new medicare advantage

New Medicare Advantage possibilities for 2019

Recently the Center for Medicare and Medicaid Services (CMS) release new guidelines. They involve expanding new Medicare Advantage Reno benefits. This could be good news for seniors. They’ve been seeing more limited benefits on Medicare plans.

Medicare Advantage plans have traditionally been very restrictive. Medicare Nevada Advantage plans replace original Medicare (parts A and B). CMS requires at least the same level of benefit as original Medicare.

Some pros and cons of Medicare Advantage:

Pros: They limit the annual expense (called a max out of pocket) when visiting in-network doctors. Some offer dental, vision and hearing benefits. They can change every year between Oct 15th and Dec 7th without health questions. Some plans have no monthly premium.

Cons: The limit your choice of doctors. The premium is usually lower than a Medicare Supplement Reno plan and therefore the coverage is less.

The new guidelines by CMS open the door for insurance companies to offer better options:

“CMS has previously not allowed an item or service to be eligible as a supplemental benefit if the primary purpose included daily maintenance. Under the new policy announced today, CMS would allow supplemental benefits if they compensate for physical impairments, diminish the impact of injuries or health conditions, and/or reduce avoidable emergency room utilization.”

Options in Nevada

Here in Nevada, we’re seeing almost all new Medicare Nevada plans offered by companies who are directly affiliated with local hospital groups. The two most prominent are Senior Care Plus (affiliated with Renown) and Prominence (affiliated with St. Mary’s / Northern Nevada Medical Center). In Nevada, the only available option to enrollees under 65 on Medicare due to a disability is a Medicare plan. One of our most popular plans is the Prominence Medicare Advantage plan. Unlike other states, Medicare Supplement plans are not available to these individuals. It seems like many people who have health conditions or don’t otherwise qualify for a Medicare Supplement. Therefore they need to choose between original Medicare and a Medicare Advantage plan.

It seems like the broadening of the rules announced by CMS opens the door for insurance companies to offer more benefits to new Medicare Advantage plans. But to be clear, just because companies can offer these additional benefits doesn’t mean they will. When the insurance companies release their plan designs for 2019 we will have a better idea of what to expect.

Find out how a health insurance broker can help you.