What changes do the original Medicare and Medicare Advantage health insurance plans have in store for their beneficiaries this year? And what do these entail for the Medical Practices in Wisconsin?
Medicare plans are set to undergo several reforms to improve their coverage and range of services. Some will involve all the healthcare program’s recipients while some are directed towards individuals who have MA (Medicare Advantage) plans.
Medicare and Medicare Advantage: What’s the Difference?
When you enroll for Medicare, you have to choose between getting an original plan or a Medicare Advantage one. MA is an extensive private plan that doesn’t just give regular Medicare coverage but has several attractive add-ons like dental, vision, hearing, and prescription coverage. Its drawback is you have to get these services from in-network providers. Not doing so would mean paying more or going through without coverage.
Below are some of the Medicare and Medicare Advantage changes set for this year.
- Uncapped Medicare Therapy
Applicable to: Original Medicare plan holders
The limit on how much Medicare can cover for outpatient speech, occupational, and physical therapy services in a given calendar year has been lifted.
- “Donut Hole” Closure
Applicable to: Medicare Part D Drug Plan
The “donut hole” is the coverage gap present in the Medicare Part D Drug Plan for both branded and generic medications. The gap’s closure means beneficiaries will be paying less to get their prescriptions – from 35% of the branded drug’s price and 44% for generic meds down to 25%.
- Home Health Care Expansion
Applicable to: Medicare Advantage plan holders
MA is set to widen its supplemental benefits coverage to include services that are not directly considered as medical treatments like home health care if they’re recommended by the patient’s doctor.
What’s in It for You?
The reforms set to happen to Medicare this year could mean great changes in your practice, too. Our team of experts at Acuity Revenue Consulting, a reputable provider of exceptional Medical consulting in Mequon, Wisconsin, can help you navigate these unknown waters. Why don’t you call us today?