Starting today and continuing over the next seven weeks, more than 4.5 million seniors in Florida will have the chance to review their coverage for 2020. And if trend lines continue, large numbers will be opting for a Medicare Advantage plan.
Medicare Advantage, an alternative to Original Medicare that offers benefits through health insurance companies, has made huge gains in recent years.
Since 2010, enrollment in Medicare Advantage has the greater momentum of the two programs, growing about nine times faster. More than 44 percent of Florida Medicare beneficiaries are now enrolled in Advantage plans, according to Florida Blue, the state’s largest private insurer.
The recent addition of some new features should only add to the program’s popularity.
Last year, the Centers for Medicare & Medicaid Services, known as CMS, approved a wide range of extras for people insured through Medicare Advantage. They include more “wellness” perks — benefits like rides to medical appointments or even the grocery store, and in-home visits to ward off isolation and loneliness for recovering patients.
Some of those expanded services were slow to catch on with seniors last year, said Deb Galloway, president of Medicare in Florida for the insurance provider, Humana. She said she expects to see more interest and growth this year.
“We saw an initial bump in 2019 and then it waned off. It’s going to take some time to catch on,” Galloway said. “People were hesitant with some of these extra programs, like our Meals on Wheels pilot or telehealth services. We didn’t see a lot of utilization.”
But CMS made more tweaks to those services for this year’s enrollment period, she said, which will streamline many of them for more enrollees.
“The more it becomes part of the normal process, the more people will catch on," she said. "Seniors are becoming more savvy.”
Medicare Advantage has seen a big push in recent months from CMS, and from President Donald Trump on the campaign trail. During his recent rally at The Villages retirement community in Central Florida, Trump touted his support for Medicare Advantage, describing it as the best health care offering available for seniors.
He also signed an executive order directing the Department of Health and Human Services to further expand plans and payment options, and to make it easier to enroll. The Centers for Medicare & Medicaid Services is launching a new Plan Finder tool on its website, marking the first time the site has been overhauled in nearly a decade.
Alex Azar, the Health & Human Services Secretary, drilled home the positive message in a September announcement of 2020 Medicare rates, citing “lower costs, more options, and benefits tailored to patients’ needs.”
But it’s not just the Trump administration betting on Medicare Advantage.
Across the nation, enrollment in Advantage plans is projected to rise by 6.2 percent to 24 million Medicare beneficiaries for 2020, according to CMS. There are 474 such plans offered in Florida this year.
Florida Blue is expanding its Advantage offerings, adding plans in 10 more counties, said Kathy Fenny, president of Medicare services for the company.
“Last year, it was a wait-and-see game,” Fenny said, referring to Advantage plans. “Now we expect to see more interest, since so many more programs are rolling out.”
Medicare Advantage plans are subsidized by taxpayers. They’re attractive because the plans are usually less expensive than Original Medicare, or what’s considered Part A and Part B of the health insurance program. Most Advantage plans offer a greater range of services, including drug coverage.
Also new this year are lower projected rates for Part D, Medicare’s prescription drug program. People can buy Part D plans from private insurance companies for a projected $30 on average for 2020, which is down from $32.50 in 2019.
Medicare’s longstanding coverage gap for prescription drugs, known as the “donut hole,” is changing too. Under new rules, consumers who reach the gap by spending a certain amount on prescriptions will have to pay only 25 percent of the cost, whether the drugs are brand name or generic. The percent they pay has been dropping since 2011, when the government began to phase in reductions for those in the gap.
In 2020, consumers will enter the coverage gap when the total cost of their drugs for the year reaches $4,020. They come out of the gap, and into a better level of coverage, when the cost hits $6,350.
Medicare Open Enrollment: Oct. 15 to Dec. 7
Call 1-800-633-4227 to reach a government worker for Medicare enrollment assistance.
Florida SHINE is a free program offered by the Florida Department of Elder Affairs and the local Area Agency on Aging. It’s made up of volunteers who can navigate Medicare’s website. Call 1-800-963-5337 or visit floridashine.org.