7 Ways Medicare Will Improve in 2019

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dm200
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7 Ways Medicare Will Improve in 2019

Post by dm200 » Mon Sep 24, 2018 12:36 pm

I am waiting to see if any of these things affect DW and/or me!

https://www.aarp.org/health/medicare-in ... -2019.html

Dan999
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Re: 7 Ways Medicare Will Improve in 2019

Post by Dan999 » Mon Sep 24, 2018 12:50 pm

Great post.
With 2 knee replacements we came close to reaching the cap for rehab, but went into the next year, so we got it covered.
The no cap rule is great. Knee rehab therapy is not something a patient voluntarily will overspend. The want to be done ASAP.

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dm200
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Re: 7 Ways Medicare Will Improve in 2019

Post by dm200 » Mon Sep 24, 2018 12:55 pm

Dan999 wrote:
Mon Sep 24, 2018 12:50 pm
Great post.
With 2 knee replacements we came close to reaching the cap for rehab, but went into the next year, so we got it covered.
The no cap rule is great. Knee rehab therapy is not something a patient voluntarily will overspend. The want to be done ASAP.
I am sure more details will come out soon, as well.

carruthers209
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Re: 7 Ways Medicare Will Improve in 2019

Post by carruthers209 » Mon Sep 24, 2018 12:56 pm

Thanks for the hyperlink to the AARP article. I think the two huge pieces that the Medicare community will be following are the "Lifestyle Support" and "In home help." I read elsewhere that this is going to be a trial program with a small population first. Quite frankly, I don't know how on earth these proposals would be affordable to Medicare which is already teetering on insolvency in a decade or two. We have Medicare Advantage at Kaiser's in northern California and I will definitely be following the implementation of this program because it will impact almost every chronically disabled person in certain categories. My guess the goal is to support and keep disabled persons in their home instead of the pricier nursing facilities which Medicaid/Medicare can pay for (with financial stipulations).

Lifestyle support
Beginning in January, Medicare Advantage plans have the option to cover meals delivered to the home, transportation to the doctor’s office and even safety features in the home such as bathroom grab bars and wheelchair ramps. To be covered, a medical provider will have to recommend benefits such as home-safety improvements and prepared meals.

In-home help
Medicare Advantage plans also will have the option to pay for assistance from home health aides, who can help beneficiaries with their daily activities including dressing, eating and personal care. These benefits represent a revised and broader definition of the traditional requirement that Medicare services must be primarily health related.

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dm200
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Re: 7 Ways Medicare Will Improve in 2019

Post by dm200 » Mon Sep 24, 2018 12:59 pm

The 2019 changes might affect when or if you have certain things done (or not done).

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dm200
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Re: 7 Ways Medicare Will Improve in 2019

Post by dm200 » Mon Sep 24, 2018 1:19 pm

I think this feature could be helpful to some folks who may be "on the fence" about whether Original Medicare (with supplement) or an Advantage plan (or which MA plan):

Plan test drives
New regulations will let people try an Advantage plan for up to three months and, if they aren’t satisfied, they can switch to another Medicare Advantage plan or choose to enroll in original Medicare. Congress required this flexibility in the 21st Century Cures Act, designed to accelerate innovation in health care.


So, for example, if someone (in this area) is on a Humana MA plan, they could "try" the Kaiser MA plan for up to 3 months to see how they like (or do not like) Kaiser.

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munemaker
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Re: 7 Ways Medicare Will Improve in 2019

Post by munemaker » Mon Sep 24, 2018 2:30 pm

dm200 wrote:
Mon Sep 24, 2018 1:19 pm
I think this feature could be helpful to some folks who may be "on the fence" about whether Original Medicare (with supplement) or an Advantage plan (or which MA plan):

Plan test drives
New regulations will let people try an Advantage plan for up to three months and, if they aren’t satisfied, they can switch to another Medicare Advantage plan or choose to enroll in original Medicare. Congress required this flexibility in the 21st Century Cures Act, designed to accelerate innovation in health care.


