Today we welcome a post from our guest writer, Danielle Kunkle. Danielle is an expert in making Medicare easy. She runs Boomer Benefits, an award-winning insurance agency specializing in providing insurance for Baby Boomers. Danielle also hosts a free webinar packed with useful, digestible information about Medicare for absolute beginners. Here she joins us to share her insight into Medicare Advantage Plans.
One of the unique things about Part C Medicare Advantage plans is that they can include some benefits that Original Medicare does not cover. They must cover all the same Medicare Part A and B benefits as Original Medicare, but they can also include ancillary benefits.
Each insurance carrier can choose which of these they want to offer, but they may include dental, vision, and hearing benefits as well as gym discounts or memberships.
Then in April of 2018, the Center for Medicare and Medicaid Services announced that beginning in 2019 Advantage plans could now include some supplemental home health benefits that fall in the arena of long-term care. These changes are specifically to benefit members with one or more chronic conditions who truly need the benefits to remain independent.
(…) beginning in 2019 Advantage plans could now include some supplemental home health benefits
While not all plans will decide to offer these, it’s exciting that they can now choose to offer them, and about 300 plans begin offering some of these benefits in 2019. We expect that many more plans will begin to incorporate them next year.
Let’s review some of the options you might find in Medicare Advantage plans going forward.
Many beneficiaries could benefit from occasional help at home
In-Home Support Services
Many beneficiaries could benefit from occasional help at home. In fact, with a little help, they may be able to stay living independently in their own home for a longer period of time before needing full-time care in a long-term care facility. In-home support services will include help with activities of daily living such as eating, dressing, and bathing.
Home Safety Modifications
One of the things that can drive up costs for Medicare and private insurance carriers who cover Medicare beneficiaries is falling. If you have an accident at home, you will often end up in the hospital and this is expensive for everyone involved.
To help prevent these injuries, Medicare Advantage plans can now install modifications to keep you safer. So, if you need a bathroom grab bar or a wheelchair ramp in your home, a Medicare Advantage plan that offers to pay for this for you might be a plan you want to consider. Plans could also consider providing special air conditioners or even carpet cleaning for people with asthma or other breathing disorders.
Adult Day Care
When someone begins to need care, it is often a family member or friend who shoulders the burden of that care. With the option to drop Mom or Dad off at an adult day care center occasionally for a few days will allow caregivers to get the respite that they need to remain strong and healthy.
While Original Medicare does cover respite care for caregivers when the beneficiary is on hospice, it does offer adult day care. This makes this an advantage for Advantage plans (pun intended!)
With the option to drop Mom or Dad off at an adult day care center occasionally for a few days will allow caregivers to get the respite that they need to remain strong and healthy.
Telemedicine
Sometimes it can be difficult to get someone who is homebound to the doctor’s office. With newly expanded options for telemedicine services, we’ll see this getting easier for beneficiaries on Medicare Advantage plans.
Transportation Benefits
For the times when a face to face visit with your doctor is required, Advantage plan enrollees may soon find that their plan offers a certain number of trips to and from medical appointments. In some cases, these benefits may also be used for picking up prescriptions at your local pharmacy.
Meal Delivery
Some beneficiaries who struggle to take care of themselves while living at home alone will surely appreciate the home delivery of hot meals.
Over the Counter Allowance
While Part D provides for medications that your doctor prescribed, Medicare beneficiaries also use a number of the over the counter drugs and supplements. These can sometimes be costly. Medicare Advantage plans will now be able to offer members a monthly or quarterly allowance that they can use to buy OTC pain relievers, allergy medications, vitamins, and other supplements.
So, as you can see, these new benefits can go a long way to helping members remain independent. They are intended to help members manage one or more chronic conditions that can make living at home without any care difficult. The goal is to reduce costly emergency room visits and provide a better member experience for these individuals as well.
The flexibility that plans will now have to tailor benefits specific to chronically ill members is something new and welcome.
While Original Medicare will not currently include these benefits, it’s a good sign that Advantage plans will begin to include them. If the new benefits are able to successfully lower medical costs, perhaps one day we’ll see Medicare itself begin to offer them as well.
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