2019 Medicare Advantage Plan Changes to Cost and Eligibility | MHP

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2019 Medicare Advantage Plan Changes

Every fall, the Centers for Medicare and Medicaid Services (CMS) finalizes changes to Medicare that will take effect the following year on January 1. Since these updates may affect your costs, benefits, and enrollment, we’ve pored through the details and summarized the changes to break down exactly how you may be impacted.

We’ll go over the most essential 2019 Medicare Advantage updates, including the new Medicare Advantage Open Enrollment Period (OEP), running January 1 through March 31. We’ll explain how CMS changes may give you more plans to choose from and different ways to compare those plans. And of course, we’ll guide you through how usual changes, like updated premiums, deductibles, and other costs, may affect how much you pay.

If you still need help wrapping your mind around these changes, give us a call. Our licensed sales agents can answer all your questions and smooth your path to a Medicare Advantage plan that best covers your needs.

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New Medicare Advantage Enrollment Period

This new Medicare Advantage Open Enrollment Period 2019 is a big deal because it could save you from buyer’s remorse after the fall Annual Enrollment Period (AEP).

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The new period will run from January 1 through March 31 and replace the old annual Medicare Advantage Disenrollment Period from now on. It’s only for people who are already enrolled in a Medicare Advantage plan and want to take any of the following steps:

  • Switch Medicare Advantage plans.
  • Leave their Medicare Advantage plan and return to Original Medicare.
  • Add a Part D plan if returning to Original Medicare.

If you’d like to drop your Medicare Advantage plan and go back to Original Medicare, contact your current insurance company. Then, contact Medicare.

If you’re thinking of changing plans during OEP, get a quote. Your new coverage could start as early as next month.

Can you change your Medicare plan at any time?

If you miss the Medicare Advantage Open Enrollment Period, you may have to wait for the next fall Annual Enrollment Period (AEP) or a Special Enrollment Period (SEP) to choose different benefits. If you’re new to Medicare, you’ll use your Initial Enrollment Period (IEP) to first enroll in Original Medicare and then, if you wish, choose a Medicare Advantage plan.

Note, however, that if you have end-stage renal disease, you’ll face more limited Medicare Advantage plan options than folks who don’t have ESRD.

Additionally, we recommend most folks consider Medicare Advantage plans that include Part D prescription drug coverage. If you choose a plan without sufficient prescription drug benefits and you haven’t shown CMS evidence of coverage from another source (such as an employer-sponsored plan), you could be penalized.

But don’t worry. We’ll help you find a Medicare Advantage plan that covers all your needs.

Can you change your Medicare health insurance plan after Open Enrollment?

While OEP is a new enrollment period beginning in 2019, all other enrollment periods will remain the same. As a reminder, here’s what those periods look like:

Annual Open Enrollment

Fall Medicare Annual Open Enrollment runs from October 15 through December 7 each year. During AEP, you can do several things:

  • Change, add, or subtract plans.
  • Switch between Original Medicare and Medicare Advantage.
  • Enroll in Part D prescription drug coverage if you haven’t already.

Special Enrollment Period

Special Enrollment Periods (SEPs) occur only in specific circumstances, such as losing some kinds of employer-sponsored insurance benefits or being dropped from a Medicare Advantage plan because it no longer serves your area. Because SEPs are tied to specific events, they don’t occur at the same time each year.

Initial Enrollment and Initial Coverage Election Periods

Your IEP begins three months before you reach Medicare eligibility age or become eligible for Medicare in another way. It runs for seven straight months. You can sign up for Medicare Part A and B (also called Original Medicare or traditional Medicare) during your Initial Enrollment Period (IEP).

Your Initial Coverage Election Period (ICEP) happens simultaneously with your IEP in most cases. You can use your ICEP to enroll in other parts of Medicare:

  • Medicare Advantage
  • Part D prescription drug coverage

Note that even though your IEP and ICEP occur at the same time, you may have to enroll in Parts A and B before enrolling in Medicare Advantage.

As a reminder, IEP and ICEP are for folks who are enrolling in Medicare for the first time. If that’s you, check out our Medicare Advantage Plan Guide to get a better idea of how MA plans fit into the overall Medicare landscape.

