Medicare Advantage customers are about to be blitzed with an array of new insurance benefits that stray well beyond the usual coverage of doctor visits and other care.
Carpet shampooing, food for a service dog, pest control and rides to a nutritionist are among the new supplemental health benefits that privately run versions of the government’s Medicare program may start offering next year.
Medicare Advantage plans already come with extras like dental benefits or gym memberships that regular Medicare doesn’t provide. But Medicare Advantage can restrict access to a network of doctors or hospitals. Regular Medicare also doesn’t do that.
About a third of the people on Medicare opt for Medicare Advantage plans, according to the nonprofit Kaiser Family Foundation.
Advantage plans are broadening their coverage reach as part of a push by insurers and the government to keep people healthy instead of waiting to cover their claims once they become sick. The idea behind this thinking is that someone who improves their diet or keeps a chronic condition like asthma under control is less likely to generate a big medical bill.
The annual enrollment period for Medicare and Medicare Advantage starts next month.
WHAT’S DIFFERENT THIS YEAR: The federal government is giving Medicare Advantage plans more leeway to pay for things they’d ordinarily never cover. The new supplemental benefits will aim to help people with chronic diseases or certain health issues stay healthy when they aren’t seeing a doctor or receiving care.
“It is moving the needle from just treating illness to preventing illness and allowing people to stay in their home longer,” said Chris Hakim, a senior vice president with the online insurance broker eHealth.
The carpet shampooing, for instance, might be covered by some plans to help their customers with asthma avoid a flare-up that lands them in an emergency room. Might is a key word here.
These new benefits will be available only through Medicare Advantage plans, not regular Medicare, and insurers are not required to offer them. Whether they do can depend on what they think their customers need to stay healthy.
Aside from these supplemental offerings, many plans also will provide telemedicine benefits to help patients connect remotely with doctors and other care providers.
EVALUATING NEW BENEFITS: The last thing some Medicare Advantage customers want is another batch of variables to think about when considering coverage.
They already have to worry about whether their drug coverage will change from year to year or if their doctors will stay in their insurer’s network. And some markets may have dozens of Medicare Advantage plans for shoppers to sort through.
Medicare Advantage customers have told researchers that they generally dislike making coverage changes after they’ve looked at all their options and picked a plan when they first qualify for Medicare, said Tricia Neuman, a senior vice president with Kaiser.
“What they say is it’s just too hard, it’s too much work, and they have little confidence they will be able to identify a better plan,” she said.
Even so, people with conditions like diabetes or asthma may want to see if there’s another plan that is better for their illness, Hakim said.
ENROLLMENT WINDOWS: Insurers started marketing their Medicare Advantage plans Oct. 1. That gave their customers a couple of weeks to learn about any coverage changes or added benefits before the Oct. 15 start of the annual open enrollment period.
Shoppers will have until Dec. 7 to enroll, switch to another Medicare Advantage plan or opt for regular Medicare and add prescription drug coverage for 2020.
After that, Medicare Advantage customers who regret their decision can make one change in the first three months of 2020. That second window applies only to those who already have a Medicare Advantage plan.