Amerigroup said that
acupuncture was the wellness benefit most Medicare Advantage members selected
last year. The federal government has relaxed rules allowing companies to add
even more wellness benefits such as transportation and pest control.
The federal government again is relaxing its
rules to allow Medicare Advantage insurers to offer customers perks such as
quarterly pest control or financial support for service dogs.
The new 2020 benefits, OK’d by the Centers for
Medicare and Medicaid Services (CMS), also include nutritional counseling with
delivery of pantry staples, free fitness trackers and regular acupuncture
visits.
Last year, Centers for Medicare and Medicaid
Services first allowed Medicare Advantage plans to expand the types of supplemental
benefits they could offer enrollees. But companies have been slow to offer the
extra benefits to the more than 24 million seniors are expected to enroll in
Medicare Advantage plans for 2020.
Martin Esquivel, vice president of Amerigroup
Texas’ Medicare product management, said the insurer already offered extra
benefits — even before CMS gave insurers more flexibility in what they can
offer as supplemental benefits.
“The goal is to ensure a safer environment for
our members,” he said.
For many consumers, he said, that means killing
household pests or providing transportation or assistance to combat loneliness.
The open enrollment period for Medicare
Advantage plans starts Tuesday and runs through Dec. 7. Residents who are 65
and older, or are deemed disabled under Social Security standards, can compare
coverage options such as traditional Medicare and Medicare Advantage and choose
Medigap supplemental insurance and drug plans for 2020.
The original Medicare plan is managed by the federal
government and provides eligible individuals with coverage for visits to their
doctors, hospitals or other health care providers. Medicare pays up to 80
percent of approved services after the beneficiary reaches his or her
deductible.
Medicare Advantage plans must cover all of the
medical and hospital services that Medicare covers, but its bundle of benefits
also includes prescription drug coverage as well as limited vision, dental and
hearing coverage.
CMS officials said beneficiaries will also have
more plan choices because about 1,200 more Medicare Advantage plans will be
available in 2020 than in 2018. They also reported Medicare Advantage premiums
are expected to decline this year by 23 percent. Benefits counselors say these
plans aren’t always cheaper in the long run.
Amerigroup Texas said its Medicare Advantage
members in Texas will be able to choose one of 10 wellness, social and support
services — which include new and existing benefits — that will go in effect
Jan. 1.
Esquivel said a popular choice last year among
Amerigroup members in Texas was the in-home assistance, which covered the cost
of sending someone to help with daily activities for four-hour shifts.
“They offer these because it’s to their
advantage to keep their members as healthy as possible,” said Laura Ramos, a
specialist at the Alamo Area Council of Governments’ Area Agency on Aging, which is funded by the
federal Older Americans Act.
Seniors need to read through the options
carefully and get help finding the best deal for their circumstance, she said.
“There are so many different plans that are
available,” Ramos said. “You cannot imagine how many people are confused or
overwhelmed by the options because plans can change year to year.”
Free, in-person assistance is available at
locations throughout the San Antonio area.
Seniors can call Alamo Service Connection at
210-477-3275 to schedule an appointment with a benefits counselor. Residents
living in Atascosa, Bandera, Comal, Frio, Gillespie, Guadalupe, Karnes,
Kendall, Kerr, McMullen, Medina and Wilson counties should call 866-231-4922 to
access the State Health Insurance Assistance Program.
Ramos said enrollees should know that doctors
and medical practices can opt out of plans — Medicare and Medicare Advantage —
at any point during the year, leaving them with health care providers who
aren’t in-network.
While plans may not charge customers monthly
premiums, there still are many out-of-pocket costs associated with plans. They
can compare the health plans online at Medicare.gov by entering their ZIP code.
Last week, there were reports that the
redesigned Medicare Plan Finder website no longer was able to add up and sort
through the prescription costs, monthly premiums and deductibles for its plans.
But Kaiser Health News reported Thursday that the website’s functions had been
restored.
Ramos said consumers also should know that
insurance providers are supposed to notify them in writing of major changes,
such as when their insulin no longer is covered by the plan. But ultimately, it
will be up to beneficiaries to ask for assistance.
“People need to ask their friends and family for
recommendations,” she said.
Laura Garcia covers the health care industry in
the San Antonio and Bexar County area. Read her stories and more local coverage
on our free
site, mySA.com, and on our subscriber site,
ExpressNews.com. | laura.garcia@express-news.net |
Twitter: @Reporter_Laura
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