Changes to Medicare Heading into 2020

By Psquared - January 23, 2020

Been hearing a lot lately about major changes to Medicare? Yeh, us too. The federal government program has been around for the last 55 years, providing health care insurance to more than 55 million people. But changes are on the horizon for 2020 so don’t be left out of the loop! Here’s what you need to know about Medicare eligibility, important dates, and specific plan guidelines:

Did you know some people automatically get basic Medicare? On the first day of the month you turn 65 years old, basic Medicare coverage kicks in if you’re already getting Social Security benefits or benefits from the Railroad Retirement Board (RRB). If you’re not yet 65 but have a disability (after receiving Social Security disability benefits for 24 months), or if you’re suffering from Lou Gehrig’s disease (ALS), you also automatically benefit.

Contact Social Security to enroll 3 months before your 65th birthday, if you’re not receiving Social Security or RRB benefits. Keep in mind that individuals do not need to sign up for Medicare each new year. Reviewing your health and prescription drug coverage is a good idea, though, especially as we head into 2020. Open enrollment closed on December 7, 2019 (it takes place each Fall). There is, however, still time to take advantage of the Medicare Advantage Open Enrollment period that closes on March 31, 2020, granted you have a Medicare Advantage plan.

Medicare is made up of four (4) distinct sections –Part A, Part B, Part C, and Part D – and it’s important to understand the difference between each!

Medicare Part A is considered hospital insurance and covers hospice care, inpatient hospital charges, home health care, and skilled nursing facility care.

Part B insures for outpatient services and most prescription medication administered by medical staff. Patients already using or in need of durable medical equipment, such as a cane, walker, wheelchair, prosthetics, or oxygen, will want to examine the benefits of this plan more closely. Shots, vaccines, and many other preventive services are covered. To understand the complex ins and outs of Part B, information can be accessed via the Federal Register or the Social Security Act. If you’re looking for an internet resource, the Centers for Medicare and Medicaid Services (CMS) offers an Internet-Only Manual (IOM). Information found on our website will point you in the right direction!

Medicare Advantage plans fall under Part C, which typically cost a monthly premium along with the Part B premium. This helps cover needs that aren’t taken care of by the traditional Part A plan alone. Examples may include dental care, yearly physical exams, health coverage while traveling outside of the United States, hearing and vision benefits, and more. Part C plans are forecasted to see a drop in prices in 2020.

Finally, Part D, which became available in 2006, is available to anyone with Part A and/or Part B. This insurance covers mostly self-administered prescription drugs. Part D is regulated by the Centers for Medicare and Medicaid Services (CMS) but coverage is not standardized nor is it administered by the federal program. Many providers are forecasting an increase in prescription drug coverage in 2020 alongside a change in which medications are actually even eligible.

An important option for many to keep in mind is the Extra Help Program which offers coverage to lower-income seniors. To answer your questions, more resources can be found through this webpage.

Your State Health Insurance Assistance Program (SHIP) can offer personalized assistance for free as you weigh your choices for medical insurance, keeping in mind your specific needs.