Medicare Will Change in 2019 (For the Better)

Medicare Card

Medicare CardNo subject is of greater interest to seniors than the Medicare program.  As Medicare’s Open Enrollment Period for 2019 coverage starts today (October 15 through December 7), there is some good news about changes coming in the new year. As a reminder, if you are already enrolled in Medicare and happy with your coverage, you do not need to do anything. Your health insurance company will send you an “Annual Notice of Change,” a letter sent each year to inform you of any changes to your personal plan’s premiums, copays, hospital, doctor and pharmacy networks and drug formularies. If you want no plan changes, your 2019 coverage will be unchanged from the past year
However, 2019 will bring some changes to the overall Medicare Program that should interest you. Here are some of the important things to know:
New Rules Allow a “Test Drive” for Advantage Plans.  Advantage Plans (also called Medicare Part C) can often offer lower costs plus side benefits. For example, some Medicare Advantage plans offer a SilverSneakers® membership as part of the program. However, there are also drawbacks like network limitations for doctors, pharmacies and hospitals. Each individual must determine for themselves whether original Medicare or one of numerous Advantage plans is best for them.
In 2019, Medicare beneficiaries can try an Advantage plan for up to three months; if you are not satisfied, you can switch to another Medicare Advantage plan or enroll in “original Medicare” depending on which coverage works better for you. During this three month period, you can make one switch to a different Medicare Advantage Plan. This test drive gives you a chance to try out a plan that may cost less and have other benefits. If the drawbacks like network restrictions are not a problem, then you can stay with this new arrangement. During the trial period you can return to old coverage if you wish.
Medicare & YouMedicare Will Provide Better Information to Beneficiaries. You should already have received the 2019 edition of the Medicare Handbook sent each year. This year it will include new checklists and flowcharts that make it easier to decide on coverage. This handbook is not a throwaway or an advertisement; it is and official document from the CMS, the Centers for Medicare & Medicaid Services.
Use it to help you find the information you may need about the 2019 coverage year.
The online Medicare tools will be easier to use, with a “coverage wizard” to help enrollees compare out-of-pocket costs and coverage options between original Medicare and Medicare Advantage plans. This can be very helpful information.
Lifestyle Support and In-home Help with Some Advantage Plans. Starting in January, 2019, some  Medicare Advantage plans have an option that will cover meals delivered in-home to beneficiaries, transportation to physician office visits and some handicap service features in-home (for example, wheelchair ramps or shower grips). These benefits will require a recommendation from a doctor or other medical care provider. Some Medicare Advantage plans may also pay for assistance from home health aides, who can help with daily activities like dressing, and personal care. These benefits will vary with the details of Advantage plans, so investigate carefully if a given plan fits your needs.
The “Donut Hole” in Drug Coverage Will Close.  This applies to original Medicare with Part D coverage. Currently, Medicare beneficiaries whose Rx expenses have reached $3,750 fall into the Part D coverage gap (the Donut Hole). This means that they are required to pay $5,000 out of their own pocket. When the $5,000 threshold is met, the donut hole closes and catastrophic coverage kicks in. At that point, 95% of drug costs are covered for the remainder of the year.
In 2019, the “donut hole” will still exist to a smaller extent, but pharmaceutical companies will now be required to pick up more of the tab, resulting in lower out of pocket expenses and closing the gap faster. This is great news for Medicare beneficiaries who have paid high out-of-pocket prices for RX brand name drugs. The gap will close further for generic (off patent) drugs in 2020.
“Telehealth” Care is Coming to Medicare. Telehealth is the use of electronic information and telecommunication to support long-distance clinical health care. Telehealth programs let patients confer with a doctor or nurse via telephone or the internet. In 2019, Medicare will begin covering telehealth services for people with end-stage renal disease or during treatment for a stroke, two conditions that are especially likely to affect seniors. Telehealth is especially critical in rural and other remote areas that lack sufficient health care services, including specialty care.
Improvements to Medicare are always welcome! The Medicare and Social Security systems are probably the most popular programs ever adopted by the American government; they make a secure senior lifestyle possible for millions of our citizens.  Nowhere is this truer than in our state, where the senior lifestyle, Florida style, is so common. Right now, seniors should be thinking about their 2019 enrollment choices. If you have any unanswered questions, there is a new OurSeniors.net partner and Approved Vendor who can help.
Humana is a well-known name in healthcare, especially in senior care. The Medicare Open Enrollment period is the perfect time to talk to them about your Medicare options. Have you investigated the extras provided by Medicare Advantage Plans? Do you know which plans have network requirements, include drug coverage or offer benefits like the SilverSneakers® Fitness Program? Humana’s Daytona Beach office is located at 1500 Beville Road. Seniors can call the office at 386-200-4191 to get full information about the many choices open to them. Do not put this important decision off. The choice you make between October 15 and December 7 will determine your health care options for 2019.
OurSeniors.net sees its mission as serving the needs of seniors in any way possible. This includes both the opportunities and the challenges of senior living and the senior lifestyle. The Medicare 2019 Open Enrollment period may be one of those opportunities, so do not let it slip by!
For help with any senior lifestyle need or question, you can contact an OurSeniors.net Advisor by phone at 866-333-2657 (se habla Español), or by using Contact Us. Check out our website at Ourseniors.net and take an online look at our senior living magazine, OurSeniors.net Magazine. You can view the entire OurSeniors.net Directory of Approved Vendors by just clicking its link.

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