5 Medicare Changes Made by the Trump Administration

Have you noticed any changes to your Medicare?

In the United States, a majority of people have seen their Medicare change in one way or another. Depending on where you stand financially, it could be a major change or nothing at all.

You might be wondering what the cause of all this is, and in short, it was the election of President Donald Trump. His election, along with the conservative Senate, allowed the Republican party to make sweeping changes to Medicare.

But knowing what changes took place can be difficult. Lucky for you, this article will tell you everything you need to know. Who knows? There may even be a medicare advantage for you.`

Read on for 5 important Trump Medicare changes.

1. Trump Medicare Changes Include Part D Drug Plans

Are you familiar with medicare part D? It’s a section of Medicare that allows those who use Medicare to pay for prescription drugs. 

It works as a regular insurance plan does. Beneficiaries pay a premium on a regular basis, and when they need to buy expensive prescription drugs, they can use the money they’ve built up.

They cannot use their policy to cover all their drug expenses, but the policy helps keep prices lower.

Opioid Denial

One big change is that those in charge of policies can deny Medicare users access to opioids if the policy owner is at risk for addiction. How the person is determined to be at risk for addiction depends on what a doctor might say or past health issues.

This change is part of the Trump administration’s desire to ease the opioid epidemic. In 2016, 19,000 people died from opioid overdose alone.

Increased Flexibility

In previous years, Part D plans allowed coverage for name brand drugs alone. This wasn’t with every case, but it happened on a regular occasion.

This meant that people were using the policy to pay for drugs which were more expensive than needed. In fact, some people had plans that made it cheaper to buy a generic drug without the help of Medicaid. Now, there is more flexibility in this area.

2. Loosening of Medicare Advantage Plans

Medicare Advantage plans are insurance plans that private companies sell. They can do this only if they have a contract with Medicare.

The reason these exist is that Medicare sometimes cannot cover everything a person needs. Also, some people may get better benefits from Medicare Advantage plans. Along with this, people may prefer buying something that isn’t related to the government directly.

Medicare advantage replaces part A and B of traditional Medicare, and some plans may help or replace part D.

Before the Trump administration, Medicare Advantage plans were a bit more strict than they are now. This is because the Obama administration made a push to have the government help with healthcare.

Keep in mind this is different than the Affordable Health Care Act (AHCA), but the AHCA did make some changes to Medicare.

More Plan Availability

Under the Trump Administration, companies can now offer more Medicare Advantage plans. Before, companies could only offer a plan in an area if it wasn’t similar to other plans in that area.

Now, Medicare Advantage companies can offer more plans to compete with other plans. This creates competition between insurance companies.

Different Deductibles

If you have regular health insurance, you may know that you can get discounts for having good health. This is because it’s less likely you’ll have health issues, meaning the insurance company won’t be worried about spending money on your policy.

Pretty neat, huh?

Medicare Advantage plans weren’t allowed to have different deductibles for policyholders who met health criteria. But this has changed to offer lower deductibles for those who are healthier.

3. More Competition

If you’re a true capitalist, chances are you believe competition leads to better prices and products. How does this work?

Let’s say Drug Company A wants to get more customers, and Drug Company B sells their product for $20. To beat out Drug Company B, Drug Company A can sell their product for $18. This means that more people will buy their product, but they won’t make as much money per pill.

In a perfect world, Company B would then try to lower their prices as well – either by finding ways to make the product for cheaper or selling them for less. Instead, they may try to market their product as better and leave the price the same.

There are plenty of different options in the free market. But, in short, competition is supposed to bring better products for cheaper prices.

Earlier this year, the Trump administration took out a provision in Medicare that banned competition between drugmakers. They hope this will lower the cost of drugs.

4. Outpatient Therapy Cost Cap is Outta Here

An outpatient is a healthcare patient who is not admitted as a patient in a hospital. Outpatient therapy is therapy those people need.

Some examples of outpatient therapy are:

• Speech Therapy
• Occupational Therapy
• Physical Therapy

In short, you can remember these types of therapy as the ones that don’t require immediate medical attention. But they do need medical attention

Before, patients who needed outpatient therapy could only get so much before they had to pay it out of pocket. And, for many years, Congress increased the cap on occasion.

Finally, though, they decided to remove this cap. Still, original Medicare will only cover up to 80% of outpatient therapy. This isn’t unusual; original Medicare tends not to cover everything.

Looking for More Articles Like This?

After reading this article, you should be up to date on all the Trump medicare changes to look out for. Whether they hurt you or help you, we hope you will know how to navigate them.

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