So, for example, if someone (in this area) is on a Humana MA plan, they could "try" the Kaiser MA plan for up to 3 months to see how they like (or do not like) Kaiser.
It is a nice concept, but really, do you really have enough experience after 3 months to make a good decision?

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dm200
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Re: 7 Ways Medicare Will Improve in 2019

Post by dm200 » Mon Sep 24, 2018 2:38 pm

munemaker wrote:
Mon Sep 24, 2018 2:30 pm
dm200 wrote:
Mon Sep 24, 2018 1:19 pm
I think this feature could be helpful to some folks who may be "on the fence" about whether Original Medicare (with supplement) or an Advantage plan (or which MA plan):
Plan test drives
New regulations will let people try an Advantage plan for up to three months and, if they aren’t satisfied, they can switch to another Medicare Advantage plan or choose to enroll in original Medicare. Congress required this flexibility in the 21st Century Cures Act, designed to accelerate innovation in health care.

So, for example, if someone (in this area) is on a Humana MA plan, they could "try" the Kaiser MA plan for up to 3 months to see how they like (or do not like) Kaiser.
It is a nice concept, but really, do you really have enough experience after 3 months to make a good decision?
Maybe you would and maybe not. You should and would do a lot of research and narrow down your concerns that might only satisfy you with such a trial. One common example/situation is whether you would be satisfied with new Physicians/Specialists. In three months, you could probably reach some conclusions.

When I switched, for example, I had to get a new PCP - as well as three or four specialists I saw regularly then. Within three months, I had seen (in person) all of these Physicians and concluded that they were all as good/satisfactory as the previous ones or better.

You are correct, though, there are aspects to MA plans that would take (much) longer to reach conclusions.

Broken Man 1999
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Re: 7 Ways Medicare Will Improve in 2019

Post by Broken Man 1999 » Mon Sep 24, 2018 3:43 pm

I am watching this one very carefully:

In-home help

Medicare Advantage plans also will have the option to pay for assistance from home health aides, who can help beneficiaries with their daily activities including dressing, eating and personal care. These benefits represent a revised and broader definition of the traditional requirement that Medicare services must be primarily health related.


If my Medicare Advantage plan offers such payments I could possibly save $12,000 - $14,000 per year. I could buy more expensive cigars and bourbon!

I kinda see my home health aide's cost as a mortgage-like expense that will end only with my death.

Nice if the amount is fully covered, or even partially covered. Either way it will be paid.

I have lost TWO long-term aides this year, both in their early 70ties. One had to leave as her knee replacement was infected, an anti-biotic didn't clear it up, so her knee replacement has to be replaced. The other aide hurt herself (not at my home) helping a client and now can just do light stuff, like companionship, meal prep and such.

Broken Man 1999
“If I cannot drink Bourbon and smoke cigars in Heaven than I shall not go. " -Mark Twain

jebmke
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Re: 7 Ways Medicare Will Improve in 2019

Post by jebmke » Mon Sep 24, 2018 4:02 pm

munemaker wrote:
Mon Sep 24, 2018 2:30 pm
It is a nice concept, but really, do you really have enough experience after 3 months to make a good decision?
No; If I see a doctor one time in a year, that is a big year for me.
When you discover that you are riding a dead horse, the best strategy is to dismount.

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dm200
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Re: 7 Ways Medicare Will Improve in 2019

Post by dm200 » Mon Sep 24, 2018 4:04 pm

jebmke wrote:
Mon Sep 24, 2018 4:02 pm
munemaker wrote:
Mon Sep 24, 2018 2:30 pm
It is a nice concept, but really, do you really have enough experience after 3 months to make a good decision?
No; If I see a doctor one time in a year, that is a big year for me.
Good for you!! Hope you keep it up.

Of course, I suppose if you only need to see a doctor once a year - maybe the "choice" of a particular doctor is not that important.

That was (and is) my "goal" as well, but have not reached it in the last 2-3 years. Trying again this year for my PCP - 4 months down - 8 months to go :sharebeer

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