Due to changes coming down the pike in 2019, the media is providing more coverage of Medicare Advantage programs than ever before, but it’s all pretty confusing. You may wonder, what exactly is Medicare Advantage?
Traditional Medicare has two or three parts: A, B and D. Part A is hospital insurance; Part B is medical insurance and Part D is prescription drug coverage. Like other medical insurance, Medicare Part A covers services that are deemed medically necessary and services that prevent or provide early detection of certain illnesses.
Medicare Advantage is sometimes called Medicare Part C. This program essentially bundles Parts A, B and usually D together into a single program. Medicare pays a fixed rate per person to the companies who provide Medicare Advantage services. Although Medicare sets minimal requirement for the services they must provide, each company individualizes the types of additional services they cover. The intended purpose of Medicare Advantage is to maximize wellness and improve case management for Medicare recipients.
The companies that provide Medicare Advantage plans decide what their out-of-pocket charges will be, so each company will have different charges. They also get to set their own rules about things like whether a referral is required to see a specialist and whether out of plan providers, facilities or suppliers can be used.
Not only do the rules vary from company to company, but they can change from year to year, so it is important to shop carefully for your Medicare Advantage plan. In 2019, Medicare changes will make some additional options available in the Medicare Advantage program. Three of the most interesting options include lifestyle support, daily living help and a “try out” period that allows people to try Medicare Advantage for three months before they have to permanently commit.
Lifestyle support
Lifestyle support include transportation to and from medical appointments, meal delivery and home safety modifications such as wheelchair ramps and grab bars.
Daily living help
Sometimes taking care of self and your home can prevent seniors from living on their own in their homes. Medicare Advantage is including benefits for home care aide support to provide help with bathing, dressing, grooming, meal preparation and some light housekeeping.
Tryout period
New things can be scary. The tryout period allows users to try a Medicare Advantage plan for up to three months and switch back to a traditional plan or another Medicare Advantage plan if they are not satisfied. turn, takes some of the stress out of choosing a plan.
The open enrollment period for Medicare Advantage will also change next year, running from January through March. Traditional Medicare enrollment will continue to be October-December.
If you live in Tulsa, Oklahoma, Life Senior Services provides free, high quality Medicare seminars and enrollment counseling each year.