Medicare 2019 Changes Overview:
The return of Medicare OEP (open enrollment period) January 1 – March 31. Beneficiaries are able to make a one-time change to another Medicare Advantage plan that would be more suitable for them!
The standard Part B Premium is $135.50/month
A new high-income bracket will apply to enrollees with income above $500,000.
The Part B deductible increased to $185 for 2019.
Part A premiums, deductible, and coinsurance are higher in 2019.
Medicare Advantage premiums are decreasing; the number of plans are increasing; and enrollment is projected to increase.
Part D basic premiums are decreasing; more part D plans are available; and the donut hole is closing early for brand-name drugs.
What is the Medicare OEP?
The OEP allows beneficiaries who are enrolled in a Medicare Advantage Plan to make a one-time change. Beneficiaries can use the Medicare OEP to:
Switch from one Medicare Advantage plan to another Medicare Advantage plan
Disenroll from a Medicare Advantage plan and return to Original Medicare, with or without a Part D drug plan
The Medicare OEP does not, however, allow a beneficiary to change from one Part D plan to another.
Part B deductible
The Part B deductible was $183 in 2017 and it remained at that level in 2018. For 2019, however, it has increased to $185. Some enrollees have supplemental coverage that pays their Part B deductible. This includes Medicaid, employer-sponsored plans, and Medigap plans C and F. Medigap plans that cover the Part B deductible can only be sold through 2019 — after that, people can keep Plans C and F if they already have them, but new enrollees will no longer be able to buy plans that cover the Part B deductible.
Many Medicare Advantage plans have low copays and deductibles that don’t necessarily increase in lock step with the Part B deductible, so their benefits designs have had different fluctuations over the last few years. (Medicare Advantage enrollees pay the Part B premium, but their Medicare Advantage plan wraps Part A, Part B, and various supplemental coverage together into one plan, with out-of-pocket costs that are different from Original Medicare).
Part A premiums, deductible and coinsurance
Medicare Part A covers hospitalization costs. For most enrollees, there’s no premium for Part A. But people who don’t have 40 quarters of work history (or a spouse with 40 quarters of work history) must pay premiums for Part A coverage.
For care received in skilled nursing facilities, the first 20 days are covered with the Part A deductible that was paid for the inpatient hospital stay that preceded the stay in the skilled nursing facility (Medicare only covers skilled nursing facility care if the patient had an inpatient hospital stay of at least three days before being transferred to a skilled nursing facility). But there’s a coinsurance that applies to days 21 through 100 in a skilled nursing facility. In 2019, it’s $170.50 per day, up from $167.50 per day in 2018.
CMS also noted that the total number of Medicare Advantage plans across the country was increasing again for 2019, from about 3,100 to 3,700.
In 2017, about 19 million people had coverage in Medicare Advantage plans. That number has been growing steadily since 2004 (when there were just 5.3 million Medicare Advantage enrollees).
CMS notes that 99 percent of Medicare enrollees will have access to Medicare Advantage plans in 2019, and 91 percent will have access to at least 10 different Medicare Advantage plans.
Part D prescription coverage
For stand-alone Part D prescription drug plans, average basic premiums were expected to decline by about $1.09 per month in 2019, dropping to a projected average premium of $32.50/month, down from $33.59/month in 2018.
And there’s significant variation in the actual premiums people pay, depending on the plan they select. In 2018, premiums for Part D across the country plans range from under $11/month to $156/month.
The good news is that the Affordable Care Act has been gradually closing the donut hole in Medicare Part D. In 2019, enrollees pay just 37 percent of the plan’s cost for generic drugs while in the donut hole. And the donut hole is closing one year early – in 2019, instead of 2020 – for brand-name drugs, which will cost the enrollee just 25 percent of the plan’s cost in 2019 (down from 100 percent before the ACA started to close the donut hole).
The Return of the Medicare OEP
Medicare beneficiaries who enroll in Medicare Advantage plans sometimes find themselves stuck in a plan that they do not like. Although the plan’s Summary of Benefits covers the specifics of how the plan works, it’s all too easy for a beneficiary to misunderstand the rules or forget to check whether a certain doctor is in the network.
Beginning in 2019, Medicare beneficiaries can use a period called the Medicare OEP to make a one-time change between the dates of January 1-March 31st.
need help sorting through Medicare options? You now have extra time this year during OEP to analyze your current plan and make appropriate changes, now through March 31. I want to be your trusted Medicare advisor. Joanne Foley insurance is dedicated to assisting the senior population with their insurance needs. With Joanne’s experience, seniors rely on my guidance to find the most comprehensive, suitable yet affordable coverage for their specific needs.
To find out more, please call Joanne Foley Insurance to arrange a no obligation explanation of these Medicare choices. They represent a carefully selected group of financially sound and reputable insurance companies to offer you the best service possible and most comprehensive coverage at competitive prices. They do more than sell insurance; Joanne Foley Insurance provides peace of mind.
For more information on Joanne Foley Insurance and how they can partner with you to get you on the right track, please call 561-316-0120, or visit www.JoanneFoleyInsurance.com.
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