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How the new Medicare flat rate affects Colorado

On Behalf of | Sep 27, 2018 | Firm News

The last decade has seen a series of major changes affecting the health system, insurance coverage and patients’ responsibility. These amendments have affected Medicare enrollees, too, and there is no sign the changes will be slowing down any time soon. The latest policies may be beneficial to some of Colorado’s Medicare patients starting in 2019.

According to the New York Times, there is a  new flat-rate plan  that would make all office visits set at the same price point. The following are three implications this may have for Colorado patients who are interested in applying for Medicare.

New copay price

Under the proposed plan, copays for Medicare would be set at a single flat rate of $93 for established patients and $135 for new patients instead of the copay fees currently ranging from $48 to $211. The current plan sets prices based on where your visit is classified on a scale of five levels. Level one entails routine, simple visits and typically costs a copay of $76. Level five is designated for complex visits and incurs a higher copay.

Same requirements

Despite payments changing under the proposed plan, there is no suggestion that the requirements for Medicare enrollment in Colorado will change. Medicare patients must still meet the  eligibility requirements  set forth by the federal government in order to receive care and treatment. Currently, unless you are on automatic enrollment, you may apply to enroll in a Medicare plan in the seven-month period that occurs three months before you turn 65, that includes the month you turn 65 or that ends three months after you turn 65.

You still need to plan ahead

These changes may make the Medicare experience more affordable for some patients, but  the necessity of planning  remains the same. It is important to consider well in advance whether you meet program requirements and understand the steps you may take now to prepare for eligibility down the road.