Medicare Advantage Plans for 2019
If you’re already enrolled in Medicare Part A and Part B or are approaching your enrollment soon, you might wonder if certain Medicare Advantage plans for 2019 will best serve your needs. Even though just about one-in-three beneficiaries who qualify for Medicare Part A and B have decided to exchange Original Medicare for a Medicare Part C plan, that percent is expected to grow in the future. To understand why some insurance company researchers think that more people will choose and compare Medicare Advantage plan for 2019 and beyond, please continue on.
Original Medicare vs. Medicare Advantage: What’s the difference?
Many people who are eligible for Medicare Advantage don’t understand how the program can benefit them or how it differs from Original Medicare. The first step to understanding Medicare Advantage plans is to explore how the program differs from its predecessor and what it can offer you. Take a look at this brief overview of Original Medicare and Medicare Advantage:
Original Medicare is an insurance program that was first introduced to the American public by the Federal government in 1965. The program features two distinct parts that are designed to provide insurance coverage for the country’s elderly population and those with disabilities.
Part A (Hospital Insurance) – covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Part B (Medical Insurance)- covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
Under this program, beneficiaries can receive care from any doctor, hospital, or other providers that accept Medicare. While Original Medicare covers a wide variety of medical services, it does not cover services such as:
- Long-term care (custodial care)
- Most dental care
- Eye exams related to prescribing glasses
- Cosmetic surgery
- Hearing aids and exams for fitting them
- Routine foot care
Furthermore, those enrolled in an Original Medicare plan are generally responsible for paying their own:2
- Prescription drugs that are not administered by a medical professional
Medicare Advantage Plans
The most significant difference between Original Medicare and a Medicare Advantage plan is that the federal government does not administer the Medicare Advantage program. Instead, the program is administered by private insurance companies that have been approved by Medicare to provide insurance benefits. A Medicare Advantage Plan must offer all the same coverage as Original Medicare, but it can also offer additional benefits such as:
- Dental coverage
- Routine vision coverage
- Vision coverage
- Hearing services
- Prescription drug coverage
Another difference between Original Medicare and Medicare Advantage that is important to note is that Medicare Advantage plans allow you to pay nothing for your covered healthcare costs once you reach a specific limit on your out-of-pocket expenses.
An Overview of the Landscape for Medicare Advantage Plans and the Part D Prescription Drug Program in 2019
The Centers for Medicare & Medicaid Services (CMS) reports that in 2019 the landscape for Medicare Advantage Plans and the Part D Prescription Drug Program will see some changes in 2019 such as:
- An all-time high for the number of Medicare Advantage enrollments with a projected 22.6 million Medicare Advantage beneficiaries in 2019.
- A reduction in the average monthly premiums as they are estimated to decline by $1.81 to $28.00 from 2018.4
- Approximately 83 percent of Medicare Advantage beneficiaries that continue their current plan will have the same or lower premium in 2019.4
- Approximately 46 percent of beneficiaries in their current plan will have a zero premium in 2019.4
- A national increase in the number of plan choices that are available to enrollees.4
- New types of supplemental benefits such as expanded health and reduced cost sharing.4
Understanding the Best Medicare Advantage Plans for 2019
According to a Deloitte survey, most of the growth in Medicare Advantage plans for 2019 and beyond will come from the people they call the “trailing” Baby Boomers.
These are the people born towards the end of the Baby Boomer generation, or up until 1964. These folks are more used to getting their health insurance from an insurance company with network providers and aren’t so adverse to the idea of selecting a PCP or getting referrals to see specialists.
While older people may prefer plans that don’t require them to select a network doctor or hospital, younger seniors are more likely to find an HMO or PPO familiar. Since many of these people have had to deal with rising premiums, they may also be more eager to make some compromises to fill in gaps for services that Original Medicare either doesn’t totally pay or doesn’t pay for at all.
