With over 58 million people receiving Medicare benefits in 2018, and nearly 10,000 Baby Boomers aging into Medicare each day, changes to Medicare affect the lives of many Americans. Changes to Medicare for 2019 have been announced by the Centers for Medicare & Medicaid Services (CMS). These changes may affect Medicare Advantage, Medicare Supplement (Medigap), and Medicare Prescription Drug Plans in 2019. Find out about these changes before the Annual Election Period (AEP) begins on October 15.
Changes Coming to Medicare
The Centers for Medicare & Medicaid Services finalized 2019 policy updates and changes to Medicare Advantage and the Prescription Drug Benefit Program with the intent “…to improve quality of care and provide more plan choices for MA and Part D enrollees.” There will be changes to Medigap policy offerings, Medicare’s Open Enrollment Period, unnecessary limits in Medicare Advantage plans, dual-eligible passive enrollment, Part D Special Enrollment Periods .
Let’s discuss a few of the biggest changes for 2019:
1. The Restoration of the Medicare Open Enrollment Period.
With the 21st Century Cures Act, a new Medicare Open Enrollment Period (OEP) will take effect from January 1 through March 31st annually. This OEP will allow individuals enrolled in a Medicare Advantage (MA) plan, including newly MA-eligible individuals, to make a one-time election to switch to another MA plan or to drop their MA plan and return to Original Medicare. Individuals using the OEP to make a change may make a coordinating decision to add or drop Part D coverage. This will eliminate the existing Medicare Advantage Disenrollment Period (MAPD).
2. Unnecessary Limits for Medicare Advantage Plans will be eliminated.
By eliminating the requirement that MA plans offered by the same organization in the same county comply with unnecessary limits requiring differences among the organization’s plans, CMS hopes to improve plan options for Medicare beneficiaries.
3. Passive enrollment opportunities and Part D Special Election Period for dual-eligible beneficiaries will be revised.
If your enrollment is disrupted by changes in a health plan’s participation, CMS will allow for passive enrollment for full-benefit dually eligible beneficiaries from a non-renewing integrated dual-eligible Special Needs Plan (D-SNP) to another comparable plan.
The Special Election Period (SEP) for dual-eligible and Low Income Subsidy beneficiaries will move from from an open-ended monthly SEP to one that may be used only once per calendar quarter during the first nine months of the year. This new policy will also establish separate SEPs that can be used within a certain period of time after a CMS or state-initiated enrollment and within a certain period of time after a change to an individual’s LIS or Medicaid status.
4. Medigap Plan C and Plan F and Medicare Cost Plans will be eliminated.
Due to a recent law that prohibits Medigap policies for newly eligible beneficiaries from covering the Medicare Part B deductible after January 1, 2020, two of the most popular Medicare Supplement policy options are being eliminated. Medigap Plan C and Plan F have millions of enrollees, so if you want to retain your coverage but change carriers, you will want to do so before 2020.
Medicare Cost Plans will not be offered after 2018. Medicare recipients may have their plans converted to a Medicare Advantage plan by their union or employer group, or you may opt to return to Original Medicare. If you return to Original Medicare, you may want to consider adding a Medigap policy and/or Prescription Drug Plan to your portfolio of coverage.
For more detailed information regarding CMS policy changes and updates, visit www.cms.gov