The open enrollment periods for Medicare Advantage plans are right around the corner. To help you prepare for any changes you want or need to make to your health insurance coverage, we’re offering this brief primer on Medicare Advantage plans and their upcoming changes.
What is a Medicare Advantage plan?
Medicare.gov defines them this way: “Medicare Advantage plans are a type of Medicare health plan offered by a private company that contracts with Medicare to provide all your Part A and Part B benefits. Most Medicare Advantage plans also offer prescription drug coverage. If you’re enrolled in a Medicare Advantage plan, most Medicare services are covered through the plan. Your Medicare services aren’t paid for by Original Medicare. Below are the most common types of Medicare Advantage plans.”
What changes can I make during the upcoming enrollment periods?
Open enrollment for Medicare Advantage and Medicare prescription drug coverage is October 15 to December 7, 2020. According to Medicare.gov, during this period, you can:
- Change from Original Medicare to a Medicare Advantage plan
- Change from a Medicare Advantage plan back to Original Medicare
- Switch from one Medicare Advantage plan to another Medicare Advantage plan
- Switch from a Medicare Advantage plan that doesn't offer drug coverage to a Medicare Advantage plan that offers drug coverage
- Switch from a Medicare Advantage plan that offers drug coverage to a Medicare Advantage plan that doesn't offer drug coverage
- Join a Medicare Prescription Drug plan
- Switch from one Medicare drug plan to another Medicare drug plan
- Drop your Medicare prescription drug coverage completely
Open enrollment for Medicare Advantage only is January 1 to March 31. During this period, Medicare.gov notes that you can:
- Switch to another Medicare Advantage plan (with or without drug coverage) if you are currently enrolled in a Medicare Advantage plan (with or without drug coverage)
- Drop your Medicare Advantage plan and return to Original Medicare. You'll also be able to join a Medicare Prescription Drug plan.
Keep in mind that during this later enrollment period, you CANNOT:
- Switch from Original Medicare to a Medicare Advantage plan
- Join a Medicare Prescription Drug plan if you're in Original Medicare
- Switch from one Medicare Prescription Drug plan to another if you're in Original Medicare
Changes to Medicare Advantage Coverage
Now that you’ve refreshed your understanding of the basics, let’s take a look at some of the new areas of coverage you’ll see in some Medicare Advantage plans in 2021.
- Telehealth services: Medicare Advantage plans are expanding their coverage of telehealth services. As a result, these plans will allow older adults to be treated in their homes using video conference sessions with their physicians rather than traveling to the doctors’ offices to receive care. This benefit especially helps those who find travel difficult or those who are at a high risk of complications if they contract a communicable disease.
This expansion of telehealth coverage includes the following fields of medicine: primary care, cardiology, dermatology, psychiatry, gynecology and endocrinology.
- Long-term care: In addition to providing the same coverage as Original Medicare for skilled services and rehabilitative care, some Medicare Advantage plans will begin coverage for a number of new services, including: adult day care, in-home personal care (assistance with dressing, eating, hygiene) and over-the-counter products (cold and allergy medications, daily supplements, pain relievers).
Note that Medicare and Medicare Advantage do not now, and will not in 2021, cover assisted-living expenses.
- Home-safety modifications: For insurance beneficiaries who may have experienced a fall at home or find movement difficult, some Medicare Advantage plans will offer coverage for a number of safety modifications, including grab bars for bathrooms, stair rails and ramps for wheelchairs.
- Meal delivery and transportation: In 2021, some Medicare Advantage plans will offer coverage for transportation assistance, including Lyft and Uber, when used to help deliver older adults to fitness centers, pharmacies and doctor appointments. Some will also offer benefits for grocery delivery services during a specific period of time—for example, during the recovery period after an illness or injury.
- End-Stage Rental Disease (ESRD) care: Thanks to changes brought about by Congress in the 21st Century Cures Act, older adults with ESRD can enroll in a Medicare Advantage plan beginning in January 2021, and they will have more coverage available to them with Original Medicare. Visit Medicare.gov for details.
Additional changes to Medicare Advantage could be announced before the upcoming enrollment periods begin. Get updates, and learn more about the new coverage options discussed here, by visiting Medicare.gov and Aarp.org.
If we can help you find the information you need to make the best decisions for yourself or a loved one, please give us a call. As a community committed to the health and quality of life of our residents, The Gatesworth is here to help.