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New Medicare Advantage Benefits – Prevention Innovations

By July 4, 2019 No Comments

New Medicare Advantage Benefits—More Innovations to Prevent Hospital Visits

It is easy to get overwhelmed by your choices for Medicare coverage, and the expansion of possible benefits under Medicare Advantage plans have made decisions about coverage even more complicated.

Currently, consumers have two major Medicare coverage options:

  1. Original Medicare, which includes Part A (hospital insurance), Part B (medical insurance), and optional add-ons of Part D (Prescription Drug Coverage) and a Medigap Policy (supplemental insurance to cover out-of-pocket costs); or
  2. Medicare Advantage (Part C), which includes Part A, Part B and Part D, but has a yearly limit on your out-of-pocket costs and can offer other benefits that Original Medicare does not cover like vision, hearing and dental.  With a Medicare Advantage plan, however, you may need to use health care providers who participate in the plan’s network and not all of the additional benefits may be available to you.

Medicare Advantage plans have recently generated more attention because for the second year in a row the administrator of the Centers for Medicare and Medicaid Services (CMS) announced that these plans will be able to increase their benefits. Specifically, starting in 2020, Medicare Advantage plans can cover benefits that have a reasonable expectation of improving or maintaining the health or overall function of beneficiaries with chronic conditions.  In 2018, CMS announced it was for the first time adding non-medical in-home care as a supplemental benefit.  Some of these added benefits include expanded home meal deliveries, transportation and even some housecleaning. The goal is ultimately to give providers more opportunities to innovate and find ways to keep beneficiaries healthy and out of the hospital.

Added Transportation Benefits for Medicare Advantage

Transportation is one area where Medicare Advantage plans have expanded opportunities to provide benefits, and rideshare companies are taking notice of opportunities to service Medicare clients under these plans.  Lyft in particular is establishing partnerships with Medicare Advantage providers, and has been partnered with CareMore since 2016.  Lyft’s success with CareMore has led CareMore to book 90% of needed non-emergency transportation through Lyft.  Through its experience with CareMore, Lyft updated its platform to allow the partner insurer or provider to call a ride directly for the beneficiary, in case they do not have a smartphone or know how to use Lyft’s app themselves.

Given the opportunities to add additional benefits to these plans are so new, however, many policies have not incorporated them yet.  For example, according to AARP, just 3% of Medicare Advantage plans offered in-home support services such as personal care or housekeeping in 2019.

As Medicare Advantage providers begin to implement new benefits, it is important to evaluate your insurance options during each Medicare enrollment period.  Additionally, even with expanded benefits, it is still crucial to plan for long-term care.  Private long-term care insurance, private paying, and Medi-Cal will still be the primary sources for paying for long-term care, not Medicare.

Please contact the Law Offices of Lisa C. Bryant, INC. at (408) 286-2122 for a free consultation to discuss Medi-Cal qualification, and how it can pay for long-term skilled nursing care for you or your loved ones.

All materials have been prepared for general information purposes only to permit you to learn more about our firm, our services and the experience of our attorneys. The information presented is not legal advice, is not to be acted on as such, and may be subject to change without notice.

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