While Original Medicare rarely changes, many insurance watchers expect Medicare Advantage plans for 2019 to vary quite a bit from the previous years. Medicare Advantage plans, sometimes called Medicare Part C, can offer a beneficiary an alternate way to receive their healthcare benefits after being enrolled in Medicare Part A and Part B. Rather than having coverage delivered by the government, a Medicare Advantage plan has payments made by a private insurance company.
Changes to Medicare Advantage Plans for 2019
As always, it’s important to watch for updates during the Annual Election Period to see if any changes to your Medicare Advantage plan for 2019 will impact you. If you’re new to Medicare, you’ll also have a chance to compare Medicare Advantage plans for 2019 during your Initial Coverage Election Period for Medicare Part A and Part B. Continue on to learn about some changes to 2018 Medicare Part C that could impact premiums, benefits, and enrollment times.
2019 Premium and Benefit Changes for Medicare Advantage Plans
You’re probably most interested to know if your premiums will change for your Medicare Advantage plan for 2019. One of the reasons that interest in Medicare Advantage plans has grown so fast is that it is possible to join many of them with a very low or even a $0 premium. While your insurance company might not have released updates for rates yet, it’s possible to make some predictions based upon a press release from CMS about costs for Medicare plans for 2019:
•Anticipated increases in costs: Between 4% and 5%
•Anticipated revenue growth for insurers: Less than 2%
These cost and revenue increases may impact Medicare Advantage Prescription Drug plans, stand-alone Part D, and MA plans without drug benefits. In some cases, insurers may not pass along these costs as increases to premiums for customers; however, they might increase copayments, coinsurance, or deductibles.
The trend of finding fewer Medicare Advantage plans for 2019 with a $0 premium will probably also continue. At the same time, plan quality has continued to increase. For 2019, the government also hopes to tune the five-star rating system and to make it more transparent for consumers and insurance companies.
New Annual Election Period Medicare Advantage Plans in 2019
CMS also announced that they will do away with the Medicare Advantage Disenrollment Period for a Medicare Advantage plan for 2019. Beneficiaries used to only be able to drop their Medicare Advantage plan, enroll in Part D, and resume Medicare Part A and Part B during the first six weeks of the year.
There will now be a new Annual Election Period for the first three months of the year, and this in addition to the typical Annual Election Period each fall. This gives Medicare beneficiaries extra time to compare changes to their current Medicare Advantage plan, switch to a new plan, or even to drop out and just remain enrolled in Medicare Part A and Part B. This gives people more time to make sure they made the best choice. During this second Open Enrollment, only one plan switch is allowed.
2019 Changes to Dual-Eligible Medicare Advantage Plan Enrollment
People who have both Original Medicare and Medicaid may choose a dual-eligible plan only one time during each quarter during the initial nine months of the year. They used to have the option of a month-to-month Special Enrollment Period. This includes Medicaid-Medicare options for Special Needs Plans SNPs or typical HMO MAPD plans.
Other Enrollment Notes for Medicare Advantage Plans for 2019
Medicare Part C won’t change its enrollment qualifications for 2019. Basically, you must have Original Medicare and not suffer from End Stage Renal Disease ESRD. People who have ESRD have other options. You can also find Special Needs Plans to help manage other chronic illnesses or situations.
Once you enroll in a Medicare Advantage plan, expect your insurer to send you a new ID card. You will usually take this card to the hospital, doctor, or another healthcare provider instead of your Medicare Part A and Part B ID card.
Popular Choices for Medicare Advantage Plans for 2019
It’s too early to know exactly how people will choose their Medicare Advantage plan in 2019. It is possible to publish some recent statistics of enrollment to make some predictions.
These are some enrollment statistics for Medicare Advantage plans in the past year:
•Total enrollment in a Medicare Advantage plan: Over 18 million
•Percent of enrollment out of all qualified for Medicare Part A and Part B: 33 percent
•Increase in enrollment in MA plans one year: two percent
•Percent in Health Maintenance Organization HMO plans: 63 percent
•Total Preferred Provider Organization PPO plans: 33 percent
Tips to Compare Medicare Advantage Plans for 2019
2019 Changes to Part D and MAPD
You can enroll in a MAPD that will bundle Part D drug benefits with medical benefits. In this case, make sure you check the formulary, or covered drug list, to find any prescriptions that you rely upon. Note that each insurer will have Prescription Drug tiers or drugs that they may cover at different benefit levels. For instance, you will probably have to pay more of the cost of brand-name medicine than for generic medicine.
In 2019, the infamous “Donut Hole,” or gap in RX coverage with Medicare Part D, will be closing. AARP reported that this gap has been slowly closing since the ACA implementation in 2010 and wasn’t expected to completely close until 2020. Now, it’s expected to close a year early in 2019, so many seniors will spend less for their prescriptions.
Understanding Kinds of Medicare Advantage Plans
The vast majority of choices for a Medicare Advantage plan for 2019 will rely upon provider networks to help control costs. Medicare Part A and B do not use networks, so if you’re used to original Medicare, you may need to spend some time understanding how these provider networks work.
If you choose an HMO, you need to get almost all of your covered health services from in-network providers. You also need a primary care doctor, or PCP, to give you referrals to specialists and certain other medical care. This means that you need to be sure that your favorite doctor and hospital are associated with the network. A PPO may charge higher rates, but it will cover out-of-network services. You still will save money with a PPO if you find in-network doctors and other medical providers.
Changes to Look for with Medicare Advantage Plans in 2019
Some MA plans offer additional benefits that you can’t get with Medicare Part A and Part B. These could include wellness programs, coverage for routine hearing and dental, and so on. Every year, you should check changes to provider networks and drug coverage to make sure the plan still serves your needs the best. Beyond this, you may expect modest increases in premiums or decreases in benefits or provider networks in 2019.