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2019 Medicare Changes You Should Know

5 minute read

By natadm

Your Medicare plan doesn’t stay the same from year to year. There are always changes, and in 2019 there are a number of big improvements coming to Medicare, changes that could affect the insurance you carry.

Heading into next year, Medicare coverage is expanding and could become cheaper for some seniors. Here are the changes you need to be aware of during open enrollment.

So, how do you take charge of your Medicare plan?

From October to December, it’s your one chance to make changes to your current or future Medicare plan. Before you do so, though, you need to know what’s changing.

Whether you’re a new Medicare subscriber or simply renewing your current plan, it’s crucial to stay on top of the changes ahead for 2019. Here’s what you need to look for in your Medicare plan.

The “Donut Hole” Coverage Gap Is Disappearing

One of the most frustrating – and expensive – aspects of Medicare has long been Part D, or the prescription drug coverage benefit. Part D required those with high prescription costs to pay more money out-of-pocket once they hit the annual cap each year.

However, in 2019 the cap is disappearing and fewer seniors will need to pay for their pricey medications. That “donut hole,” or gap in prescription coverage, is closing thanks to the Affordable Care Act (ACA). AARP¹ reports that Congress passed a bill that will eliminate the donut hole for brand-name prescription drugs in 2019 and for generic drugs in 2020.

Medicare Will Make it Easier to Understand Your Coverage

Another long frustrating feature of Medicare? It can be incredibly difficult to understand what, exactly, is covered under each part of Medicare and any supplemental insurance you carry. It’s so confusing that a survey by WellCare Health Plans² found that 23 percent of seniors say reviewing their Medicare coverage is the most unpleasant task.

Fortunately, Medicare is making changes to help seniors better understand their coverage. The annually updated Medicare handbook is getting a complete overhaul and will include visuals like checklists and flowcharts to make it easier for seniors to choose and change coverage. Additionally, the Medicare Plan Finder tool available online will be easier to use – seniors will be able to easily and instantly compare plans, out-of-pocket costs, coverage limits, and more.

Telemedicine Will Be Available

More and more people are turning to telemedicine – or online doctors – for their health needs. Telemedicine makes it easy to ask questions, get a prescription, and even have minor health concerns diagnosed over the internet. You don’t even need to leave home; just get online and meet with a doctor via video chat.

Now, senior Medicare subscribers are able to take advantage of telemedicine too. In 2019, Medicare is broadening the telehealth programs that are covered, meaning you’ll be able to “meet” with a doctor or nurse online. And these appointments will be covered for even serious illnesses, such as those with renal disease and treatment after a stroke.

You’ll Be Able to “Test Drive” Plans

If you’ve ever wanted to try out a plan before signing up for an entire year of coverage, you’ll finally have your chance in 2019. During the 2019 coverage year, Medicare subscribers will be able to try out Medicare Advantage plans for up to three months. If you decide you no longer want that plan, you’ll be able to easily switch to another or enroll in original Medicare (Parts A and B).

This solves a significant problem for Medicare subscribers. You’ll no longer need to stick with your plan or pay fees if you realize your plan isn’t working for you. It’ll also allow you to choose a new plan if you discover your chosen Advantage plan is too expensive, lacks coverage, or simply doesn’t suit you.

The Therapy Cap Is Ending

For over 20 years, AARP³ reports, seniors have had to live with caps on the therapy they’re prescribed thanks to limitations imposed by Medicare. Seniors who needed therapy to recover from falls and strokes, or who relied on therapy for chronic illnesses like arthritis and Parkinson’s disease, were forced to pay out-of-pocket once they reached the cap of $2,010 each year.

In 2019, that cap is going away for good. Heading into this year, Medicare subscribers are now covered for any and all therapy needs – the therapy cap has been repealed, meaning there’s no limit. You may still need doctor’s prescriptions and approvals in order to have your therapy session covered for the long-term, but you’ll pay far less out-of-pocket.

Increased Lifestyle Support

Seniors who are in need of daily assistance with activities that can affect their health are getting more Medicare help in 2019. For this new calendar year, Medicare Advantage plans will begin offering lifestyle support, or coverage for activities that seniors need. Whether you need transportation to and from doctor’s appointments, meals delivered to you daily, or the addition of bathroom grab bars or wheelchair ramps, all of your needs could now be covered.

To get these different options or services covered, you’ll just need your medical provider to recommend them. With that recommendation, you can submit to Medicare Advantage for approval. Just make sure to verify that your Advantage plan offers this kind of coverage, as it’s a new benefit.

More In-Home Help Coverage

Perhaps one of the most helpful change happening for 2019, Medicare Advantages plans are increasing the coverage for home health aides. So many seniors rely on the help of at-home care services for activities big and small – but in years past, this was a luxury that had to be paid out-of-pocket.

Now, Medicare Advantage plans will allow seniors to get insurance coverage for home health aides on a daily or regularly scheduled basis. If you need an aide’s help with activities like getting dressed, eating, and caring for yourself, you may be able to cut the cost with Medicare’s help.

Stay Informed to Make The Most of Medicare

Don’t let the Medicare open enrollment period pass you by. It’s crucial to check in on your plan and all of the changes for 2018. If you don’t do your research, you could wind up paying more for less coverage.

You have only one chance to make changes to your Medicare enrollment, and it’s right now. Open enrollment ends in December, so make sure to adjust your plan before then!




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