Medicare Advantage Plans Will Shift Focus to Prevention
Are you a Medicare Advantage Plan beneficiary? There are some changes around the corner that may improve your care options.
Prevention makes sense
Max is 79 years old and lives by himself. He has diabetes that he controls fairly well with medications. However, he’s experiencing increased numbness in his feet. One morning, as he steps out of the bathtub, he slips.
As he falls, he hits his head on the side of the tub.
An hour later, Max wakes up on the wet floor, the shower curtain twisted around his body. He tries to move, but searing pain flashes from his right hip. His granddaughter, Amy, eventually finds him and calls an ambulance.
Max has broken his hip and requires surgery. The procedure goes well, and Max makes a full recovery. In the meantime, the surgery cost — billed to Medicare — exceeds $20,000.
The installation of a bathroom safety rail may have prevented Max’s fall. Compared to the expense of a surgery, it would’ve cost Medicare around $200.
Changes in the pipeline for Medicare Advantage Plans …
To reduce these expenses, while improving seniors’ quality of life, a new law will soon create changes to the Medicare system — it will focus on helping people with chronic illnesses.
In particular, under Medicare Advantage plans, patients with chronic illnesses, such as diabetes and rheumatoid arthritis, will have better access to home modifications such as grab bars and wheelchair ramps.
Other preventive measures will include telehealth services. The electronic communication services will connect healthcare providers with patients in need of ongoing care (for example, post-stroke and dialysis patients).
Helping seniors get ahead
Ultimately, preventive and “non-medical” services, which may also include expanded care with meals-on-wheels or transportation to medical appointments, will provide greater opportunities for Medicare Advantage beneficiaries to receive care before their condition gets worse.
Of course, the changes won’t happen in time for this year’s Annual Enrollment Period (AEP), starting in October. But you should see new Medicare Advantage benefit options for 2020.
Do you have questions about the upcoming AEP — or possible changes to the Medicare Advantage plan? We can help!
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