If you have spent any amount of time watching TV in the late morning or early afternoon lately, you have likely seen many, many commercials asking you to call to see if you are getting the benefits you are entitled to being a Medicare beneficiary.
You may have seen some famous figures such as Joe Namath hawking these topics. If you have any history with Medicare Advantage Plans, you may notice the focus of the commercial has moved to these so-called “extra benefits” as compared to the “core benefits”. Why is that?
Let’s review why this has become such a hot topic over the past few years and what you really need to be on the lookout for. We’ll also review the strategy for evaluating these extra benefits annually. If you are looking for a Medicare Advantage Plan with Dental, Hearing, Vision, and additional coverage, we can help you with your needs.
As specialized independent Medicare agents local to you in North Carolina, Virginia, Maryland, Pennsylvania, and Delaware, we understand the details of the Medicare Advantage and Medicare Supplement Plans in your county.
Plans Differ by Counties, So Find the Best One for You
Original Medicare has always and continues to offer little to no Medicare Dental, Vision, or Hearing benefits. It has been a wonder to me how our healthcare system, Medicare or not, disconnects the holes in our head (mouth, eyes, and ears) from the rest of our body when it comes to insurance coverage. One nearly always has to buy additional insurance. Original Medicare is no different, with extremely limited coverage for these areas.
Keep in mind that Medicare Advantage Plans, also known as Part C, are administered by private carriers. If you are on a Medicare Advantage Plan in NC, VA, MD, PA, or DE, your plan is being run by companies such as UnitedHealthcare, BlueCross BlueShield, Anthem, Aetna, Humana, Cigna, among others. These carriers submit bids annually to participate in plans in your area and the bids are submitted at the county level.
For example, whether you are in Wake County in NC, Baltimore County in MD, Alexandria County in VA, York County in PA, or New Castle County in DE, your plan is likely different than the neighboring counties for Medicare Advantage Plans, even from the same carrier. Note that we at Elite Senior Insurance are independent Medicare agents near you and can look at all the plans within the county that you live in to try to help you make the best decision for your needs.
Also note here that we’re not discussing Medicare Part D coverage as part of this blog, however, information on Medicare Part D can be found elsewhere on our site.
A Brief History of Medicare Advantage
Reviewing the history of the Medicare Advantage Plan will help us understand how these extra benefits came into existence. Medicare Advantage began as an experimental program in the 1970s, and it became formalized in 1997 as part of the Balanced Budget Act and in 2003 it went into law.
In 2010, the bidding process was changed to more accurately align cost management within the Medicare Advantage Plans through private carriers and the cost of care through Original Medicare. As with anything else, the more experience one has the more accurate they can become projecting costs. In essence this is where the financial ability to pay for extra benefits comes from.
The Competitive Environment Drives Down Prices
Thus, it’s important to understand that for every beneficiary that is a participant in a Medicare Advantage Plan, regardless of location, Medicare pays a monthly stipend on that beneficiary’s behalf to the private insurance company that the beneficiary is enrolled with to pay for their care. Also, it’s important to be reminded that Medicare Advantage Plans are most often Medicare Advantage HMOs or Medicare Advantage PPOs, regardless of the part of the country you are in. By establishing HMOs or PPOs, the private carriers are able to manage costs.
It is in the private carriers’ best interests to find ways to pass along cost savings to the participants, because this is a competitive bidding environment for all of the major carriers in your county, whether it be Cumberland or Johnston County in North Carolina or Baltimore or Hartford County in Maryland. The carriers in those counties are competitively going after you as an enrollee. This competitive environment has caused Medicare HMOs and PPOs providers to constantly try and improve their plans to attract new or retain existing beneficiaries.
Noticeable Trends with MA Plans
Over the past few years, I’ve noticed some trends that had become predominant and accelerated in nature regarding Medicare Advantage Plans – both for HMOs and PPOs. First and foremost are monthly premiums. Just a few years ago it was relatively rare to see a monthly premium of $0 dollars. Now it is extremely common to see multiple plans in a single county contain more than one choice of a plan with zero monthly premium. As an example, a plan in Wake County, North Carolina, a few years ago carried a premium of $38.00 a month that same plan in 2020 and 2021 is $0.00 monthly.
