What are the Additional Benefits Offered by Medicare Advantage Plans in Massachusetts this Year?

by Digital Solution Expert Digital Solution Expert

If you are a senior who is eligible for Medicare in Massachusetts, you have the option to select an alternative to Original Medicare like a Medicare Advantage plan (also known as Medicare Part C). It’s not like Original Medicare because it offers a choice of plans with varying benefits and premiums. Medicare Advantage plans usually include benefits not covered by Original Medicare, such as vision, dental, and prescription drugs.

As statistics show, Medicare Advantage is popular among seniors across the US. Massachusetts has a lower participation in Medicare Advantage. Only 21% of the state’s seniors enrolled in a Part C plan to receive their Medicare benefits. There are four basic plan types – HMO (Health Maintenance Organizations), PPO (Preferred Provider Options), PPFFS (Private Fee-for-Service), or SNP (Special Need Plans). Massachusetts is ranked at 35^th for Medicare Advantage participation in the US.

Will we see more than twenty-five million enrollments in 2021?

Medicare Advantage plans have changed in a big way this year because of the continuing rise in enrollments and more benefits offered in Massachusetts and elsewhere. With the sizeable aging population in our country, the trend will continue to grow. It is the first time in our history that Medicare Advantage has touched 40% of the total Medicare-eligible population. Last year, over twenty-five million people were enrolled in Medicare Advantage plans. According to reliable sources, the total Medicare-eligible population wasover sixty-two million. Between 2013 and 2016, the Medicare Advantage grew by 60%. The cost of enrollment is down, and there are various new benefits.

Popularly known as an ‘all-in-one’ health plan, Medicare Advantage is sold by private insurance companies as an alternative to traditional Medicare. Plans must offer the same level of cover as original Medicare with their own set of rules, restrictions, and costs. In 2021, enrollments are expected to increase to approximately twenty-six million.

Some major changes to Medicare Advantage plans in 2021:

Telehealth services and coverage has been expanded. Based on the analysis of data, this year, more than 94% of Medicare Advantage plans will offer additional telehealth benefits for over twenty million beneficiaries, which is 58% higher compared to plans offering telehealth benefits last year.
New coverage options for long-term care, like home safety modifications (grab bars for bathrooms, wheelchair ramps, staircase rails, etc.), meal delivery, transportation, in-home personal care services, adult day programs, and more.
Additional coverage options for people with end-stage renal disease (ESRD) vary for the different states.
The maximum out-of-pocket limit has been increased to $7,550 this year.
The maximum deductible for a standard plan has been increased to $445 this year, and the threshold for entering the catastrophic coverage phase has increased to $6,550.
The way that COVID-19 has affected Medicare Advantage plans is that insurers waived cost-sharing requirements for its treatment. It means that Medicare Advantage beneficiaries are not required to pay cost-sharing if they need hospitalization for COVID-19 specifically.

Seek clarity for prescription drug coverage

Part D plans pay for prescription drugs.It is optional for seniors in Massachusetts who qualify for Original Medicare. Many Medicare Advantage plans have a Part D component as part of their unified plan coverage. The federal government permits private insurance companies offering prescription drug plans through Medicare Advantage in Massachusettsto charge a range of monthly premiums. They cannot discriminate against beneficiaries with existing health conditions or charge an additional sum for high-risk clients. If you have the slightest doubt about which plan is suitable, consult a licensed professional over the phone.