The open enrollment period for 2019 Medicare coverage recently began on October 15, and will extend until December 7. This means it’s once again time for current beneficiaries and eligible Americans to start thinking about which Medicare plans are most advantageous for their health needs and budget parameters.
Making this decision is based on a variety of factors such as the kind of benefits available, the physicians in-network, the deductible amount, and the cost of both premiums and out-of-pocket expenses. Once you determine what plans offer the coverage you are looking for at a rate you can afford, this can help inform your choice of whether to stick with Original Medicare (Parts A and B), or to select Medicare Advantage (Part C), Prescription Drug Coverage (Part D) and other Supplement plans in addition.
If you are among the more than 56 million Americans who depend on Medicare for health insurance, consider the average price breakdown from these survey results enumerated below when shopping around for your 2019 benefits.
Medicare Costs At-a-Glance Based on Current Beneficiary Responses
Recently, a segment of the senior population enrolled in Medicare coverage was polled in regard to the expenditures accrued from their current plans. They were surveyed on three main areas of cost related criteria—monthly premiums and out-of-pocket costs, deferral or avoidance of treatments, and usage of supplementary benefits.
To address this issue of monthly expense, the survey found that 33% of respondents are charged less than $100 each month in premiums, and 57% are charged between $100 and $199. Conversely, just 10% of respondents are charged $200 or more in premiums. Next, factoring in the out-of-pocket expenses, around three quarters of these polled beneficiaries indicated they owe less than $100 out-of-pocket each month, while 22% stated they owe upwards of $100.
When asked if they delay or decline certain medical procedures due to cost despite having a Medicare plan, 19% of respondents answered “yes.” Others chose to offset these more expensive treatments by adding a Medicare Advantage or Supplement plan to their existing policies. In fact, 45% indicated they are enrolled in an Advantage plan, while 26% are enrolled in a Supplement plan, and another 43%, who are currently without a Supplement plan, have considered adding this coverage.
Other Factors to Keep in Mind when Reviewing Medicare Plans
Calculating and comparing the estimated prices can help steer your decision, but there are other elements worth researching too. As you examine the different coverage options during the course of open enrollment, familiarize yourself with the various Medicare changes and updates taking place in 2019.
One of the major amendments going into effect this new year is the freedom for Medicare Advantage enrollees to switch from one Medicare Advantage plan to another, or revert to Original Medicare with standalone prescription drug coverage, between January 1 and March 31. This time-frame gives you three months to determine if a certain plan works for you and then to adjust the coverage if needed. However, within this grace period, just one change is permitted.
The other modification relates to Part D coverage—as of 2019, beneficiaries with high-cost prescriptions will not be subjected to the “donut hole” issue anymore. This means the gap between your Part D’s coverage limit and the maximum out-of-pocket cost will be reduced, so the amount you are required to cover will decrease to 25% of the total price for brand-name medications and 37% for generic medications.
The average monthly premium for Part D coverage is also expected to lower from $33.59 down to $32.50 once the new year begins. If you are high on the income bracket though (at least $500,000 for individuals and $750,000 for couples), prepare to be charged increased rates for both Part D and Part B premiums in 2019. In fact, these added surcharges will result in paying 85% of the total coverage.
Finally, the Center for Medicare and Medicaid Services (CMS) has projected that Medicare Advantage premiums will reach their most affordable cost in three years, with a 6% decrease to $28.00 or lower each month. The number of Advantage policies offered will expand also, giving about 91% of beneficiaries over 10 plans to choose from. This upsurge in variety and downturn in cost is forecasted to boost Medicare Advantage enrollment to an impressive 22.6 million Americans, the highest concentration to date.
As you navigate the different Medicare policies and programs available for this upcoming year, the information provided is intended to ease your mind and streamline your choice. For an additional resource, this Guide to Medicare can help you understand the different nuances and facets of coverage more in-depth, so you can enter 2019 feeling empowered and secure in your healthcare decision.