The New Year almost always brings change within the kingdom of Medicare, whether in premiums, benefits, eligibility or deductibles.
Following is a summary of the changes on the horizon for Medicare recipients as of January 1, 2019:
- Medicare Part A inpatient hospital deductibles will see a $24 annual increase. The 2019 deductible will be $1,364 in 2019, up from the $1,340 deductible seen in 2018;
- Daily coinsurance rates under Medicare Part A will also rise. In 2019, beneficiaries must pay a coinsurance amount of $341 per day for the 61st through 90th day of a hospitalization (the rate was $335 in 2018);
- For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $170.50 in 2019 (up from $167.50 in 2018);
- In better news, the infamous Medicare D “donut hole” will close for name-brand prescription drugs in 2019. The “donut hole” represents a period of time where beneficiaries exhaust their benefits and must pay for medications until they reach the threshold for “catastrophic” coverage. This interval will be eliminated in 2019 for brand-name drugs and will be eliminated for generic drugs in 2020.
- Caps limiting coverage in the areas of physical, speech and occupational therapies have also been eliminated for beneficiaries of original Medicare. Patients in need of post-stroke rehabilitative therapies formerly were capped at $2,010 for physical and speech language therapy combined, and $2,010 for occupational therapy. Congress has removed these limits.
- Telemedicine coverage continues to expand. In 2019, Medicare will begin covering telehealth services for people with end-stage renal disease or during treatment for a stroke.
- Medicare Advantage Plans now have the ability to offer non-medical forms of support if they are ordered by a physician and available in a given area. Offerings include meals delivered to the home, transportation to the doctor’s office and safety features in the home such as bathroom grab bars and wheelchair ramps. These benefits, however, are not widely available. Of the 3,700 plans across the country next year, only 273 in 21 states will offer at least one of these new benefits. About 7 percent of Advantage members — 1.5 million people — will have access, as estimated by Medicare officials.
- Beneficiaries of Advantage plans will find they have more flexibility when it comes to switching. If a beneficiary chooses a plan and is dissatisfied in some way, they can switch to another Advantage plan or enroll in original Medicare as long as they do so in under three months.
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