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2019 Medicare


2019 Medicare Supplement


While there won’t be any 2019 Medicare changes to the Medigap plans, it will be the last year that individuals new to Medicare will have an opportunity to purchase a Medigap Plan F. Those individuals who have enrolled in Medicare prior to January 1st, 2020 can still purchase a Medigap plan F in the future, but new enrollees after January 1st, 2020 will not.

One trend to watch for in 2019 is a normalization of rates for Medigap Plan G. In our opinion Companies have offered enticingly competitive rates on the Plan G Medicare Supplement to increase their Plan G enrollment prior to the MACRA rule taking effect on January 1st, 2020. We expect these rates to be gradually increased over the next couple years to insure the desired loss ratio of each company.


2019 Medicare Part D 


Some positive news is on the way for Prescription Drug Plans in 2019 that should lower out of pocket costs for beneficiaries by allowing more flexibility to the Medicare Part D program.

  1. Some low-cost generics can be substituted onto a Plan’s formulary at any time during the plan year, so beneficiaries aren’t stuck paying for high name-brand drugs and can have lower cost sharing with the generic.
  2. Pharmacy options will be increased by simplifying the “any willing provider” requirement to increase competition with pharmacies.
  3. More plans will be available to an individual beneficiary by removing the requirement that Medicare Part D plans have to “meaningfully differ” which will increase competition among plans.
  4. CMS also intends to lower the amount low income beneficiaries pay for biosimilars. A biosimilar is a biologic medical product which is almost an identical copy of an original product that is manufactured by a different company.


2019 Medicare Advantage


Medicare Advantage plans will have higher reimbursement rates for 2019. This will allow companies to lower beneficiary cost sharing or increase the benefits provided if they so choose. CMS is redefining the standards for health-related supplemental benefits in Medicare Advantage plans to include additional services that increase health and improve the quality of life, including coverage of non-skilled in-home supports and other assistive devices. This will broaden he type of services offered in the Medicare Advantage Program.