PUBLISHED TUE, OCT
15 20199:01 AM EDT Sarah O’Brien@SARAHTGOBRIEN
KEY
POINTS
·
While
Medicare.gov’s revised Plan Finder tool is intended to be more user-friendly
than the one it replaced, the new version has required a number of fixes and
changes since its release in August, and more could be coming.
·
Some
plans will offer supplemental benefits next year that go beyond traditional
medical care, although they may only be available to qualifying beneficiaries
with chronic illnesses.
·
If
you sign up for an Advantage Plan during the current six-week window and
realize afterward that you don’t like it, you can switch your coverage once
between Jan. 1 and March 31.
It’s the time of year for people on Medicare to
give their coverage a checkup.
The program’s annual enrollment period runs from
Oct. 15 through Dec. 7, which is when you can make changes to your coverage
that will take effect Jan. 1. During this window, you can:
• Switch to an Advantage Plan from original
Medicare (Part A hospital coverage and Part B outpatient care);
• Switch to original
Medicare from an Advantage Plan;
• Move from one
Advantage Plan to another;
• Move from one
prescription drug plan (Part D) to another, or purchase one if you did not when
first eligible.
Experts say that even if you’ve been happy with
your 2019 coverage, both Advantage and prescription drug plans are modified
from year to year — and new plans become available, as well — which means it’s
important to evaluate whether your current option is still the best available
for you.
“Each insurance carrier revisits their [drug]
formulary and they renegotiate provider contracts,” said Elizabeth Gavino,
founder of Lewin & Gavino in New York and an independent broker and general
agent for Medicare plans. “So you need to make sure your providers,
prescriptions and your preferred pharmacy are still on the plan.”
Additionally, changes can affect your premiums,
copays, deductibles and covered services, along with the cost of your
prescriptions. And, you might find coverage that meets your needs at a better
cost.
If, after evaluating your options, you determine
that you want to stick with your current coverage, you don’t need to take any
action.
It’s worth noting that Medicare’s fall open
enrollment is different from your initial enrollment period, which is a seven-month
window that starts three months before your 65th birthday and ends three months
after your birth month.
Also during that initial sign-up time, you can
sign up for an Advantage Plan, which includes Parts A and B and, typically, a
Part D prescription plan. These plans also often include additional coverage
such as dental, vision or wellness programs.
Here are some key things to keep in mind this
year.
What’s new
If you use the Plan Finder tool on Medicare.gov to compare your
options each year, you’ll be navigating a new system.
The updated version, which became available to
users in late August, was met with criticism due to various changes — and
glitches — that caused incomplete or incorrect results to be generated. While
the Centers for Medicare and Medicaid Services has deployed many fixes in the
wake of the negative feedback, it’s uncertain whether more tweaks are in store
or if users will continue running into issues.
“The intentions were good, but the timing was
terrible,” said Danielle Roberts, co-founder of insurance firm Boomer Benefits
in Fort Worth, Texas.
She added, though, that users can always call
1-800-MEDICARE if any information seems to be missing or anything is unclear.
As of Tuesday, there were still differences
between the new and old versions that were not viewed as improvements. For
example, users were still finding incomplete results related to prescription
drugs, including the details of a particular plan’s limits on the quantity of
the medicine you need covered.
Meanwhile, you also might notice some
supplemental benefits available through Advantage Plans that you hadn’t seen in
the past.
While many plans already offer extras such as
dental or vision coverage, new rules allow Advantage Plans to offer services
that go beyond traditional medical care. For example, roughly 500 plans are
expected to offer services such as adult day care or caregiver support systems
next year, according to the Centers for Medicare and Medicaid Services. Another
250 plans will offer things such as meal delivery, rides to the grocery store
or even pest control.
However, not all extra benefits are available to
everyone who enrolls in the particular plan offering them. Some may only be
extended to people with certain chronic illnesses or conditions — and even
then, whether you qualify must be assessed by the plan once you’re enrolled.
“You won’t know if you’re eligible for those
supplemental benefits until you’re in the plan,” said David Lipschutz,
associate director for the Center for Medicare Advocacy. “So don’t be lured in
only by the bells and whistles.”
If you pick an Advantage Plan during fall
enrollment and realize afterward that it’s not a good fit, you can change your
coverage between Jan. 1 and March 31 by switching to either another Advantage
Plan or to original Medicare and a stand-alone prescription plan.
Be aware that while you can change your mind
about your coverage several times during the current open enrollment period,
you can only make one change during the January-through-March window.
The average premiums for Advantage Plans is
forecast to be $23 next year, down from close to $27 in 2019. Yet this year,
56% of enrollees paid no premium, according to the Kaiser Family Foundation.
Regardless of the amount, keep in mind that it’s
in addition to your Part B premium. Although there’s been no official word yet
on what that 2020 base amount will be, it’s projected to rise to $144.30 from
$135.50 this year, according to the latest Medicare Trustees report. The
deductible for Part A is forecast to increase to $1,420 from $1,364, and the
deductible for Part B is projected to go to $197 from $185.
Additionally, monthly premiums for standalone
prescription drug plans will be lower next year, dropping to $30 from $32.50 in
2019, according to estimates from the government.
To make sure your doctor, hospital or other
provider still participates in your Advantage Plan, you have to check with the
insurance company that offers it. You can either visit the provider’s website
or call.
If you work with a Medicare agent, that person
should be able to help you figure out what coverage is best for your personal
situation. And, Gavino said, make sure the agent includes all plans available
to you when evaluating your options — not just the policies they sell.
Also, be aware that open enrollment has nothing
to do with Medigap policies, which can only be paired
with original Medicare (not Advantage Plans). While there are some changes in the lineup of Medigap
plans available to people turning 65 after this calendar year, they do not
affect you if you reach that age before the end of 2019.
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