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January 9, 2019

NEW YEAR NEW MEDICARE ADVANTAGE PLANS AND BENEFITS

Medicare Advantage 2019 Enrollment Continues to Increase

According to the Kaiser Family Foundation, more than 20 million Medicare beneficiaries (34%) are enrolled in Medicare Advantage plans nationally. Additionally, more Medicare Advantage plans are available in 2019 than any year since 2009.


Within the increase of 417 plans since 2018, much of the growth in plans will occur in Florida. KFF explains 75 more plans are being offered in Florida for 2019. Currently, there are 391 plans being offered in Florida by 8 insurers. Additionally, the increase in number of Special Needs Plans(SNPs) nationally is up from 630 plans in 2018 to 717 plans in 2019.

The growth in plans in Florida correlates with the larger than national average for Medicare Advantage at 42% as of December 2018. The below grid shows the penetration rate per county in Florida.



The average Medicare beneficiary nationally can choose between plans offered by 7 insurers(firms) in their county. This number increases greatly to 13 insurers (firms) with plans being offered in Miami-Dade county.
There are 14 new health plans offering Medicare Advantage nationally in 2019 with 4 of those being offered in Florida. Three of these four Medicare Advantage plans are fully contracted for FAHA H&S members with one remaining in the final stages of negotiation. Credentialing applications have been sent to those applicable FAHA H&S members based on the geographical counties the plans are operating.

In addition to the increase in plans, increases in supplemental benefits being offered in the new year are touted while premiums for these plans are decreasing by an average of 6% according to CMS. The national average for Medicare Advantage premiums will be at $28.00 down from an average of $29.81 in 2018. Approximately 46% of Medicare Advantage enrollees will have a zero premium.

New flexibilities on supplemental benefits are now available for the first time in 2019. Some of these new supplemental benefits include: adult day care services, in-home support services, caregiver support services, home-based palliative care and therapeutic massage.

For the first time since 2010, there is a second open enrollment period from January 1 – March 31, 2019. This time-period is for those Medicare Advantage enrollees who choose to switch from the health plan they chose during the annual election period of October 15 - December 7, 2018. Enrollees can make only one election during this time to a different Medicare Advantage plan or back to original Medicare.


If you have questions, please contact Dana McHugh via email or by calling her at (850) 339-2909.

 

 


RIPPED FROM THE HEADLINES

Medicare Cuts Payments to Nursing Bundled Payments Save Money “Nearly Exclusively” By Cutting Skilled - A key mandatory bundled payment program saved the government money almost entirely through the reduction of skilled nursing facility reimbursements, a new study from researchers at Harvard University concluded. Read more...

Humana CEO: Home-Based Care, Social Determinants of Health “Most Impactful” to Health Care System - Advances in home-based care capabilities and being able to properly address social determinants of health for older adults and chronically ill populations are among “the most impactful” influences on the U.S. health care system, according to Bruce Broussard, CEO and president of Humana. Read more...

Health plan updates

Availity Gateway Processing Experience Changes Effective January 19, 2019.  Availity Gateway will be implemented to help process your claims sooner by decreasing claims holds and allowing for a more seamless processing experience for you. Read more...


Changes in Prior Authorization for Medicare Part B Medications. Effective January 1, 2019, some Medicare Part B medications will be subject to step therapy guidelines. The purpose of the step therapy guidelines is to ensure that lower cost medications have been tried before moving on to more expensive drug regimens. Read more...

Copyright 2019 — Publication of FAHA H&S
Chair: Brian Robare
President/CEO: Steve Bahmer
Principal/Editor: Dana McHugh

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