By TOM MURPHY September 25, 2019
Medicare
Advantage customers are about to be blitzed with an array of new insurance
benefits that stray well beyond the usual coverage of doctor visits and other
care.
Carpet
shampooing, food for a service dog, pest control and rides to a nutritionist
are among the new supplemental health benefits that privately run versions of
the government’s Medicare program may offer starting next year.
Medicare
Advantage plans already come with extras like dental benefits or gym
memberships that regular Medicare doesn’t provide. But Medicare Advantage can
restrict access to a network of doctors or hospitals. Regular Medicare also
doesn’t do that.
About a
third of the people on Medicare opt for Medicare Advantage plans, according to
the nonprofit Kaiser Family Foundation.
Advantage
plans are broadening their coverage reach as part of a push by insurers and the
government to keep people healthy instead of waiting to cover their claims once
they become sick. The idea behind this thinking is that someone who improves
their diet or keeps a chronic condition like asthma under control is less
likely to generate a big medical bill.
The
annual enrollment period for Medicare and Medicare Advantage starts next month.
WHAT’S
DIFFERENT THIS YEAR
The
federal government is giving Medicare Advantage plans more leeway to pay for
things they’d ordinarily never cover. The new supplemental benefits will aim to
help people with chronic diseases or certain health issues stay healthy when
they aren’t seeing a doctor or receiving care.
“It is
moving the needle from just treating illness to preventing illness and allowing
people to stay in their home longer,” said Chris Hakim, a senior vice president
with the online insurance broker eHealth.
The
carpet shampooing, for instance, might be covered by some plans to help their
customers with asthma avoid a flare-up that lands them in an emergency room.
Might is a key word here.
These
new benefits will only be available through Medicare Advantage plans, not
regular Medicare, and insurers are not required to offer them. Whether they do
can depend on what they think their customers need to stay healthy.
Aside
from these supplemental offerings, many plans also will provide telemedicine
benefits to help patients connect remotely with doctors and other care
providers.
EVALUATING
NEW BENEFITS
The
last thing some Medicare Advantage customers want is another batch of variables
to think about when considering coverage.
They
already have to worry about whether their drug coverage will change from year
to year or if their doctors will stay in their insurer’s network. And some
markets may have dozens of Medicare Advantage plans for shoppers to sort
through.
Medicare
Advantage customers have told researchers that they generally dislike making
coverage changes after they’ve looked at all their options and picked a plan
when they first qualify for Medicare, said Tricia Neuman, a senior vice
president with Kaiser.
“What
they say is it’s just too hard, it’s too much work, and they have little
confidence they will be able to identify a better plan,” she said.
Even
so, people with conditions like diabetes or asthma may want to see if there’s
another plan that is better for their illness, Hakim said.
ENROLLMENT
WINDOWS
Insurers
will start marketing their Medicare Advantage plans Oct. 1. That gives their
customers a couple weeks to learn about any coverage changes or added benefits
before the Oct. 15 start of the annual open enrollment period.
Shoppers
will have until Dec. 7 to enroll, switch to another Medicare Advantage plan or
opt for regular Medicare and add prescription drug coverage for 2020.
After
that, Medicare Advantage customers who regret their decision can make one
change in the first three months of 2020. That second window applies only to
those who already have a Medicare Advantage plan.
Follow
Tom Murphy on Twitter: @thpmurphy
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