Changes to Medicare Advantage in 2023
As the Covid-19 pandemic shows, there are many flaws in the current Medicare situation. For example, during a pandemic, many people with Covid-19 were not able to get prescribed drugs, even if they were enrolled in Medicare Advantage or had other plans with prescription drug coverage (so-called Part D).
Author:Daniel JamesReviewer:Karan EmeryApr 25, 2022426 Shares425.8K Views
As the Covid-19 pandemic shows, there are many flaws in the current Medicare situation. For example, during a pandemic, many people with Covid-19 were not able to get prescribed drugs, even if they were enrolled in Medicare Advantage or had other plans with prescription drug coverage (so-called Part D).
In most cases, this situation was caused by the bankruptcy of some of the small pharmacy companies and healthcare institutions that were part of the networks offered by Medicare Advantage and other plans, including Part D. So, the US government decided to create a new set of rules for all Medicare plans with prescription drug coverage.
Communications And Marketing Oversight
The US government proposes strengthening the oversight of all providers who offer any Medicare Advantage and other prescription drug coverage plans. This proposal comes as a response to numerous complaints from various Medicare plans holders regarding unclear and misguiding marketing campaigns about the whole range of different services and coverage they will get after enrollment.
The use of third-party marketing organizations to look after the ads and marketing campaigns for plans with prescription drugs coverage was proposed among other actions. Also, to overcome any possible language obstacles, various translation services need to be offered for US legal residents from abroad. Lastly, enrollee ID card standards will be improved and renewed.
Making Networks More Adequate
The US government also would like to create a specific set of rules to prove that every network has a sufficient number of suppliers and providers to cover all possible needs of customers. Those rules will be valid for all Medicare Advantage providers and their networks.
Those rules are explicitly designed to ensure that all networks can provide all their clients with all necessary services. Medicare Advantage organizations that do not follow those rules just yet will have a full year to prepare and start providing all the required services for their patients.
All Enrolled Persons Will Be Input On D-SNP Operations
One of the most effective ways to control the service quality is to contact the customers directly. So, the US government made a specific proposal to create an enrollment advisory committee that will gather all feedback from the customers who recently enrolled in a new Medicare Advantage Plan.
Grievance And Appeals Processes Will Be Simplified
Until 2022 all Medicare Advantage beneficiaries were supposed to file a separate appeal or grievance for each separate part of their plan. This process takes lots of time, especially in case of a multilayered appeal or grievance. As a result, to ensure that all beneficiaries can easily make their statement and communicate with Medicare Advantage providers, the process of filing appeals and grievances would be simplified.
Conclusions
As you can see, there is not much difference between enrolling in Medicare in 2023 and 2022. You can also find plenty of additional info about Medicare Advantage and Medicare Original on Hella Health. In any case, remember that Medicare Advantage won't be mandatory in 2023. But, the overall process of communication with Medicare providers, creating appeals, and providing feedback will become much more effective.
Daniel James
Author
Daniel James is a distinguished gerontologist, author, and professional coach known for his expertise in health and aging.
With degrees from Georgia Tech and UCLA, including a diploma in gerontology from the University of Boston, Daniel brings over 15 years of experience to his work.
His credentials also include a Professional Coaching Certification, enhancing his credibility in personal development and well-being.
In his free time, Daniel is an avid runner and tennis player, passionate about fitness, wellness, and staying active.
His commitment to improving lives through health education and coaching reflects his passion and dedication in both professional and personal endeavors.
Karan Emery
Reviewer
Karan Emery, an accomplished researcher and leader in health sciences, biotechnology, and pharmaceuticals, brings over two decades of experience to the table. Holding a Ph.D. in Pharmaceutical Sciences from Stanford University, Karan's credentials underscore her authority in the field.
With a track record of groundbreaking research and numerous peer-reviewed publications in prestigious journals, Karan's expertise is widely recognized in the scientific community.
Her writing style is characterized by its clarity and meticulous attention to detail, making complex scientific concepts accessible to a broad audience. Apart from her professional endeavors, Karan enjoys cooking, learning about different cultures and languages, watching documentaries, and visiting historical landmarks.
Committed to advancing knowledge and improving health outcomes, Karan Emery continues to make significant contributions to the fields of health, biotechnology, and pharmaceuticals.
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