Last April, the U.S. government announced it would increase 2019 payments by 3.4% on average to the health insurers that manage Medicare Advantage insurance plans, a “higher-than-expected rise reflecting a projection of higher medical cost growth.”1
So what does this mean for your clients? While the rate change ultimately affects how much insurers will charge Medicare recipients for monthly healthcare premiums and plan benefits, there’s more to the story for 2019.
But first, some definitions: Original Medicare vs. Medicare Advantage
Government-managed Medicare coverage is known as Original Medicare. It includes Part A (hospital insurance) and Part B (medical insurance), with an option to add Part D prescription drug coverage and Medicare Supplement Insurance (Medigap) to help fill in any gaps.
Once enrolled in A and B, some seniors choose to get their Medicare coverage through Medicare Advantage Plans (Part C plans) offered by private insurers, which provide coverage for the services under A and B, and sometimes additional coverage such as prescription drug coverage. Costs can be similar to those for Original Medicare but depend on a number of factors including deductibles and copays under the chosen plan.
Changes for 2019
- For starters, prescriptions drug premiums are expected to fall. The decrease of $1.09 per month may seem measly, but this could add up — especially for seniors prescribed multiple brand name drugs.
- A recent policy from the Trump administration will provide Medicare Advantage plans with new tools to negotiate lower prices. More than 20 million Americans are enrolled in these plans, which spent $11.9 billion on Medicare Part B drugs in 2017, the category where plans will now have more power to drive down prices.
- And while not yet finalized, the Centers for Medicare and Medicaid Services is proposing changes to dramatically simplify and streamline Medicare’s conditions of participation and conditions for coverage so they can meet health and safety standards more efficiently.
What your clients may not know
There are several lesser-known uses for Medicare Advantage in 2019 your clients may not be aware of. Share this infographic to get them up to speed.
“7 Ways Medicare Will Improve in 2019,” AARP, September 2014