Last Friday Congress passed and President Donald Trump signed into law the Bipartisan Budget Act of 2018 (BBA 2018). This Budget Act provides Congress until March 23rd to enact appropriation and certain other funding measures and establish a general agreement on spending that will last into 2019. This legislation contains a number of healthcare provisions that are important to people on Medicare.
Here is what you need to know:
- Beginning in 2020 Medicare Advantage plans may offer telehealth medical services as supplemental Medicare benefits to chronically ill members. Telehealth services provide virtual medical, health and education services via the internet as a means to help enhance care and education delivery. The Budget Act further instructs the Department of Health and Human Services to develop regulatory guidance to expand the availability of telehealth medical services to all Medicare Advantage Enrollees.
- The Budget Act advances the elimination of the “donut hole” in Medicare Part D from 2020 to 2019, a full year earlier than projected. The donut hole is the gap in which prescription drug expenses under Part D are not covered. Beginning in 2019 Part D enrollees will pay 25% of the costs of all their prescription drugs from the time they enter the gap until they reach catastrophic coverage. In addition, a larger discount will apply to Part D prescription drugs thus reducing the amount that the health plans will need to cover.
For 2018 the threshold for entering the donut hole will remain at $3,750 worth of prescription drug costs. If your formulary medications have a total retail value of over $3,750, or you have retail drug costs of over $313 per month you will enter the donut hole and receive a discount on your Medicare Part D prescriptions. (Not what you spend, but the actual retail value of the medications you use) If you are receiving Extra Help for your Medicare Part D you will never have a donut hole in your coverage.
We love and care about you, hence, for a better understanding of the details, and the impact of these changes to your current situation, give us a call. We put together this video for you to better understand this topic.