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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).

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.

COPYRIGHT_WI: Published on https://washingtonindependent.com/w/changes-to-medicare-advantage/ by Karan Emery on 2022-04-25T13:41:16.178Z

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.


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.

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About The Authors

Karan Emery

Karan Emery - I'm a research scientist interested in learning more about how neural activity influences and shapes human behavior. Project design and management, data analysis and interpretation, and the creation and implementation of testing tools are among my specialties. I enjoy coming up with new ideas and coming up with practical solutions to issues that are widely applicable. My colleagues would describe me as a driven, resourceful individual who maintains a positive, proactive attitude when faced with adversity. Currently, I’m seeking opportunities that will allow me to develop and promote technologies that benefit human health. Specific fields of interest include data analytics, biotechnology, and pharmaceuticals.

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