Trump Medicare Changes - What To Expect In 2019

By: Thomas Wright
Published: Thursday, December 27 2018
Last Updated: 4 years ago

2019 is almost upon us, and the new year will bring more Medicare changes under Trump. Thankfully, the changes will mainly focus on the private sector, including Medicare Advantage and Medicare Part D. Whether you are getting ready to enroll or switch to a prescription drug plan in the coming new year, know that you have plenty of choices that members did not have in the past. You will have more options to choose from, and some of the premiums are even lower than before.

The Medicare changes under Trump also reveal that there will be even more benefits. This should get more members during the open enrollment period. The new year is a good time to shop around for plans even if you are happy with your current plan. Here are 8 Trump Medicare changes to look out for in 2019.

More Medicare Advantage Plan Options

In 2019, there will be over 600 Medicare Advantage plans. There will be a wider variety of options for members on Medicare Advantage. Over 91% of people on Medicare can choose from over 10 Medicare Advantage plans in their geographic location. Some health insurance plans may offer various Medicare Advantage plans in just one area alone.

This will give you more options for Part D plans as well. Aetna is just one insurance company that plans to expand its Medicare Advantage plans in 358 counties in six additional states. Mutual of Omaha, a Medicare partner, is also exploring the Part D industry in the coming new year.

Average Part D Premiums Decrease

According to the Centers for Medicare and Medicaid Services, the average Part D premiums will decrease by $1 each month in 2019. It is not just the premiums that are on the decline. Some insurance plans that have low premiums may include higher copays for prescription drugs or higher prices at preferred pharmacies.

Compare each of the plan's costs on prescription drugs to ensure you are getting a fair deal on prescription drugs. You can compare costs in your local area with the Medicare Plan Finder. It also allows you to estimate costs for copays and premiums on your prescription drugs.

More Plans With Preferred Pharmacies

If you want to use a certain pharmacy, you should get on a Part D plan since they have lower premiums and lower copays. If you prefer to use a certain pharmacy, verify it is a preferred pharmacy under your Part D plan. Walgreens is an example of a preferred pharmacy that is featured on AARP United Healthcare, BlueCross BlueShield, and Cigna plans.

Some of these Part D plans may cost you more money if you get your prescription drugs elsewhere. For example, the Humana Walmart plan has premiums that cost $22.50 per month at Walmart, Sam's Club, and Humana's Mail Order Pharmacy. The company also offers other Part D plans without the need for a preferred pharmacy.

Pay Less In The Donut Hole

The donut hole is another name for the coverage gap. It means you will pay more out-of-pocket costs for your prescription drugs. One of the Trump Medicare changes includes getting rid of the donut hole. Even without it, you will still have to pay the remaining costs for your prescription drugs.

Once the costs of your prescription drugs hit $3,820, you must pay 25% for brand-name drugs until you hit the $5,100 limit. Then you can pay the remaining 5% for prescription drugs. The Medicare Plan Finder can give you a breakdown of the drug costs listed under each Part D plan.

Average Medicare Advantage Premiums Decrease

In 2019, the average premiums for Medicare Advantage plans will decrease to $28 per month. That is down from $29.81 in 2018. Most of these Medicare Advantage plans will have no premiums. That does not mean you will not pay a premium for Part B plans, which will cost $135.50 per month for most members in 2019.

Lower premiums mean smaller provider networks. Make sure your plan includes the physicians and hospitals you want to use. You may have access to different plans within the network, but each one has its own cost-sharing and premiums. Higher premiums mean lower copays, so if you are relatively in good health, you should choose a plan with low premiums and high copayments.

Less Coverage For Out-Of-Network Care

Keep in mind that some Medicare Advantage plans will have higher copays if you use an out-of-network provider. Many of them will not provide coverage for care outside of your network unless it is an emergency visit. Some of the low-cost Medicare Advantage plans will cover out-of-network care for emergencies.

In 2019, some plans will include more options and will expand their network coverage but will cost more money. Ask your insurance plan if the providers and hospitals you prefer to use will be included in its network. Some insurance plans give options in each area that have various networks.

Medicare Advantage Plans Include New Benefits

One of the Trump Medicare changes revealed that Medicare Advantage plans will include more benefits in the new year. Some of these benefits are not even available through traditional Medicare coverage. Some of these additional benefits include dental care, fitness club memberships, and vision care services.

The Trump Medicare changes allow plans to expand their benefits in 2019 and provide even more benefits by 2020. Some of these plans will include new benefits such as adult day programs, in-home assistance, home-delivered meals, and meals following hospital discharge.

More Ability to Switch Plans

If you are unhappy with your Medicare Advantage plan, you will now have the ability to switch to another plan. Members have from January 1 to March 31 to drop their current plan and switch to another Medicare Advantage plan. You should not jump from your plan to another unless you qualify during that enrollment period.