Medical insurance can be quite complex, and with the number of plans available in the market, it can be overwhelming to make a decision. If you are new to Medicare or looking to review your Medicare coverage, this article is for you. By 2023, there will be significant changes to Medicare Advantage plans 2023. This article will cover the changes and what you need to know as you make your decision.
Firstly, let’s understand what Medicare Advantage (also known as Part C) plans are. These are health plans offered by private insurance companies approved by Medicare. The plans must provide similar benefits as Original Medicare, but they can also cover extras such as vision, hearing, and dental services. The plans have an annual limit on out-of-pocket expenses, which makes them appealing to many beneficiaries.
Starting in 2023, Medicare Advantage plans will be required to cover some services that have been deemed essential by Medicare. The essential services include transportation to and from medical appointments, meal delivery, and in-home supports. These services are intended to help beneficiaries access care and avoid the risk of being hospitalized. The added benefits will provide more comprehensive coverage to Medicare beneficiaries, which is great news for those who need help with day to day tasks.
One crucial thing to keep in mind is that Medicare Advantage plans network doctors, hospitals, and healthcare providers. This means that beneficiaries must receive covered medical services from providers within their plan’s network to avoid paying out-of-pocket expenses. Starting in 2023, the network size for Medicare Advantage plans will increase. This means beneficiaries will have more choices of providers within their plan’s network.
Another significant change coming in 2023 is the new expenditure minimums for Medicare Advantage plans. A medical loss ratio is the percentage of premiums collected by the insurer that are spent on medical expenses. Currently, Medicare Advantage plans are required to spend at least 85% of their premiums on medical expenses or quality improvements. In 2023, the expenditure minimum will be increased to 88%. The increase in expenses allocated for medical care and quality improvement is to ensure that beneficiaries get the most value for their money.
In 2023, Medicare Advantage plans will introduce a new program known as a hospice benefit-carve-in. Currently, Medicare beneficiaries must choose between hospice coverage by Original Medicare or Medicare Advantage plans. Starting in 2021, all Medicare Advantage plans were required to pay for hospice coverage, which is a significant step in helping beneficiaries get the care they need. By 2023, all Medicare Advantage plans will have incorporated the benefit, improving access to care for all beneficiaries. The changes that will come with Medicare Advantage plans in 2023 improve access to care, enhance medical loss ratio requirements and expand networks for beneficiaries. These changes also offer several choices for individuals looking for coverage that best meets their healthcare needs. As you evaluate your healthcare needs, consider your options under Medicare Advantage to take advantage of the changes and provide yourself with the best care possible.