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En español | Medicare’s annual eight-week open enrollment period begins today. Beneficiaries have until Dec. 7 to take stock of their current coverage and decide whether it meets their health care needs — and budget.
All the decisions made during open enrollment will take effect in January. If you don’t want to change your coverage, no action is required. But, with few exceptions, this is the one chance to change coverage during the year.
Parsing the different Medicare options can be daunting, but the Centers for Medicare and Medicaid Services (CMS) has added new features to its online enrollment process meant to make it easier. CMS is encouraging beneficiaries to set up a personalized account at MyMedicare.gov, which offers some easy-to-understand tools to help with decision-making. These include a new cost calculator and an online chat feature.
CMS just announced that the 2019 monthly premiums for Part B, which covers doctor visits, diagnostic tests and outpatient services, will be $135.50 in 2019 and the Part B annual deductible will be $185. The Part A deductible for hospital stays will be $1,364.
A good rule of thumb for open enrollment, says Leigh Purvis, director of health services research in AARP’s Public Policy Institute, is to look at the four C’s: cost (premiums and cost-sharing); coverage (are your current health care providers in network? Are your prescription drugs covered?); convenience (are in-network providers and/or the plan’s preferred pharmacies nearby?); and customer service (Medicare health and prescription drug plans are rated from poor to excellent on various aspects of customer service).
It can be tempting — and easier — for Medicare beneficiaries to simply stick with their current coverage, Purvis notes, but “there’s so much flux in terms of what plans are covering and how they’re covering it that we want to make sure people look at their options and change when it makes sense to do so.”
In fact, Medicare has made some important changes beneficiaries should consider this enrollment period.
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- eMedicare. This is Medicare’s initiative to make the program easier for people to navigate using Medicare.gov. One new feature: Beneficiaries can now go to the site and answer five questions. The answers will allow Medicare to provide information about their options with original Medicare or Medicare Advantage. The site also includes a new out-of-pocket cost calculator, an online chat feature and other tools.
- Extra benefits for Medicare Advantage. For 2019, the federal government has expanded the availability of extra benefits that Medicare Advantage plans can offer, such as portable wheelchair ramps and “other assistive devices and modifications” that help beneficiaries who have injuries or other physical impairments. The plans also can offer services such as transportation to the doctor’s office and home accessibility features such as bathroom grab bars and wheelchair ramps, if a doctor recommends them. However, some plans will cover these services only for beneficiaries who meet certain eligibility criteria.
- Trial period for Medicare Advantage. Beneficiaries who sign up for a Medicare Advantage plan during open enrollment can make changes between Jan. 1 and March 31. If you don’t like your plan, you can go back to original Medicare and sign up for a Part D plan or switch to another Medicare Advantage plan. (Note: Anytime you switch to traditional Medicare, you should check carefully about your ability to buy Medigap coverage.)
- Medicare Advantage premiums. CMS expects the average premiums for these plans to drop slightly, to $28 in 2019.
- Prescription drug premiums. The average basic Part D prescription drug premium is expected to dip slightly, to $32.50 next year.
- No more therapy cap. Congress has eliminated the annual limits on how much Medicare will pay for physical, speech and occupational therapy services.