With every new year come changes in all aspects of life. Your medical insurance is no different, with the continued evolution of the Affordable Care Act and private insurance unfolding as we speak. Medicare is also slated for shifting coverage as we move into the new decade. If you rely on Medicare for your healthcare, read on for some of the changes to your policy that you can expect to see in 2020.
Medicare in 2020
One of the biggest changes to take effect on January 1, 2020 is that newly eligible beneficiaries will no longer be able to apply for a Medicare Supplement Insurance (Medigap) plan. These plans were in place to provide coverage for the the Medicare Part B deductible. The new rule impact Medigap Plans F & C. It is important to point out that if you had this coverage before 2020, your plan remains in place; and if you were eligible prior to 2020, you can still apply as a new participant as long as your state offers that option.
The rule which discontinues Plan F & Plan C enrollment is a function of the 2015 Medicare Access and CHIP Reauthorization Act, known more commonly as MACRA. The Act gradually phased out Medicare Supplement insurance plans. The intention was to compel Medicare Part B beneficiaries to be more invested in their care, or “keep some skin in the game.” The Act requires that some Part B coverage costs be paid out of pocket.
What was the reasoning behind MACRA? Legislators felt that because Medicare plans were 100% subsidized, appointments were scheduled needlessly simply because they were free – causing misuse of the benefit.
Medigap Plan G a New Option
Beginning in 2020, Medigap Plan G will offer a new, high-deductible choice. Enrollment would require that the beneficiary first pay out-of-pocket costs for covered care, up to the set deductible. Plan G benefits would then be applicable for the remainder of the calendar year. This option replaces high deductible Plan F, which will no longer be available to newly eligible individuals.
Medicare Part D Donut Hole Will Decrease
The “donut hole” reflects the lapse in Part D prescription drug coverage which kicks in once your out-of-pocket prescription drug spending has reached a certain annual threshold. Changes to the program include that individuals will be required to spend more on covered drug costs before the donut hole is reached. The threshold is increasing from $3,820 to $4,020. Once you enter the donut hole, you will need to spend $6,350 before entering the catastrophic coverage phase. This has been increased from $5,100 in 2019.
Going forward in 2020, Part D beneficiaries will pay 25% of the cost of generic and brand name drugs while in the “donut hole” stage, down from 37% in 2019.
Medicare Advantage to Add Benefits in 2020
Medicare Part C plans (Advantage plans) offer the same benefits as the original program, and some plans provide additional benefits. Depending on your state and plan, Medicare Advantage may cover prescription drugs, dental, vision, hearing aids or gym memberships. In 2019, select Medicare Advantage plans began adding “primarily health-related” services to their coverage, including home health care services, caregiver support services, adult day care and non-emergency transportation to appointments.
The Centers for Medicare and Medicaid Services (CMS) expects that in 2020, approximately 500 additional Medicare Advantage plans, representing 2.6 million enrollees, will offer these extended services under their plan options.
REMEMBER: Not all plans will offer these services, therefore it is highly recommended that you speak to your local insurance agent to understand what your particular plan will cover.
No matter what your stage in life, robust health insurance coverage is essential. At Anderson & Associates Insurance Group, we are dedicated to helping you find the best coverage for your situation. It’s a new year, and a great time to reevaluate your coverages and policies.
