Earlier this year we wrote about a host of new features and benefits that Congress and the Trump Administration had decided to allow in Medicare Advantage plans. Now that open enrollment is here, we thought it would be a good idea to revisit this issue to help our AgingOptions blog readers know what questions to ask as you shop for medical insurance plans for calendar year 2019.
The Promise: New Rules, New Choices
Last April we wrote, “Under new federal rules, beginning in 2019 your ride to the doctor’s office or your home-delivered meal might be covered by your Medicare Advantage plan. The same goes for that air conditioner you need to help deal with your chronic asthma or the grab bar you needed installed in your shower for safety. Indeed, the popular Medicare Advantage programs are getting something of a make-0ver, and the result could make these policies even more attractive to seniors as a feature-laden alternative to traditional Medicare.”
We first read about this expansion of benefits in this article published last spring on the Kaiser Health News website. “Medicare Advantage Plans Cleared to Go Beyond Medical Coverage,” said the title – “Even Groceries.” Under a new set of guidelines approved in early 2018 by the Center for Medicare and Medicaid Services (CMS), the definition of “health-related” benefits was being significantly expanded, giving the private insurance companies that offer Medicare Advantage plans the latitude to sweeten the pot of features for policy holders. The new rules were to take effect in 2019, so shoppers should have started seeing the enhanced benefits in time for Medicare open enrollment starting October 15th.
Where Are the New Benefits?
So are all those enhancements showing up in the new Medicare Advantage plans being rolled out for 2019? Not exactly. In researching this question, we found this article in Forbes magazine this week that explains why these new features apparently aren’t quite ready for the market. “Earlier this year, Congress and the Trump Administration for the first time allowed Medicare Advantage plans to offer their members non-medical supportive services such as transportation and home meals,” writes Forbes. “As insurers begin to roll out their plans for Medicare’s 2019 open season enrollment, we are starting to see what these new benefits are going to look like.” But as it turns out, “relatively few plans will offer the supplemental services in 2019.”
The Forbes report suggests a few key reasons for the delay. First, the new government guidelines were only issued a few months ago, so insurers had little time to put together benefit packages. This made it difficult for company actuaries to determine how much to charge, since the insurance companies were offering benefits for which they had no experience. Adding to the uncertainty, no one knew how those shopping for policies would react, and what they would be willing to pay for. “Marketers are unsure which additional services will attract consumers,” Forbes writes. “And, most of all, this is all very new and insurers are, well, cautious.”
Transportation, Food, Even Home Modifications
As the original Kaiser explained, many Medicare Advantage plans already offer some health benefits like eyeglasses, hearing aids, dental care and gym memberships not covered by Medicare. But the new rules, which the industry had sought, were expanded those benefits to include items and services that go way beyond medical treatment. The CMS guidelines now allow insurers to “provide care and devices that prevent or treat illness or injuries, compensate for physical impairments, address the psychological effects of illness or injuries, or reduce emergency medical care.” Exactly what services and products this might include is unclear. However, one company, Anthem, is offering expanded benefits in a handful of states (not including Washington), so this company list (from the Forbes article) might prove typical:
- Up to 16 home delivered healthy meals for each health event (64 meals per year)
- Up to 60 one-way trips per year to health-related appointments and covered services.
- Up to 124 hours of support from a home health aide or similar assistance.
- A $500 allowance for safety devices such as shower stools or temporary wheelchair ramps.
- Up to 1 visit per week for adult day services.
- Up to 24 acupuncture and/or therapeutic massage visits.
Dispel the Confusion with a Proper Plan
There’s so much confusion and misinformation out there about health insurance! Our recommendation is that you shop carefully and consider all the pros and cons when selecting health insurance. Don’t be swayed by the promises of benefits that might add cost but not add value. Remember, too, that what’s right for someone else may not be right for you. Contact us here at AgingOptions and we can make certain you receive the advice and insight you need.
These articles made us realize once again how important it is for seniors to get solid, professional and objective advice, not just about medical issues but about every aspect of growing older. That certainly applies in the area of retirement planning. Instead of relying on a so-called investment advisor or insurance consultant who has a product to sell, we encourage you to seek the advice of an experienced professional like Rajiv Nagaich from AgingOptions. Rajiv will show you how all the pieces of your retirement plan need to fit together, just like the pieces of a puzzle: financial, legal, medical, housing and family. The result is a seamless plan called a LifePlan, a blueprint that will guide you as you create the fruitful and secure retirement of your dreams.
Why not invest just a few hours and find out more? Join Rajiv Nagaich at an upcoming LifePlanning Seminar – a free session packed with valuable information to show you what a wonderful experience retirement can be. For dates, times and locations, click here – then register online or call us during the week. We’ll look forward to meeting you and answering your retirement questions.