Medicare, particularly Original Medicare, is a government-funded health insurance program for Americans who are at least 65 years of age as well younger people with certain health conditions. It covers inpatient hospital services and necessary outpatient and preventive care. It has become an important safety net for millions of Americans, as well as helping to reduce poverty among seniors caused by excessive medical expenses.
Unfortunately, Vox explains that Medicare still has its shortcomings because it is not as comprehensive as other kinds of health insurance. For one, Medicare has limited coverage for essentials, such as long-term care and eye care, which can place a financial burden on the elderly and individuals with disabilities. Another problem is that there may be no limit to the out-of-pocket expenses a person on Medicare may have.
Biden proposes Medicare changes since the plan’s signing in 1965
In an attempt to plug the holes, the Biden administration has proposed expansive Medicare changes worth $3.5 trillion. Its main proposal is to lower the Medicare eligibility age from 65 to 60, which would open up access to an additional 23 million people. This is promising news, considering that a Stanford University research concluded that 60- to 64-year-old Americans have higher mortality rates than those in the 65 to 69 age bracket. This stems from the fact that up to 25% of those aged 60 to 64 don’t have health insurance outside of their Medicare. Furthermore, the COVID-19 pandemic has only worsened access to healthcare — and the government’s proposed changes can ease the burden for millions of older adults and their families.
Another proposed change is to lower prescription drugs prices. Part D already has extensive coverage, but a patient may still end up paying out-of-pocket costs totalling thousands of dollars. This can negatively affect the way they take their prescribed doses. It’s worth noting that a person must first be enrolled in Part A and/or B in order to be eligible for Part D. But because Part D can only provide so much coverage, the rate of standalone drug plan enrollment (meaning those not enrolled through Medicare Advantage or employer group plans) has started to decrease slightly.
As of 2019, Rhode Island-based issuer CVS Health still has the most enrollees in terms of standalone drug plan enrollment, though this has decreased a bit compared to 2018. Lowering prescription drugs prices will have an immediate impact on those on Medicare because they can take their medications as prescribed. This means they can fill prescriptions and won’t have to resort to dangerous alternatives, such as skipping doses or cutting pills in half.
Experts assure Medicare Advantage enrollment will remain unaffected
Biden’s administration also wants to push for expanding Medicare’s coverage to include dental, vision, and hearing benefits. These services are not entirely new in Medicare as a whole, as Houston-based insurer KelseyCare shows that vision and dental services are among the perks that differentiate Advantage plans from the Original Medicare. Older adults can get routine check-ups and treatments in these areas that may not be covered by Parts A and B, which the new bill aims to change.
However, despite this addition, Avalere senior consultant Tom Kornfield states that this won’t be enough to cause a major shift from Advantage plans to Original plans. This is due to there being other reasons people enroll and stay in Medicare Advantage, including out-of-pocket caps and fitness memberships. He also recalls that the introduction of Medicare Part D more than 15 years ago didn’t trigger a massive shift away from Advantage plans.
The Biden administration’s proposed changes to Medicare are promising. If the bill passes, older adults and individuals with disabilities, as well as their families, can relieve some of their worries about healthcare and the related costs. For more news for international events, check our blog here on International Inside.