Adding or changing your Medicare Supplement plan

The first time you can enroll in a Medigap (Medicare Supplement) plan is during the Medigap Open Enrollment Period. This one-time, six-month period begins as soon as you join Medicare Part B for the first time.

During your unique Medigap Open Enrollment Period, you have the right to enroll in a Medigap plan’s supplemental benefits with certain protections. For example, insurance companies can’t do the following:

  • Deny you coverage.
  • Charge you more due to age or preexisting conditions.
  • Make you wait for coverage.

Your Medigap Open Enrollment Period is the best time to enroll in Medigap because you’ll get the best deal if you take advantage of the above protections. You can still change Medicare Supplement plans at any time, but you won’t be guaranteed coverage in a new plan.

Note that you can’t enroll in Medigap if you have Medicare Advantage instead of traditional Medicare. Medigap plans are supplemental benefits designed to help with the out-of-pocket costs of traditional Medicare, such as Part A and B deductibles.

Is Medicare Plan F being phased out?

The short answer is yes. 2019 will be your last year to enroll in a new Medicare Plan F policy. If you do join in 2019 (or you had Plan F already), you can keep your coverage beyond 2020.

Unfortunately, enrolling in Plan F now might not be a good idea in the long run. Since new people won’t be able to enroll, but folks can leave the plan at any time, your coverage may become more and more expensive as the number of people paying Plan F premiums dwindles.

Since Medicare recipients typically don’t get the same guaranteed rights to enroll in a new Medigap plan after the Medigap Enrollment Period, rising Plan F costs could put you in a tough spot. You might get priced out of Plan F and not have other coverage options.

2019 Medicare expenses

Each year, CMS adjusts premiums, deductibles, and other Medicare costs to account for inflation, available funding, and other factors.

Most expenses have increased a small amount in 2019, but what you pay for your Part D prescription drug plan may decrease. Average Part D premiums dropped, and the federal government was able to close the coverage gap (or donut hole) a year earlier than expected.

Here’s an overview of how maximum Medicare costs changed in 2019.

Part A6
Daily Coinsurance For Hospital Stays
61-90 days$335$341
Lifetime Reserve Days$670$682
Skilled Nursing Facility Stay
21-100 days$167.50$170.50
Part B7
Standard Premium$134$135.50
Annual Deductible$183$185
Part C (Medicare Advantage)8
Average Premium$29.81$28
Part D
Average National Base Premium9$35.02$33.19
Maximum Deductible10$405$415
Initial Coverage Limit11$3,750$3,820
Out-of-Pocket Threshold12$5,000$5,100

In addition to paying Medicare Advantage (Part C) premiums, Medicare Advantage beneficiaries will need to pay their Part A and B premiums if applicable to their situation.

All Medicare Advantage plans must offer coverage as good as or equal to Original Medicare (Parts A and B) and Part D (if you have a Medicare Advantage plan that includes prescription drug coverage). Essentially, the deductibles and copays listed above are the maximums Medicare Advantage plans can charge. That means you’ll pay the same amount or less.

To learn more about all the parts of Medicare, read our Medicare 101 page.

How to change Medicare Advantage plans during OEP

Just as CMS updates the Medicare program each year, many Medicare Advantage insurance companies change their plans annually as well. That makes Medicare Advantage Open Enrollment the perfect time to review your current Medicare Advantage health plan and see if you can snag a better deal for next year.

Need help choosing a Medicare plan? The easiest way to find the right plan and get enrolled is to give us a call.

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Switching from Medicare Advantage to traditional Medicare

If you want to change from Medicare Advantage back to traditional Medicare, you’ll need to drop your current plan by contacting your insurance company. Then, enroll in Medicare Parts A and B through the Social Security Administration.

If you want to add a Part D prescription drug plan or Medigap plan, our licensed sales agents can help, so give us a call at the number above.

How to cancel Medicare completely

Disenrolling from Medicare is a big decision with weighty consequences. If you can’t show evidence of coverage that’s as good as or better than Medicare, you may rack up Late Enrollment Penalties. These penalties grow the longer you go without Medicare after you have eligibility.

Furthermore, some folks have to give up their Social Security benefits and pay back any benefits received when they drop out of Medicare. If you’ve been a recipient of either benefit for several years, that could be a large sum!

