Health
January 20, 2021
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What families’ caregivers need to know about

By: Julie Ann Soukoulis
December 28, 2018

Medicare changes

As family and friends grow older, you may find yourself in the role of caregiver.

You could be asked to make decisions of all kinds such as assisting with daily activities, health issues, treatments or help with Medicare. When you understand the new changes in Medicare and the various enrollment periods, you’ll be better equipped to help guide your loved ones in making Medicare decisions to best meet their needs.  

Changes in Medicare for 2019  

Some of the changes happening next year will affect all Medicare beneficiaries, while others will apply to individuals on certain plans. This year the Centers for Medicare & Medicaid Services (CMS) updated their handbook, which beneficiaries receive in the fall.  

CMS also changed the online Medicare Plan Search tool to make it easier to use; this includes a “coverage wizard” that helps enrollees compare out-of-pocket costs and coverage options between Original Medicare and Medicare Advantage plans.  

Medicare Part A and B increases in 2019  

When you’re a caregiver it’s important that you understand Medicare changes to best help the ones you care about. The 2019 Medicare changes will take place Jan. 1 and will be in effect all year. Changes you need to know about include the increases in Part A and Part B, including premium and deductibles.  

Part A premium increases

Most beneficiaries won’t have to pay a Medicare Part A premium. If your loved one has fewer than 40 quarters of employment they may pay a monthly premium.   If they had at least 30 quarters or if they were married to someone with at least 30 quarters of coverage, then they may buy into Part A at a reduced monthly rate, which will be $240 in 2019.  For some people who have exhausted other entitlement, they will pay the full premium which increased to $437 a month for 2019.  

Part A deductible increases

The Part A deductible increased and will be $1,340 in 2019. Beneficiaries with traditional Medicare as their only coverage will be expected to pay this if they are admitted to the hospital.  

Beneficiaries must pay a co-insurance amount of $341 per day for the 61st through 90th day of hospitalization in 2019. For lifetime reserve days the amount went up to $682 per day.   

Medicare recipients in skilled nursing facilities can expect the daily co-insurance for days 21 through 100 of extended care services in a benefit period to be $170.50 in 2019.  

Part B increases

The new premium for Part B in 2019 will be $135.50 each month.   

The Part B deductible will increase from $183 to $185 in 2019. Beneficiaries with a Medigap Plan C or Plan F have coverage for this deductible.  

Medicare Advantage plan enrollees have low co-pays and deductibles that won’t necessarily increase with the Part B deductible.   

Help affording Medicare increases

Having additional coverage with Medicare will help cover the costs of many of these increases. Talking to a licensed insurance expert can make your life easier and help you gain confidence in your loved one’s health care coverage.  

The return of the Medicare open enrollment period  

The Medicare Open Enrollment Period (OEP) takes the place of the Medicare Advantage Disenrollment Period (MADP), which used to be Jan. 1 through Feb. 14 every year.   

The MADP only allowed beneficiaries to dis-enroll from their Medicare Advantage coverage and switch back to Original Medicare. They couldn’t switch from one MA plan to another MA plan.   

Now, Medicare Advantage beneficiaries can switch to another MA plan if they choose or switch back to Original Medicare.  

During OEP:  

Switch from one Medicare Advantage plan to another

They can only make one change during this enrollment period, so make the change count.

Dis-enroll from a Medicare Advantage plan and switch back to Original Medicare, with or without a Part D Prescription drug plan.

This new law will allow beneficiaries to make Medicare Advantage plan changes; however, it’s important to understand that you will not be able to switch stand-alone Part D Prescription Drug plans during the Medicare OEP. You can enroll in a Part D plan if you’re switching back to Original Medicare, but you cannot switch from one Part D to another.   

Beneficiaries enrolled in a stand-alone Part D plan will need to make changes during AEP (Oct. 15 through Dec. 7 of every year). You can compare AEP vs OEP more in detail here.  

Each year by Sept. 30, Medicare Advantage recipients will receive an Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) from their insurance carrier for their Medicare Advantage and Medicare Prescription drug plan providers.  

When this information is obtained, it’s important to look at the changes and adjust coverage as needed. CMS will post plan changes in Oct., months before the new year and changes go into effect. Medicare.gov is a reliable resource for caregivers. Use it to compare plans, look up information and learn more about Medicare.  

Author: Lindsay Engle is the Healthcare Expert at MedicareFAQ, a learning resource center for senior healthcare. Lindsay loves working in the senior healthcare industry.   

Julie Ann Soukoulis is the owner of Home Instead Senior care office in Rohnert Park, mother of two and passionate about healthy living at all ages. Having cared for her own two parents, she understands your struggles and aims, through her website, www.homeinstead.com/sonoma to educate and encourage seniors & caregivers. Have a caregiving or aging concern?  She’d love to hear from you at 586-1516 anytime.