Medicare Open Enrollment

It is that time of year for Medicare Open Enrollment!  The Open Enrollment period goes from October 15th ending December 7th.  There are changes this year that you should be aware of when making decisions about your coverage.

The Medicare Advantage Disenrollment Period (January 1 – February 14 every year) will be replaced with a different arrangement. This will be effective starting in 2019, according to the Centers for Medicare & Medicaid Services (CMS).

The Medicare Advantage Disenrollment Period lets you drop your Medicare Advantage plan and return to Original Medicare (Part A and Part B). It also lets you sign up for a stand-alone Medicare Part D Prescription Drug Plan.

In 2019, a new Medicare Advantage Open Enrollment Period will run from January 1 – March 31 every year. If you’re enrolled in a Medicare Advantage plan, you’ll have a one-time opportunity to:

  • Switch to a different Medicare Advantage plan
  • Drop your Medicare Advantage plan and return to Original Medicare, Part A and Part B
  • Sign up for a stand-alone Medicare Part D Prescription Drug Plan (if you return to Original Medicare). Most Medicare Advantage plans include prescription drug coverage already. Usually you can’t enroll in a stand-alone Medicare Prescription Drug plan if you already have a Medicare Advantage plan, but there are some situations where you can. Call your Medicare Advantage plan if you have questions.
  • Drop your stand-alone Medicare Part D Prescription Drug Plan


Here are seven improvements to Medicare that that AARP has identified.  They will take effect in 2019. Some of the changes will affect all beneficiaries while others will apply just to individuals who select Medicare Advantage plans.

Donut hole 

An expensive element of the Medicare Part D prescription drug benefit requires enrollees with high prescription costs to pay more for their medicines after they reach a certain level of spending in one year. This creates a coverage gap – also called the “donut hole.” After a beneficiary’s out-of-pocket spending reaches a second threshold, they enter catastrophic coverage and pay substantially less. Under the Affordable Care Act (ACA), the donut hole was scheduled to close in 2020. But the spending bill Congress passed in March will close the donut hole for brand-name drugs in 2019. The gap will close for generic drugs in 2020.

Therapy cap gone

Beneficiaries of original Medicare won’t have to pay the full cost of outpatient physical, speech or occupational because Congress permanently repealed the cap that has historically limited coverage of those services.

Better information

Medicare is updating the handbook it sends to beneficiaries every fall. It will include checklists and flowcharts to make it easier to decide on coverage. The online Medicare Plan Finder tool will be easier to use and an improved “coverage wizard” will help enrollees compare out-of-pocket costs and coverage options between original Medicare and Medicare Advantage.

More telemedicine

Medicare is steadily broadening the availability of telehealth programs that let patients confer with a doctor or nurse via telephone or the internet. In 2019, it will begin covering telehealth services for people with end-stage renal disease or during treatment for a stroke.

Lifestyle support

Beginning in January, Medicare Advantage plans have the option to cover meals delivered to the home, transportation to the doctor’s office and even safety features in the home such as bathroom grab bars and wheelchair ramps. To be covered, a medical provider will have to recommend benefits such as home-safety improvements and prepared meals.

In-home help

Medicare Advantage plans also will have the option to pay for assistance from home health aides, who can help beneficiaries with their daily activities including dressing, eating and personal care. These benefits represent a revised and broader definition of the traditional requirement that Medicare services must be primarily health related.

Plan test drives

New regulations will let people try an Advantage plan for up to three months and, if they aren’t satisfied, they can switch to another Medicare Advantage plan or choose to enroll in original Medicare. Congress required this flexibility in the 21st Century Cures Act, designed to accelerate innovation in health care.


What Proposed Budget Cuts Could Mean to Older Adults

There has been significant coverage of President Trump’s $18 billion proposed budget cuts from non-defense discretionary finding in this current fiscal year. Some of these cuts will hit older adults hard.  Proposed cuts include or total elimination include:

  • The State Health Insurance Assistance Programs (SHIPs) – eliminating $49 million of the $52 million dollar funding.
  • Older Americans Act Title V Senior Community Service Employment Program (SCSEP) – total elimination.
  • Senior Corps: All three programs (Senior Companion, RSVP and Foster Grandparents) – cuts of 60-80%.
  • Community Services Block Grant- eliminates $306 million of $715 million provided in FY 2017.
  • Community Development Block Grant – cuts of roughly 50%.

What does this mean for older adults?

  • SHIP funds the Health Insurance Counseling and Advocacy Program in California (HICAP). HICAP saves money for people on Medicare by helping them enroll in more cost-effective plans, appealing billing errors and getting them help with outstanding bills or penalties — all of which the program’s mostly volunteer counselors are trained to do. HICAP is highly cost effective because of the number of trained volunteers that work in the program. Last year, the Northern California HICAP provided services to 5,146 Medicare beneficiaries in the nine-county area where it operates.
  • As older adults live longer and sometimes outlive their retirement, seeking and finding employment is essential. SCSEP is the nation’s oldest program to help low-income, unemployed individuals aged 55+ find work. SCSEP matches eligible older adults with part-time jobs for community service organizations. Participants build skills and self-confidence, while earning a modest income. For most, their SCSEP experience leads to permanent employment.
  • Senior Corps achieves two significant goals. First, it provides volunteers to work throughout the community, volunteering as foster grandparents, senior companion, and in many other capacities. Second, it provides older adults with the opportunity to stay connected and to give back to their community. The benefits of volunteerism is huge. Senior Corps connects today’s 55+ with the people and organizations that need them most. It helps them become mentors, coaches or companions to people in need, or contribute their job skills and expertise to community projects and organizations. Volunteers receive guidance and training so they can make a contribution that suits their talents, interests, and availability. Conceived during John F. Kennedy’s presidency, Senior Corps currently links more than 270,000 Americans to service opportunities. Their contributions of skills, knowledge, and experience make a real difference to individuals, nonprofits, and faith-based and other community organizations throughout the United States.
  • Community Block Grants are used for funding many programs. Meals on Wheels is a program that supports the delivery of meals to 2.4 million homebound older adults and does get funding from the Community Development Block Grant program. Meals on Wheels would not be eliminated. However, it already is cannot keep up with the demands of the rapidly increasing aging population. Cuts would only add to potential food insecurity among older adults.

It is abundantly clear that the local aging network should be expanding programs to meet the great increases in need as the Baby Boomers continue to age. Elimination of programs only adds to the scarcity of services for our most vulnerable adults.

Medicare Part B

The National Association of Agencies on Aging (N4A) is beginning advocacy efforts to stop a substantial increase to Medicare Part B premiums.  According to the recent Medicare Trustees report, Medicare Part B premiums are expected to increase by 52 percent for nearly one-third of all Medicare beneficiaries in 2016.

Also, the Part B deductible is expected to increase by $76 to $223. These increases are directly tied to the prediction that there will not be a Social Security Cost-of-Living Adjustment (COLA) for 2016, which will likely be announced on October 15.

Because of a complicated formula that ties premium increases to COLAs, Medicare beneficiaries who are new to the program, who are not collecting Social Security, who are dually eligible for Medicare and Medicaid and who already pay higher, income-related premiums will shoulder the full cost of this increase unless a legislative fix is forthcoming. n4a and 70 other national advocacy groups recently sent a letter to House and Senate leadership and to the Chairs and Ranking Members of the Senate Finance Committee, the House Ways and Means Committee and the House Energy and Commerce Committee, encouraging them to work with the Department of Health and Human Services (HHS) to pass a legislative fix to give HHS flexibility to mitigate these increases.

Pam Miller
Executive Director