Three Stories to Report on Medicare Advantage Before and After Open Enrollment Ends

by December 5, 2018

Few beneficiaries understand the details of Medicare Advantage plans, which should have reporters rushing to look into one or more of these following angles. (Photo via PixaBay.com)

There’s still time for those 65 and older to change their health coverage for 2019 before December 7—and even after January 1, 2019—if they signed up for a Medicare Advantage plan and want to make a change.

The tight deadline hands business reporters an opportunity to come up to speed on an issue that will start the ball rolling on health coverage stories in 2019.

Advantage plans provide the same benefits as Original Medicare, and 90 percent include prescription drug coverage. Dangling zero-based premiums, and benefits for vision, dental, and hearing aids in 2019, Medicare Advantage plans are booming, according to the Kaiser Family Foundation (KFF).  In 2018, Advantage plans provided health insurance to more than one in three Medicare beneficiaries. By 2019, the Centers for Medicare & Medicaid Services (CMS) estimates that plans will double to cover 22.6 million Medicare beneficiaries.

But few beneficiaries understand the details of these plans, which should have reporters rushing to look into one or more of these following angles as the Dec. 7 deadline approaches:

Do You Understand Your Medicare Advantage Plan?

Private insurance companies contract with the federal agency to offer these plans, which must provide the same benefits as Original Medicare. Unlike Medigap, the supplemental health coverage insurance that pays for the 20 percent of costs not covered by Medicare, Advantage plans are different, says  CMS.  Costs, co-pays, and deductibles can vary from plan to plan, and doctors and hospital networks are restricted. Understand how a Medicare Advantage plan works before you join, says CMS. Engage readers in an online forum. Include representatives from S.H.I.P., your state’s health insurance assistance program, a Medicare expert such as Frederic Riccardi, director of client services at The Medicare Rights Center in New York City, and insurance agent Joe Graves at ihatebuyinginsurance.com.

Do You Expect to Receive a Supplemental Health Benefit in 2019?

Earlier this year, CMS announced supplemental health-related benefits including air conditioners for those with asthma, healthy groceries, rides to medical appointments and home-delivered meals. But only 7% of Medicare Advantage members in 21 states can expect to receive just one of these benefits, according to Kaiser. Were supplemental benefits an important factor in choosing an Advantage plan in 2019? Ask your panel.

Do You Know You Can Disenroll from Your Medicare Advantage Plan?

CMS allows Medicare beneficiaries to switch back to Original Medicare from a Medicare Advantage plan during a special “disenrollment” period that occurs from January 1 to February 14 of every year after Medicare Open Enrollment ends. They may also qualify if they move out of their plan’s service area; qualify for a low-income subsidy, have full Medicaid coverage and Medicare, or live in nursing home, skilled nursing facility, or rehabilitation hospital. Find out how many on your panel are now considering this choice.