\u201cIt\u2019s a good time for current beneficiaries to review their policies and for new applicants to make important choices,\u201d said Carol Levine, director of the Families and Health Care Project at the United Hospital Fund in New York and author of the new book AARP\u2019s Navigating Your Later Years for Dummies.<\/em><\/p>\n This year\u2019s open enrollment period is October 15th to December 7th for 2019 coverage. And Medicare consumers need to have all their ducks in a row before they make any healthcare decisions. That includes shopping for Medicare supplement insurance.<\/p>\n \u201cWhatever path you may take toward a secure and healthy future, Medicare sets the framework,\u201d Levine notes. \u201cSeniors need to know that whatever Medicare covers (and it covers a lot), you don\u2019t have to pay for. Additionally, you\u2019ll want to know whatever Medicare doesn\u2019t cover (that\u2019s a lot, too), where you\u2019ll have to find other sources of payment.\u201d<\/p>\n To set the table for seniors headed into a new year and a new Medicare experience, here are key areas of focus for healthcare consumers in 2019\u2026<\/p>\n There\u2019s good news and bad news on the Medicare financing front. According to the Kaiser Family Foundation<\/a>, Medicare spending made up 15 percent of total federal spending in 2017 and is projected to rise to 18 percent by 2028.<\/p>\n Meanwhile, the Medicare Hospital Insurance (Part A)<\/a> trust fund is projected to be depleted in 2026, three years earlier than the 2017 projection.<\/p>\n Some of the proposed program changes to address Medicare spending challenges include:\n.\n\u2022 Restructuring Medicare benefits and cost sharing.\n\u2022 Further increasing Medicare premiums for beneficiaries with relatively high incomes.\n\u2022 Raising the Medicare eligibility age.\n\u2022 Shifting Medicare from a defined benefit structure to a \u201cpremium support\u201d system.<\/p>\n KFF stated those changes \u201ccould increase the financial burden on future generations while leaving unaddressed long-term financial challenges, raising the question of whether raising the Medicare payroll tax or increasing other existing taxes should be considered.\u201d<\/p>\n To shore up Medicare savings, the U.S. government is introducing a new income tier for 2019 that will force more affluent Medicare recipients to bear a larger financial burden. Beginning next year, Medicare consumers with incomes of $500,000 or more and couples earning $750,000 will have to pay 85 percent of the total cost of their Medicare parts B and D benefits. That\u2019s up from 80 percent in 2018.<\/p>\n The new tier represents a double hit, of sorts, to wealthier Americans. Back on January 1, 2018, a new statute called for Medicare beneficiaries who earned $133,501 to $160,000, or $267,001 to $320,000 for couples, to pay 65 percent of the cost of their parts B and D benefits. That\u2019s up from up 50 percent in 2017. Medicare consumers who earn up to $85,000, $170,000 for couples, will continue to pay 25 percent of their benefit costs.<\/p>\n While the official open enrollment period starts on October 15th and runs through December 7th, the Centers for Medicare & Medicaid Services<\/a> (CMS), which administers Medicare, offers beneficiaries two new adjustments for 2019:<\/p>\n \u2022 Explanation of coverage (EOC) must be delivered by October 15th. \u201cBefore the new changes from CMS for the 2019 plan year, the due date was Sept 30,\u201d said Katie Hulan, a specialist at Indellient, a consulting firm that works with healthcare providers on Medicare plans.<\/p>\n \u2022 A new open enrollment period \u201cdo over.\u201d Starting January 1, 2019, the CMS will allow Medicare A members to elect another health plan between January 1st and March 31st. \u201cThat\u2019s in case if they discover things aren\u2019t as they were promised when they enrolled,\u201d states Hulan.<\/p>\n As part of the Medicare enrollment process, plan providers must submit website marketing content for review. That includes contracted third-party websites, said Hulan. \u201cPlans do not need to submit web pages with or containing CMS-required content for review,\u201d she notes. \u201cThis means almost every website needs to be reviewed now.\u201d Also, website content that hasn\u2019t been reviewed and approved can\u2019t be viewable to the public. \u201cThis is a significant change as sponsors were previously permitted to post websites that were pending review,\u201d she said.<\/p>\n During the annual enrollment period, Medicare consumers can make the following changes to their plan coverage, the CMS notes:<\/p>\n \u2022 Users can switch from Original Medicare to Medicare Advantage, or vice versa.<\/p>\n \u2022 Users can switch from one Medicare Advantage plan to another, or from one Medicare Part D prescription drug plan to another.<\/p>\n \u2022 Users who fail to enroll in a Medicare Part D plan when first eligible can sign up during the general open enrollment. A late enrollment penalty may apply.<\/p>\n One major option that Medicare consumers have going into 2019 is between Original Medicare and Medicare Advantage, sometimes called Medicare Part C.<\/p>\n \u201cThe 2018 Chronic Care Act passed by Congress as part of the Bipartisan Budget Act of 2018 gives Medicare Advantage plans more flexibility in covering non-medical products and services, such as bathroom grab bars and wheelchair ramps,\u201d said Levine. \u201cThese private insurance plans can also expand telehealth services so that people who live in rural areas or have mobility problems can communicate more easily with a doctor\u2019s office.\u201d<\/p>\n Do these add-ons make Medicare Advantage a better deal than Original Medicare?