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Medicare Advantage plans may offer more

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By Tom Murphy
Posted on November 06, 2019

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 offer starting next year.

Medicare Advantage plans already come with extras like dental benefits or gym memberships that regular Medicare doesn’t provide. But unlike regular Medicare, Medicare Advantage can also restrict access to a network of doctors or hospitals.

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.

This year’s annual enrollment period for Medicare and Medicare Advantage runs through Dec. 7.

What’s different this year

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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 only be available 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.

How to choose?

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.

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.

—AP

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