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October 16, 2018

What to Know About Medicare Open Enrollment for 2019

Open enrollment for Medicare for 2019 runs from Oct. 15 to Dec. 7, and whether you’re wondering about the changes in store for 2019 or have questions on what the best option is for you, this blog post will provide the resources you need.

What Does Open Enrollment Allow Me to Do?

Similar to private insurance, Medicare open enrollment gives you the opportunity to move to a Medicare Advantage plan if you’re covered under traditional Medicare, change Medicare Advantage plans if you’re already covered under one or switch back to traditional Medicare or make changes to your prescription drug coverage.

What is Changing for Medicare Open Enrollment 2019

The following changes may affect all beneficiaries or just those enrolled in the Medicare Advantage plan:

The Donut Hole is Going Away: The donut hole—the coverage gap some people encounter once they have surpassed the amount for covered prescription drugs—will be closing in 2019. It was supposed to close in 2020 under the Affordable Care Act, but Bipartisan Budget Act of 2018 passed by Congress earlier this year will close the donut hole in 2019.

What does this mean for you? While the donut hole was initially created to encourage older adults to ask for generic drugs, for those with conditions that required name-brand medications, the donut hole was often a source of stress.

Under the Bipartisan Budget Act of 2018, you will still pay up to 75 percent of brand name expenses until you reach the catastrophic limit. When you reach the gap, the legislation requires drug companies to bear more of the cost. So, you will only pay 30 percent of the cost of brand name prescriptions. In 2018, drug manufacturers footed 50 percent of the cost of name brand drugs, but in 2019 they will cover 70 percent of the cost.

Caps for physical, speech and occupational therapies will be eliminated, which means you won't have to pay the full cost of these services if you are a beneficiary of original Medicare.

The Addition of Telehealth Services: Medicare will now pay telehealth services for certain conditions. Under the current proposal, Medicare will pay for you to check in with your doctor virtually—either by phone or video chat. It will also cover telehealth services utilized for end-stage renal disease and treatment of a stroke.

The Addition of Home Health/Long Term Care Support: With a medical provider’s recommendation, Medicare Advantage will have the option to pay for things like meals delivered to your home, transportation to medical appointments and safety features like the installation of grab bars. It will also pay for home health aides.

The New ID Cards will not include Your Social Security Number: Instead of your Social Security number, you new ID card will feature your Medicare beneficiary identifier. These cards will automatically be mailed to you if you have not changed addresses. If you need to update your address, visit your Social Security account to do so. Just like with your previous card, do not share your Medicare beneficiary identifier with anyone who is not providing Medicare services.

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