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New Medicare Advantage Plan Benefits Hard to Find

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New Medicare Advantage Plan Benefits Hard to Find

New Medicare Advantage Plan Benefits Hard to Find
November 21
23:22 2018

The television has been filled with dozens and dozens of commercials, advertising the new 2019 Medicare Advantage plan benefits.

I just saw one commercial that talked about the new benefits including things like transportation to medical appointments, meals delivered to the home for post-surgery and home-bound people, wheel chair ramps, grab bars for bathrooms and even help with air conditioners for some people who suffer with asthma. They say there are many other new benefits.

If you listen to the television commercials, it sounds like these new benefits will all be covered by many of the Medicare Advantage plans available, but is that true?

According to Kaiser Health News:

“But the new benefits will not be widely available, and they won’t be easy to find.”

“Of the 3,700 plans across the country next year, only 273 in 21 states will offer at least one. About 7 percent of Advantage members — 1.5 million people — will have access, Medicare officials estimate.”

“That means even for the savviest shoppers it will be a challenge to figure out which plans offer the new benefits and who qualifies for them.”

“Medicare officials have touted the expansion as historic and an innovative way to keep seniors healthy and independent. Despite that enthusiasm, a full listing of the new services is not available on the web-based ‘Medicare Plan Finder,’ the government tool used by beneficiaries, counselors and insurance agents to sort through dozens of plan options.”

“Even if people sign up for those plans, they won’t all be eligible for all the benefits. Advantage members will need a recommendation from a health care provider in the plan’s network. Then they may need to have a certain chronic health problem, a recent hospitalization or meet other eligibility requirements.”

True, if you can find a plan that offers you the new benefit you are after, be careful, because not everyone qualifies and there is a lot of information missing from the government website. It’s highly recommended that before signing up for a Medicare Advantage plan to cover your needs, that you conduct extensive research to make sure what is available, what you qualify for and who provides it.

Kaiser offers more explanation:

“Among the new benefits that some Medicare Advantage plans said they will offer are:”

  • Trips to the pharmacy or fitness center in addition to doctor’s appointments for plan members, depending on where they live or their health conditions.
  • A monthly or quarterly allowance for over-the-counter pharmacy products such as cold and allergy medications, eye drops, vitamins, supplements and compression stockings.
  • House calls by doctors or other health care providers, under certain conditions.
  • A home health care aide for a limited number of hours to help with dressing, eating and other daily activities, possibly including household chores and light housekeeping.

“However, plans offering these and other services will likely have only some of the options and will have different eligibility criteria and other limitations. The same services likely won’t be available in every county the plan serves.”

“For example, next year an estimated 150,000 Humana Medicare Advantage members in Texas and South Florida — two of the 43 states Humana serves — who cannot be left alone at home will be able to get a free in-home personal care aide for up to 42 hours a year, so that their regular caregiver can get a break. And more than half of the members in Cigna-HealthSpring Advantage plans will have access to free transportation services in all but five of the 16 states and the District of Columbia where the company sells coverage.”

For one thing, many Medicare Advantage plans restrict subscribers to specific doctors or doctor groups and hospitals.

In other words, before you leap into a plan, take small steps and make sure you know what you are leaping into.


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