<\/p>\n Levine advises taking a long-term view.<\/p>\n \u201cThat depends on whether the plan you choose would offer these features, and whether you would find them valuable,\u201d she said. \u201cMedicare Advantage plans already have more add-ons than Original Medicare, but don\u2019t have as extensive networks of providers and health care settings.\u201d<\/p>\n Anyone making this choice should look at the whole range of benefits, not just the most appealing ones, Levine advises.<\/p>\n The Part D payment donut hole will be eliminated in 2019, instead of 2020. \u201cIn 2018, the coverage gap with no insurance (i.e., the donut hole) begins once a beneficiary reaches his\/her Part D plan\u2019s initial coverage limit ($3,750) and ends when he\/she spends a total of $5,000 out of pocket,\u201d said Hector De La Torre, executive director of the Transamerica Center for Health Studies, a nonprofit division of Transamerica Institute. \u201cThe new coinsurance rates (for beneficiaries to pay) will be set at 25% of brand-name and 37% of generic drugs.\u201d<\/p>\n CMS is reinterpreting the \u201cuniformity requirements\u201d for Part C benefits offered to beneficiaries. \u201cThey\u2019re allowing Medicare Advantage plans the ability to reduce cost sharing for supplemental benefits, as well as offering different deductibles based on beneficiaries\u2019 ability to meet specific medical criteria (known as the Targeted form of supplemental benefits,\u201d said Torre.<\/p>\n \u201cMedicare Advantage plans must specify which supplemental benefits are covered in the Evidence of Coverage, as well as any limitations.\u201d In 2020, those with a chronic illness will have a \u201cwider array of supplemental benefits\u201d instead of the current requirement that these benefits be \u201cprimarily health-related,\u201d Torre adds.<\/p>\n Elimination of the ACA Individual Mandate No Threat to Medicare<\/p>\n The individual mandate repeal should not affect Medicare because \u201cit is universal for those over 65 and incorporates incentives\/penalties to sign up for coverage around their 65th birthday,\u201d said Torre.<\/p>\n Since the summer, Medicare has been issuing new identification cards, which are designed to reduce fraud by replacing the beneficiary\u2019s Social Security number with a random number that has both letters and numbers. \u201cThe change has instead produced new scammers,\u201d said Levine. \u201cThese fraudsters may call a beneficiary and claim that Medicare charges for the new card. Not true, it is free. The cards are being issued in waves across the country, so not everyone will get the new card at the same time.\u201d<\/p>\n The bottom line? Healthcare experts say the changes coming to Medicare in 2019 will have less of an impact on consumers than you might think.<\/p>\n \u201cAlthough the Centers for Medicare & Medicaid Services report states the changes are intended to help serving beneficiaries and relieve some of the burdens on health care providers, the bottom line is that the changes will actually save Medicare about $295 million each and every year beginning in 2019,\u201d said Sonny O\u2019Steen, an expert in Medicare supplement plans.<\/p>\n \u201cAs for the changes that have been approved and published, they affect health care providers much more than beneficiaries and appear to be intended to reduce the cost of Medicare to the government,\u201d O\u2019Steen adds.<\/p>\n There are some concerns about Medicare costs and budgeting going forward, in addition to the increasing number of beneficiaries as more baby boomers turn 65 years old, therefore increasing the covered population.<\/p>\n \u201cHowever, Medicare has been a tremendous success in covering seniors over time (over 98 percent) and there is sufficient bipartisan support to make any adjustments\/improvements over time,\u201d said Torre.<\/p>\n Tips for existing and first-time medicare beneficiaries<\/p>\n","protected":false},"author":3,"featured_media":8154,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[99,101],"tags":[],"class_list":["post-7999","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-fall-2018","category-fall-2018-columns"],"acf":[],"_links":{"self":[{"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/posts\/7999","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/comments?post=7999"}],"version-history":[{"count":6,"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/posts\/7999\/revisions"}],"predecessor-version":[{"id":8200,"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/posts\/7999\/revisions\/8200"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/media\/8154"}],"wp:attachment":[{"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/media?parent=7999"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/categories?post=7999"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/tags?post=7999"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"\"](\"https:\/\/healthyaging.net\/magazine\/wp-content\/uploads\/2018\/10\/part-c-graphic-mag.jpg\")
<\/a>Graphic: InsuranceQuotes.com<\/em><\/p>\nHere\u2019s What to Focus on When You Enroll in Medicare<\/h4>\n
Spending up But Long-Term Risks Remain<\/h4>\n
Higher Earners to Pay More<\/h4>\n
New Wrinkles on Open Enrollment<\/h4>\n
More Flexibility for Medicare Advantage<\/h4>\n
Adjustments on \u201cDonut Hole\u201d<\/h4>\n
New Changes to Supplemental Insurance<\/h4>\n
Watch Out for Card Fraud<\/h4>\n
Outlook on Medicare Going Forward<\/h4>\n
Brian O\u2019Connell is a contributing writer for InsuranceQuotes.com<\/a>, an online marketplace for insurance policy quotes.<\/h5>\n","protected":false},"excerpt":{"rendered":"