Medicare Advantage benefits expand
The federal government again is relaxing its rules to allow Medicare Advantage insurers to offer customers perks such as quarterly pest control or financial support for service dogs.
The new 2020 benefits, OK’d by the Centers for Medicare and Medicaid Services (CMS), also include nutritional counseling with delivery of pantry staples, free fitness trackers and regular acupuncture visits.
CMS first allowed Medicare Advantage plans to expand the types of supplemental benefits they could offer enrollees last year. But companies have been slow to offer the extra benefits to the more than 24 million seniors that are expected to enroll in Medicare Advantage plans for 2020.
Martin Esquivel, vice president of Amerigroup Texas’ Medicare product management, said the insurer already offered extra benefits — even before CMS gave insurers more flexibility in what they can offer as supplemental benefits.
“The goal is to ensure a safer environment for our members,” he said.
For many consumers, he said, that means killing household pests or providing transportation or assistance to combat loneliness.
The open enrollment period for Medicare Advantage plans starts Tuesday and runs through Dec. 7. Residents who are 65 and older, or are deemed disabled under Social Security standards, can compare coverage options such as traditional Medicare and Medicare Advantage and choose Medigap supplemental insurance and drug plans for 2020.
The original Medicare plan is managed by the federal government and provides eligible individuals with coverage for visits to their doctors, hospitals or other health care providers. Medicare pays up to 80 percent of approved services after the beneficiary reaches his or her deductible.
Medicare Advantage plans must cover all of the medical and hospital services that Medicare covers, but its bundle of benefits also includes prescription drug coverage as well as limited vision, dental and hearing coverage.
CMS officials said beneficiaries will also have more plan choices because about 1,200 more Medicare Advantage plans will be available in 2020 than in 2018. They also reported Medicare Advantage premiums are expected to decline this year by 23 percent. Benefits counselors said these plans aren’t always cheaper in the long run.
Amerigroup Texas said its Medicare Advantage members in Texas will be able to choose one of 10 wellness, social and support services — which include new and existing benefits — that will go in effect Jan. 1.
Esquivel said a popular choice last year among Amerigroup members in Texas was in-home assistance, which covered the cost of sending someone to help with daily activities for four-hour shifts.
“They offer these because it’s to their advantage to keep their members as healthy as possible,” said Laura Ramos, a specialist at the Alamo Area Council of Governments’ Area Agency on Aging, which is funded by the federal Older Americans Act.
Seniors need to read through the options carefully and get help finding the best deal for their circumstance, she said.
“There are so many different plans that are available,” Ramos said. “You cannot imagine how many people are confused or overwhelmed by the options because plans can change year to year.”
Ramos said enrollees should also know that doctors and medical practices can opt out of plans — Medicare and Medicare Advantage — at any point during the year, leaving them with health care providers who aren’t in-network.
While plans may not charge customers monthly premiums, there still are many out-of-pocket costs associated with plans, which can be compared online at Medicare.gov.
Ramos said consumers also should know that insurance providers are supposed to notify them in writing of major changes, such as when their insulin no longer is covered by the plan. But ultimately, it will be up to beneficiaries to ask for assistance.
“People need to ask their friends and family for recommendations,” she said.