“Senior citizens” and “the Medicare population” are often mentioned as a huge, monolithic bloc, but the 63 million people in the United States enrolled in Medicare represent a large range of ages, abilities, and interests. Each Medicare beneficiary is an individual, with individual needs.
The best Medicare Advantage plans are designed with that in mind. By carefully evaluating the available options, Medicare beneficiaries can find coverage that meets their medical and prescription needs – and helps them stay as active and independent as possible.
“When we talk about Medicare beneficiaries, we’re talking about a broad spectrum of people with different goals for their lives, who are in different stages of their lives, with different capabilities,” said Alexis Ryon, chief operating officer for Cigna’s Arizona Medicare Advantage business. “Therefore, choosing a Medicare Advantage plan is not a one-size-fits-all situation.”
Today’s Medicare Advantage plans offer features that vary with the company that offers them, geographic location, and other factors. “Medicare Advantage has core benefits: doctor visits, lab work, specialists, and hospital visits,” Ryon said. Most Medicare Advantage plans – including most offered by Cigna – also include a pharmacy benefit.
“As a Medicare Advantage plan, we also have the opportunity to offer what we call supplemental benefits, which go above and beyond those standard benefits,” she said. “That’s where we architect a plan that helps our senior population to age well or live with more vitality.”
Plans can design their plan with components from a long list of supplemental benefits, and prospective customers should check carefully to ensure a plan offers the benefits that are important to them before enrolling.
Medicare offers a variety of enrollment periods, each governed by specific requirements. For example, people who are turning 65 have a seven-month window to sign up for Medicare without the risk of future penalties. Those already enrolled in Medicare can select a new Medicare Advantage plan each year during the Annual Election Period, which runs from October 15 through December 7. If they decide their Medicare Advantage plan is not a good fit, they can choose a different plan during the annual Open Enrollment Period, January 1 through March 31.
Below, we look at supplemental features that might appeal to the broad spectrum of Medicare beneficiaries in various situations and stages of life.
People Staying Active, Fit, and Health Conscious
People who fit this description tend to be on the go and are highly independent. They are in control of their health, are careful about what they eat, and take steps to stay fit. Overall, they describe themselves as “aging well.” They are among the majority of older adults who can exercise safely, according to the National Council on Aging. The benefits are many: Regular exercise can help prevent bone loss, relieve arthritis pain, strengthen immunity, improve mood, and even help prevent chronic disease.
Plans that offer a fitness benefit, which can pay for a gym membership or provide at home fitness tools, might be just right for their needs. Plans with zero copays for preventive health screenings – including visits with their primary care provider, lab screenings, and cancer screenings – can help them to stay on top of their health with lower out-of-pocket costs than other plans.
People Aging in Place Who Have Increasing Needs
While almost 90% of Americans say they would like to stay in their homes as they age, that can become more difficult as the years go by. People who are aging in place are often less able to get around easily, in or out of their home. If they no longer drive or own a car, accessing care can be a hurdle.
Some plans address that by providing transportation, such as rides to and from doctor appointments. If the customer prefers, virtual care can also be a welcome option, especially while COVID-19 infections remain a concern. If customers want to install safety features in their home, such as grab bars, ramps, or elevated toilets seats, some plans can help with that as well.
People Living on a Limited Budget
Nine percent of Americans older than 65 lived in poverty in 2020, according to the U.S. Census Bureau, with a household income less than $12,413 for one person or $15,659 for two. Even those who are above the poverty line may have difficulty affording essentials like medications, glasses, and hearing aids.
To bridge that gap and help Medicare members plan their costs for the year, some plans offer low out-of-pocket maximum amounts, dental visits, vision coverage, an allowance for glasses or contacts, hearing coverage, an allowance for hearing aids, and an allowance for over-the-counter medications – none of which are covered by traditional Medicare. “As we all continue to age, we have more medical needs that pop up,” Ryon said. “These supplemental benefits provide that extra support for our customers.”
Coping With Declining Health or Chronic Conditions
Chronic conditions become likely as we age: Approximately 85% of older adults are dealing with at least one chronic health condition, while 60% have at least two chronic conditions, according to the Centers for Disease Control and Prevention (CDC). As a result, these Medicare Advantage customers may require an elevated level of assistance, especially when they are aging in place.
For those who need companionship or help with day-to-day activities, some Cigna plans coordinate with Papa Health to connect customers with a college student or a nurse in training. These “Papa Pals” are available to provide transportation, help with light chores, or just spend time together, perhaps watching movies or playing games. “They’re really a trusted companion,” Ryon said, and the service is especially important given the isolation many older people have faced over the past two years.
When a customer is hospitalized, plans can connect them with case management nurses to coordinate with their primary care physician and make the transition home as easy as possible. All Cigna plans offer to deliver 14 meals to the home after a hospital stay, and even arrange for the delivery person to put them in the freezer. “We don’t want you to have to worry about where your next meal is coming from,” Ryon said. “They are high quality, nutritious meals, tailored to the customer’s dietary needs or other considerations.”
Every Medicare Advantage Customer Is Unique
While the preceding descriptions are examples of Medicare Advantage customers, people are unique and have unique needs. “At Cigna Medicare, our goal is to create an ecosystem that allows our customers to age well within their own health journey,” Ryon said.
Part of that is ensuring consistency among the features offered from year to year. “Health care is extremely is confusing; Medicare is no different,” she said. “We prioritize consistent benefits and a high-quality experience to help our customers understand and make the most of their Cigna Medicare Advantage plan. We want their health care to be simple, predictable and affordable. That is our core mission.”
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