Still-growing demand among seniors for Medicare Advantage plans has spurred a slew of new health coverage options featuring lower costs and better perks as insurers compete to grow their market shares.

“This is a ripe market, and we’re able to take those dollars and invest them in some really smart ways to keep these plans affordable,” said Ellen Galardy, senior vice president of consumer markets.

Among expanded offerings folded into the dozens of 2022 plan details made public Friday: $50 to $75 quarterly allowances for personal care items ranging from toothbrushes to electronic scales; discounted sleep apnea and home health devices; expanded vision and dental benefits as high as $6,000 a year; discounts for diabetes-related care and testing; and newly covered services such as hospice care, therapeutic massage and acupuncture.

Medicare Advantage plans are privately offered alternatives to traditional Medicare and supplemental government-provided plans. They’ve long been popular among those who are 65 or older or have disabilities, and membership continues to grow.

Many Medicare Advantage plans up for grabs retain previously popular perks such as free Silvers Sneakers gym classes, telehealth appointments, transportation to doctor appointments, and post-hospital stay meal services.

A majority of plans appear to be offering reduced premiums and copays along with extra perks and benefits, though shoppers should be sure to consult with advocates, brokers or insurance company representatives to determine the best plan for their specific needs.

Open enrollment runs Oct. 15 through Dec. 7 for all Medicare-related coverage that begins on Jan. 1.

Seniors who select a Medicare Advantage plan, as opposed to traditional Medicare and supplemental Medigap plans, will have a chance to switch to a different Medicare Advantage plan between Jan. 1 and March.

Nationwide, participation in Medicare Advantage plans has climbed from 32% five years ago up to 42% in 2021, according to a report last March by The Chartis Group research firm. Meanwhile, traditional Medicare plans declined by 2.6%.

In terms of people: About 950,000 fewer individuals enrolled in original Medicare plans and 2.25 million more enrolled in Medicare Advantage alternatives.

“Medicare Advantage has always been very popular, but it’s improved more and more and more,” said Bob O’Connor, vice president and chief Medicare officer for Aetna’s Keystone Market. “Even people that would have traditionally been under traditional Medicare or Medicare supplement plans are really taking another look, because the benefit packages have really become very comprehensive. We even added chiropractic care and acupuncture to some of our plans. We offer $0 plans in every county in the state.”

All Medicare Advantage plans come with more services and perks than included in original Medicare, and like Medicare may not burden consumers with more than 20% of most outpatient services.

“By law, the Medicare Advantage plan has to include everything that the basic Medciare plan includes,” Galardy said. “The government plan is the minimum that we start from. So with a $0 premium, it’s hard for me to imagine someone that wouldn’t find more value in a Medicare Advantage plan.”

Still, the scope of benefits, amounts of copays and access restrictions across Medicare Advantage plans vary widely.

“Copays are certainly different. You may see maybe $10 more to see a specialist or go to the hospital, but these are still very affordable copay plans,” Galardy said. “They’ve all got a lot of zeroes in them — $0 to go see your PCP. $0 for Tier 1 drugs. $0 for a lot of tests done at the doctor’s office, so things like lab work.”

“The word ‘complete’ refers to the fact that it’s got robust coverage — think about all the typical medical benefits, plus things like over-the-counter drug, vision, comprehensive dental.

"There are two types we predict are going to be fastest-selling giving what the consumers what they said they wanted more of — more choices, lower premiums but still access to all of the doctors that they can trust.”

Consumers also should beware that most major insurance providers offer plans that could restrict access to certain medical providers.

Medigap plans could be a good option for people who travel frequently and have high-cost needs. The option, which is available for purchase directly from the government or private insurers, comes with a higher monthly premium but also hard caps on annual costs and almost “complete flexibility,” Galardy said. Under Medigap as well as original Medicare coverage, no doctor who accepts any Medicare plans can turn a patient away.

“So if you’re someone that has grandchildren who live in one place and you live in another, or you don’t want to have to think about provider networks because you’re constantly on the go,” said Galardy, “we know some people who Medigap plans work well for them.”

 

Author: Natasha Lindstrom
Source: © 2021 Trib Total Media
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