Costs and Comparing the Best Medicare Advantage Plans for 2019
Naturally, one feature of Medicare Advantage plans that have attracted a lot of beneficiaries are the relatively low premiums. While it’s harder to find a Medicare Advantage plan with $0 monthly rates than it used to be, sometimes an HMO won’t charge extra. You might expect a better PPO or HMO to charge modest premiums though. Still, increases have been fairly modest.
A Medicare Advantage plan for 2019 isn’t expected to cost much more than it did the current year, according to CMS. The agency that oversees all Medicare Advantage plans has announced some news for next year:
- CMS gave approval for premium increases of only 3.4% for 2019
- They expect insurance company revenues to increase by about 1.84%
In any case, you probably shouldn’t expect drastic changes in the rates or benefits that an average beneficiary will see for Medicare Advantage plans in 2019.
Why Consider Medicare Advantage Plans for 2019?
You may wonder why people enrolled in Medicare Part A and Part B may prefer to get healthcare benefits through Part C instead of just sticking with Original Medicare. Medicare Part A and Part B do offer beneficiaries broad coverage for various healthcare needs, but they still include deductibles, copayments, and coinsurance. People may find that they can reduce the cost of benefits by enrolling in a Medicare Part C plan.
In addition, a Medicare Advantage plan may include some benefits that Medicare Part A and Part B do not have. Here are some examples:
- Medicare Advantage Prescription Drug plans sometimes called MAPD, will bundle in Part D prescription coverage. While most Medicare Part C plans do include a drug plan, Medicare Part A and Part B offer very limited drug coverage.
- Some people actually find it’s easier to have claims handled and find a hospital, doctor, or other medical services when they have a list of in-network providers.
- A Medicare Part C plan will probably also come with other perks, like discounts for dental or vision, memberships to fitness clubs, and savings on over-the-counter prescriptions.
How Will Medicare Advantage Plans in 2019 Work?
It’s important to understand that not all MA plans rely on a network, but most of them do. These are the two most common kinds of Medicare Advantage plans to compare:
Health Maintenance Organization HMO plans:
You should plan to get almost all of your healthcare from an in-network doctor or hospital, and you need a primary care doctor for referrals. On the other hand, HMOs usually do the best job or controlling costs. Furthermore, HMO plans usually feature the lowest premiums and out-of-pocket costs. Special Needs Plans SNPs and Dual-Eligible plans are usually HMOs.
Preferred Provider Organization PPO plans:
These plans allow you to choose out-of-network providers if you don’t mind paying somewhat more, and you may find this extra flexibility valuable. You also don’t need a primary care doctor and can often find plans that include Part D prescription drug coverage.
How Your Medicare Advantage Plan for 2019 Will Covers Prescriptions
Your Medicare Advantage plan might not include prescriptions, but most of them do. If it doesn’t, you might need to buy Part D on its own. These tips will help for either Part D or a MAPD plan:
- Look at the formulary to see which drugs the plan covers.
- Also, check Prescription Drug tiers to learn how payments could vary for brand-name or generic prescriptions.
When to Enroll and Compare Medicare Advantage Plans for 2019
You can enroll in a Medicare Advantage plan during your Initial Election Period if you’re new to Medicare. Otherwise, you have to wait for the Annual Election Period each fall to switch or join plans for the next year.
Medicare also had an annual Medicare Advantage Disenrollment Period each January; however, they have announced that this will be replaced by an additional Annual Election Period at the beginning of the year. This new Annual Election Period will be more limited than the one in the fall, but it still gives you another opportunity to compare and switch your enrollment.
Need Help Finding an Affordable Medicare Advantage Plan for 2019?
At My Medigap Plans, we help people like you find Medicare coverage they can afford. No matter what type of plan you’re looking for, we can help you compare coverage between some of the top medical insurance providers in the industry. To start comparing rates and coverages in your state simply use our convenient online comparison tool located at the top of this page. Want to speak to an agent? Give us a call today, and one of our licensed insurance agents will help you find the Medicare coverage you need.