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What the New Congress means for Medicare

While Congress may be a house divided, 2019 has shown to bode well for Medicare. As Medicare turns 53, it continues to strive to make improvements as it ages and it seems its 60 million members agree. Pulling in higher satisfaction rates than almost any other type of health insurance; it looks like Medicare will continue to adjust coverage to meet the needs of its members.

Medicare Improvements in 2019

The changes to Medicare for 2019 are welcome improvements over what was implemented in 2018. Some of these changes affect everyone who is receiving benefits, while other changes will only affect those who are enrolled in Medicare Advantage plans.

Medicare Part D

Changes to Medicare Part D is one of the most significant improvements. For many, this coverage can be quite expensive. This benefit requires members with high prescription costs to pay more for their medications after a certain annual spending threshold has been met. This creates a gap in coverage, called the “doughnut hole,” for beneficiaries until they reach a second out-of-pocket spending tier.

Once this occurs, they begin what is called Catastrophic Coverage and pay a significantly lower amount. Under the Affordable Care Act, this gap was scheduled to close in 2020, but thanks to a bill passed by Congress in March, it closes in 2019 for brand name drugs. For generic medications, it will close in 2020.

Other Changes to Original Medicare

Beneficiaries will no longer have to pay the full cost of outpatient treatment for services such as:

  •    Physical therapy
  •    Speech therapy
  •    Occupational therapy

This is because Congress permanently repealed the cap that has limited coverage for those services in the past.

Changes to the handbook that Medicare sends out every fall will also take place to include checklists and flowcharts making the coverage selection process more manageable. The online Medicare Plan Finder is undergoing a facelift as well. The updated tool will be more user-friendly and include an improved coverage wizard to help beneficiaries compare their out-of-pocket expenses.  

Another feature for members is the availability of Telehealth programs that allow patients to confer with a nurse or doctor over the phone or online. As of 2019, it provides coverage for Telehealth services for those with end-stage renal disease or during the courses of treatment from a stroke.

Final Thoughts

It looks as if the new Congress may bring additional changes to Medicare in the future as well. For many in the House, they are pushing towards the expansion of Medicare for All. This could benefit those under the age of 65 as well as those who already receive benefits.

To learn more about how the new Congress affects Medicare and your benefits, contact the professionals from at (877) 829-1109. Our licensed insurance experts will be happy to answer any questions you have.