for these drugs will, therefore, be a welcome change for many beneficiaries who take brand-name medications for which there is no generic option.
A Chance to “Try It Before You Buy It”
Beginning on January 1st, beneficiaries who are enrolled in a Medicare Advantage plan will have a new, additional three-month window each year to leave that plan if they are unhappy for any reason. From January 1 – March 31, beneficiaries can make a one-time change from their current Medicare Advantage plan to either another Advantage plan or back to Original Medicare.
This new window is particularly important because so many seniors each year use their Annual Election Period in the fall from October 15th – December 7th to try Medicare Advantage plans for the first time. While many are happy with their new coverage choice, there are always people who make plan selections that they didn’t fully understand.
For example, no one wants to enroll in a Medicare Advantage Part C plan only to learn that their doctor isn’t in the network or the drug formulary doesn’t cover an expensive and important medication. Prior to this, beneficiaries could only return to Original Medicare during a 6-week Medicare Advantage Disenrollment Period.
Now beneficiaries will also have the chance to make a switch from one 2019 Medicare Advantage plan to another Medicare Advantage plan that better matches their expectations.
Another reason this new period is helpful is that many Medicare beneficiaries are unaware that their Medicare Advantage plan will have benefit changes from year to year. If they overlook reviewing their Annual Notice of Change packet where the upcoming changes are explained, they could find themselves being unhappy with one of the changes in January when it’s too late to change.
Now beneficiaries in this situation will be able to make a late switch if they missed that opportunity during the Annual Election Period.
Beneficiaries making a change should remember, however, that in most states they will have to answer health questions to add a Medigap plan if they return to Original Medicare.
What are the Best Medicare Advantage Plans 2019?
One of the most common questions we get here at Boomer Benefits is: What are the best Medicare Advantage plans for 2019? We wish it could be so simple as to give you a list and let you peruse the top three plans. However, every person’s needs are different, so the best Medicare Advantage plan for you is likely to be different than the best plan for your neighbor who has a different budget and see different doctors and takes different medications.
However, our team of Medicare insurance experts can help you find the plan in your area that most closely matches your personal needs and budget. Give us a call today to get someone on your side with Medicare Advantage plans in 2019.