Medicare Advantage Is About to Change. Here’s What You Should Know.

Medicare Advantage plans will be allowed to cover adult day care, home modifications and other new benefits. But they may not be available to all enrollees every year.

Trump Administration plan to reduce medical office visits to a simplified code and a universal payment regardless of complexity is a step in the right direction - away from complexity and toward simplicity. Devil’s in the details. Docs will fight it tooth and nail. - Sanders DiPiero

Did you fall in the bathroom and fracture your hip? Medicare, if you have it, will pay thousands of dollars for surgery to repair the injury and thousands more for your resulting hospital stay and rehab in a nursing home.

But Medicare wouldn’t have paid $200 to have grab bars installed in your bathroom, or covered the cost of a $22-an-hour aide to assist you in the shower — measures that might have helped you avoid the accident.

For decades, public health experts, doctors, patients and families have lamented this narrow, often counterproductive approach to older Americans’ health care.

“You don’t want somebody with asthma rushing to the emergency room with a breathing problem that could have been prevented with an air conditioner,” said Tricia Neuman, who directs the Medicare policy program at the Kaiser Family Foundation. Yet Medicare covers costly emergency medicine, not window units.

That might start to change next year, though, for those enrolled in Medicare Advantage plans — about a third of those insured by Medicare. Officials announced this spring that they’d “reinterpreted” the definition of “supplemental benefits” for Medicare Advantage.

When Medicare’s open enrollment period begins on Oct. 15, the private insurers that underwrite Advantage plans — which already lure seniors with things traditional Medicare can’t cover, like eyeglasses, hearing aids and gym memberships — will be free to add a long list of new benefits.


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