Medicare, the federally funded healthcare program for those 65 and older and some disabled individuals, is constantly evolving to meet the needs of its beneficiaries. Here is an overview of some of the most significant changes to Medicare that are expected to take place in the near future.
Increase in Medicare Part B premiums and deductibles
Medicare Part B, which covers outpatient medical services, is expected to see an increase in premiums and deductibles in 2023. The standard premium for Part B is currently $148.50 per month, but this amount may increase for those who are not held harmless, meaning that their Social Security benefits did not increase this year. The deductible for Part B is also expected to increase from its current rate of $203 per year.
Changes to Medicare Part D income-related monthly adjustment amounts (IRMAA)
Medicare Part D, which provides prescription drug coverage, has income-related monthly adjustment amounts (IRMAA) that are added to the premiums of high-income beneficiaries. The IRMAA thresholds are expected to increase in 2023, meaning that more beneficiaries may be subject to these additional premiums.
Expansion of telehealth services
The COVID-19 pandemic has highlighted the importance of telehealth, and Medicare has responded by expanding its coverage of these services. In the past, telehealth was only covered in certain circumstances, such as when a beneficiary was in a rural area or unable to leave their home. However, due to the pandemic, Medicare now covers a wider range of telehealth services, including virtual check-ins and e-visits. It is expected that these expanded telehealth benefits will continue even after the pandemic ends.
Changes to Medicare Advantage plans
Medicare Advantage plans, which are offered by private insurance companies, are an alternative to Original Medicare (Parts A and B). These plans typically offer additional benefits, such as vision and dental coverage, but may also have higher out-of-pocket costs. In recent years, there have been changes to the way that Medicare Advantage plans are paid for, with the goal of making these plans more affordable for beneficiaries. It is expected that there will be further changes to Medicare Advantage in the future to further improve the value and cost-effectiveness of these plans.
Introduction of value-based payments
Value-based payments are a way of reimbursing healthcare providers based on the quality of care that they provide, rather than the number of services. The goal of value-based payments is to improve the overall quality of healthcare while also reducing costs. Medicare has already started implementing value-based payments for certain services, and it is expected that these payments will be expanded to other areas in the future.
Increased focus on preventative care
Preventative care, such as vaccines and screenings, can help to prevent diseases and other health problems before they occur. Medicare has always covered a wide range of preventative services, but there is a growing emphasis on the importance of these services in helping to improve the overall health of beneficiaries. It is expected that Medicare will continue to expand its coverage of preventative care services in the future.
Changes to the Medicare trust fund
The Medicare trust fund, which is used to pay for hospital and other inpatient services (Part A), is funded through a combination of payroll taxes and premiums paid by beneficiaries. The trust fund is projected to become insolvent in 2026, at which point it will no longer have enough money to pay for all of the benefits that it is required to provide. Congress will need to take action to address the solvency of the trust fund and ensure that it has the resources to pay for the benefits that beneficiaries are entitled to. Potential solutions could include increasing the payroll tax rate, increasing premiums for beneficiaries, or finding ways to reduce costs within the Medicare program.
Changes to the Medicare appeals process
The Medicare appeals process allows beneficiaries to challenge decisions made by the program, such as a denial of coverage for a particular service or treatment. In recent years, there have been efforts to streamline and simplify the appeals process to make it easier for beneficiaries to navigate. For example, the Department of Health and Human Services (HHS) has implemented the Medicare Appeals Council (MAC) as a way to centralize the appeals process and make it more efficient. It is expected that there will be further changes to the appeals process in the future to continue improving it for beneficiaries.
Possible expansion of Medicare to cover more services
There have been calls from some lawmakers and advocacy groups to expand the services that are covered by Medicare, such as dental, vision, and hearing coverage. While it is not certain whether these expansions will be implemented, it is possible that Medicare may cover a wider range of services in the future.
CONCLUSION
Overall, there are many changes to Medicare that are expected to take place in the coming years. These changes are designed to improve the program and make it more responsive to the needs of its beneficiaries. It is important for beneficiaries to stay informed about these changes and how they may affect their coverage.
If you are a Medicare beneficiary in Albuquerque, New Mexico, and have questions about the upcoming changes to the program, or if you are looking for a Medicare plan that is right for you, the Medicare Answer Team in Albuquerque can help. The Medicare Answer Team is a team of trained experts who are available to provide personalized assistance and answer your questions.
In addition to answering your questions about Medicare, the Medicare Answer Team can also provide information about life insurance options. Life insurance can help to protect your loved ones in the event of your unexpected passing, and there are a variety of plans available to meet different needs and budgets. The Medicare Answer Team can help you understand your options and find a life insurance plan that is right for you.
Don’t let the changes to Medicare and the complexity of finding the right plan overwhelm you. The Medicare Answer Team and the Medicare office in Albuquerque are here to help you make informed decisions about your healthcare and financial protection. Contact the Medicare Answer Team today to get the assistance you need.