Changes Coming to MedicareSubmitted by S. F. Ehrlich Associates, Inc. on October 1st, 2018
September 30, 2018
AARP Bulletin1 points out nine anticipated changes to the Medicare program for 2019. If you’re an enrollee, or about to become one, pay attention, because a lack of information may cost you a lot of money.
- Bye-bye doughnut hole: Most seasoned Medicare recipients are aware of the donut hole. Pay X amount of dollars, then pay more than X dollars, and then pay less than X dollars. The donut hole for brand-name drugs ends in 2019 and ends for generic drugs in 2020.
- Bye-bye therapy cap: Congress lifted the cap on coverage for outpatient physical, speech, and occupational therapy.
- Better information: Look for a more informative handbook to help you to decide which plan to use. Also, “the online Medicare Plan Finder tool will also be easier to use…”
- More Telemedicine: In 2019, Medicare will “begin covering telehealth services for people in end-stage renal disease or during treatment for a stroke.”
- Potential lifestyle support: In 2019, Medicare Advantage Plans “will have the option to cover meals delivered to the home, transportation to the doctor’s office and even safety features in the home such as bathroom grab bars and wheelchair ramps.”
- In-Home Help: “Medicare Advantage plans also have been given the option to pay for assistance from home health aides, who can help people with their daily activities including dressing, eating and personal care.”
- Plan Test-Drives: “New regulations will let people try an Advantage plan for up to three months – and then switch to another Medicare plan, including original Medicare.”
One significant factor involved with these changes is they don’t apply across the board to traditional Medicare and Medicare Advantage Plans. In fact, the best plan for you may no longer be the plan you’re currently using.
Medicare is not a set-it-and-forget-it program. If your income changes, Medicare premiums may adjust. If your income drops, for example, Medicare may eventually reduce your monthly premium, but it might take a year (and the filing of another tax return) to figure it out unless you visit a Social Security office and tell them. Similarly, if your prescription medicines change, the best plan for you may not be the one in which you’re currently enrolled.
This is not only complicated but potentially costly if you select the wrong plan and miss out on some benefits that would otherwise be covered. To help sort through the options, we’ve referred a few clients to a Medicare consultant, with excellent results. There’s obviously a cost to retain a consultant for this type of service, but you may benefit from paying lower premiums and/or finding the most appropriate plan for you. If you need help trying to figure out the best program for you, don’t hesitate to call us.