Your Medicare is Changing

This year, you will want to take a close look at your Medicare coverage or your Medicare Advantage plan. There are a number of changes that will affect all Medicare recipients and some that apply only to Medicare Advantage plan policyholders. Here are some of the changes you can expect to see:

Therapy cap is gone

Those with Original Medicare will no longer have to shoulder the full cost of outpatient physical, speech and occupational therapy. The cap has been permanently removed by Congress.

Donut Hole is closing

Medicare drug plans have a coverage gap, often called the ‘donut hole.’ The gap begins after you and your drug plan spend a certain amount and has been slowly closing over the years. In 2019, the gap for brand-name drugs will close one year ahead of schedule. Once you enter the coverage gap, you will pay 25% of the plan’s cost for covered brand-name drugs. You will pay 37% of the plan’s cost for generic drugs. The coverage gap for generic drugs will close in 2020. 

Advantage plan 'extras' 

A number of Medicare Advantage plans are introducing innovative benefits that go beyond traditional health care. Check to see if your plan offers any of the following:

  • Transportation to and from health-related appointments
  • Help with grab bars and wheel chair ramps
  • Coverage for alternative medicine visits
  • Home health aide chore service
  • Allowance for approved non-prescription health products
  • Day care visits
  • Healthy home delivered food (post-hospital visit)
  • Allowance for assistive and safety devices

Other Advantage plan improvements

  • Expanded dental coverage
  • Better hearing aid benefits
  • Video visits with board-certified doctors or licensed therapists

What if I don’t like my plan?

Advantage plan members can try an Advantage plan and if they change their mind, they can switch to another Medicare Advantage plan or move to Original Medicare between January 1 and March 31, 2019. Congress required this flexibility in the 21st Century Cures Act.

Open enrollment dates

You have until December 7, 2018 to make changes in your Medicare coverage. Before you move to a different plan, be sure your choice of doctors, hospitals, prescription medications and other health care providers are covered. Any changes you make during Medicare’s Open Enrollment will become effective January 1, 2019.

Laura Mutsko

Laura Mutsko is a licensed insurance agent offering a complete line of health and life insurance products, including Individual, Group and Family Health, Medicare Advantage Plans, Medicare Supplement Plans, Medicare Part D Prescription Coverage, Vision, Dental and Life Insurance. Contact Laura at 440-255-5700. Mutsko Insurance Services, LLC is located at 6982 Spinach Drive in Mentor, Ohio.

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Volume 9, Issue 11, Posted 12:01 PM, 11.04.2018