Nationwide, based on the 2019 benchmark/bidding/rebate process, the Medicare Advantage average monthly plan premium in 2020 was estimated to decrease 14% to $23.00 from an average of $26.87 in 2019. Since 2017, the average monthly Medicare Advantage premium has decreased by an estimated 27.9%. This is the lowest that the average monthly premium for a Medicare Advantage Plan has been since 2007, right after the second year of the competitive bidding process.
Another reason that cost savings has been presented is the increasing popularity and use of the Medicare Advantage Plans, creating economies of scale to be exploited. In addition, the use of independent Medicare agents, like those at Elite Senior Insurance, to help in the selection process and to educate the beneficiary on Medicare so they can make the best choice.
Specifically, there are over 24 million projected Medicare Advantage participants in 2020. That represents 35 to 40% of all people in Medicare and the numbers are increasing as indicated by the fact that in 2015 over half of the people signing up for Medicare for the first time are choosing a Medicare Advantage Plan as opposed to staying on Original Medicare.
Growing Benefits Means Finding Better Plans for You
As previously mentioned, Original Medicare offers little to no coverage for Dental, Vision, or Hearing. As a result, the private carriers have an opportunity to attract you to them by providing for these things, and more!
In terms of Medicare dental coverage, I’ve seen it go from zero to the thousands of dollars in benefits. Also, I’ve seen it go from just covering basic dental services to comprehensive dental services as well. The coverage varies in both dollar amount and services by carrier, so it’s important to use an independent Medicare agent to help you find the best fit for you.
When it comes to hearing, many plans nowadays offer a hearing exam. Where the true value comes into play is when one is in the need for hearing aids. Hearing aids can cost in the thousands of dollars so if you are in the need of hearing aids having a plan that can reduce that cost dramatically can be very important. The private carriers have realized this need exists and have created benefits that are very attractive. Once again, the benefit levels vary by carrier, so it is important to use an independent Medicare agent near you be it in North Carolina, Virginia, Pennsylvania, Delaware, or Maryland.
In addition to hearing dental and vision, other areas have come into light as extra benefits in order to attract you to a specific carrier. These things include gym memberships at typically no cost to you, transportation assistance to get you to your doctor’s appointments, over the counter benefits, personal emergency response devices, often at no cost. Lastly some carriers even offer in home meals and in home help for someone who has recently been discharged from the hospital for a procedure or other events.
How Do I Know What the Best Benefits Are?
I’ll reiterate that the type and amount of benefit varies by carrier, and annually these can change. Thus, it would be important for you to review your plan every year to see where the coverage is getting better for an area that you may come into need for. As an example, let’s use hearing aids. Let’s say up until this point you have not needed to be concerned about hearing aids, but all of the sudden you have an onset of hearing loss and you find that you’re going to be in the market for hearing aids soon.
If that’s the case, it would be in your best interest to find the carrier that, for one, has the best financial benefits but also, number two, how do they go about reimbursing for that benefit? Is it an easy process or is it a more cumbersome one? Knowing the process and steps involved is another illustration of where a knowledgeable, independent Medicare near you can help.
Elite Senior Insurance Can Help You
In summary, the types of “extra benefits” and the amount of them changes every year. It is a comfort to know that independent Medicare agents near you exist at Elite Senior Insurance.
Our agents study every plan, every year, for these extra benefits, and can align your needs with them. Elite Senior Insurance agents serve all the counties in the mid-Atlantic states of Maryland, Delaware, Pennsylvania, Virginia, and North Carolina. Our independent Medicare agents are extremely knowledgeable of the Medicare Advantage plans near you and can help you find a Medicare Advantage Plan that works best for you.
Please visit our website at www.eliteseniorinsurance.com for contact information or the agent near you.