Medicare and the New Congressional Budget

Medicare Advantage

Congress just passed a two-year budget that has some Medicare provisions that you should know about. The bill, which had passed the House, passed with a 91-8 vote in the Senate.

Until now, Medicare has not covered long-term supports and services. With a growing number of aging seniors, a model of care that helps to manage sometimes complex chronic conditions and improves quality of life has been needed.

With the new budget, Medicare would now cover some of these long-term integrative services. Medicare Advantage plans will be able to include so-called nonmedical services, such as rides to a doctor or home-delivered meals. The Medicare Advantage companies will be able to choose which they offer.

Shifting attention to chronic care

In addition, a former bill designed to improve chronic care was added to the budget bill. This will allow managed-care organizations to provide social supports and to offer benefits that cater to the specific needs of members, rather than having to offer the same benefits to the group.

This will mean that plans will be able to tailor benefits to different geographic areas.

The bill also includes another change that will help with prescription drug costs. It will require drug makers to offer discounts to those Medicare beneficiaries whose costs have put them in the donut hole. This would occur in 2019.

The bill provides for changes to Medicare Advantage offerings but not traditional Medicare.

Catch 22

One issue looming over the budget bill is that it adds signficantly to the deficit. This may have an impact on Medicare, Medicaid and Social Security later in terms of higher premiums. Medicare premiums may already increase for those higher-income seniors.

Time will tell how these Medicare changes will affect members: positively or negatively. We will keep you updated on further developments.

For more information on the budget bill, visit


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