As you can see, we emphasize caution when considering disenrolling from Medicare. There are some circumstances, however, where the pros of disenrolling outweigh the cons.

If you get a job with an employer offering health care benefits with an HSA (Health Saving Account), you’ll need to drop all Medicare coverage before you can contribute to the HSA. In this case, you’ll need to do so in person at your local Social Security office by calling 1-800-772-1213 (TTY 1-800-325-0778) to make an appointment.

Social Security will set up an interview with you to ensure you understand the consequences of completely canceling Medicare. They’ll also help make sure your new health plan includes Medicare-approved prescription drug coverage. Doing so will help ensure you don’t get hit with a Late Enrollment Penalty if you decide to get a Medicare prescription drug plan later.

2019 Changes that affect comparing Medicare Advantage plans

In 2019, CMS will allow Medicare Advantage companies to roll out several changes that may affect how beneficiaries compare, choose, and enroll in plans. These changes include the types of plans insurers can create, how companies market those plans, improved quality star ratings, and more.

Medicare Advantage changes for dual eligibility

People who qualify for both Medicare and Medicaid (“Dual eligibles”) may be able to rest easier in 2019 if they have a Special Needs Plan that targets dual eligible people (D-SNP). In cases where an insurance company stops offering a D-SNP, CMS will now passively re-enroll affected beneficiaries in a comparable Medicare-Medicaid plan for smooth, seamless coverage. 13

Medicare Advantage advertisements

In 2019, Medicare insurers will see looser regulations about what kinds of marketing materials need CMS approval before companies can use them. As a result, you may see more ads for Medicare Advantage plans in the mail or online.

Just remember no matter how good a plan sounds in a flyer or on a website, that doesn’t mean it’s the right plan for you. It’s better to talk to an expert who can compare lots of plans based on your unique situation and suggest a few that may be the best fit.

More plans on the market

Another change that may affect how you compare and choose Medicare Advantage plans? Looser regulations on what kinds of plans companies can offer.

Before, CMS insisted that every plan a company sold must be significantly different from any others they offered in the same service area. This is no longer the case in 2019.

You may notice more plans on the market, and it could be more difficult to distinguish what makes one better than another. In fact, there are about 600 more Medicare Plans in 2019 than there were in 2018. 14

But don’t worry. We have your back. No matter how many plans are out there, our Suggest-a-Plan tool can still help you sort through them, and our licensed Medicare Advantage sales agents can answer all your questions.

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Quality Star Ratings

The CMS Star Rating System serves as a tool for gauging the quality of plans. Every Medicare Advantage, Medigap, and Part D prescription drug plan earns between one and five stars based on customer service, patient outcomes, any complaints CMS receives, and more. CMS rewards high-scoring companies with quality bonus payments, so insurers are highly motivated to achieve five stars.

For 2019, CMS has added measures to make these ratings more accurate and transparent, so you can count on them even more when comparing plans.

Other Medicare Advantage comparison factors

The updates we’ve discussed could change the way you choose your next Medicare Advantage plan, but they’re not the only factors you should consider. While no significant changes were made to the Medicare Advantage program that would affect the following elements, these factors are also essential to consider:

Which providers you can use

HMOs, PPOs, SNPs, and some PFFS Medicare Advantage plans require or prefer that you get services from a pre-approved network of doctors, hospitals, pharmacies, and other providers.

Staying within these networks keeps costs down for both you and the company, but if you’d rather stick with your family doctor or someone closer to home, you may want to choose a different plan.

Where you can get services

Speaking of seeing doctors closer to home, what if you plan on calling more than one place home in 2019? If you’re like many retirees who plan to travel a lot either internationally or domestically, you may want a plan covering health care outside your hometown.

Other coverage you already have

If you have health care benefits through an employer or another organization, you may not need as many bells and whistles with your Medicare Advantage plan. Downsizing could save you some cash without compromising your care.

The takeaway

If you’re considering switching up your Medicare Advantage coverage, annual changes can complicate your choices. But don’t worry—you’re not in this alone! Talk to an experienced MedicareHealthPlans licensed sales agent who can answer your questions, narrow your options, and help you enroll. Call us today so we can help take some of the pressure off you.

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