Medicare Changes for 2019

Open Enrollment for 2019 Medicare Advantage (MA/MAPD) has begun. Here’s what you need to know about the changes being implemented to the program this year.


Medicare Part B Premium

The last few years have seen multiple increases in the Medicare Part B premium, the cost for Medicare that most people see coming out of their Social Security. This year is no different, but many people may not notice, as the premium is only increasing by $1.50, from $134 to $135.50

Coverage Gap (Donut Hole)

One of the biggest headaches for a Medicare beneficiary who uses a lot of prescription drugs is the coverage gap. This is a requirement for the insured to pay a substantially higher share of drug costs one spending reached a certain limit throughout the calendar year. The insured pays the higher share until a further spending limit, where the insured then enters catastrophic coverage and pays substantially less. The area between initial coverage and catastrophic coverage was also know as the “donut hole.” While a provision in the Affordable Care Act (ACA or Obamacare) required that the donut hole close in 2020, Congress passed a provision in the March spending bill to close the gap early for brand-name drugs in 2019. The generic drug gap will close in 2020 as scheduled.

Benefit Expansions

In the past, CMS required benefits that Medicare Advantage plan sponsors (insurance companies) could offer beneficiaries be primarily healthcare related. CMS relaxed those rules for 2019 and beyond, allowing insurers to offer things such as in-home cleaning and assistance, meals delivered to the home, safety devices like personal emergency response systems, bathroom grab bars and wheelchair ramps.

More Opportunities to Change Plans

New regulations required by Congress in a provision of the 21st Century Cures Act will allow people to test their Medicare Advantage plans for up to three months before deciding whether to keep their current plan, switch to another plans, or revert back to Original Medicare. This new provision was designed to accelerate innovation in health care.

What’s New In Tampa Bay

While all of the above changes are on a macro level, effective all across the country, there are changes that are occurring on a micro-level here in Tampa Bay. Increasing Medicare Advantage enrollment among Medicare beneficiaries and increasing competition from insurers has driven down the average annual cost of many health plans available in the area. New insurers have entered the Medicare Advantage market in 2019 (Baycare Health and Devoted Health) as well. There is never a better time to review your coverage to ensure that you are still in the option that works best for you.