Medicare Under Biden: What Are The Proposed Changes And Challenges?

With the 2020 election just weeks away, President Trump has been vocal that should he win reelection, programs such as Medicare would be open to cuts to help reduce the federal deficit which topped $1 trillion before the pandemic.

Democratic nominee Joe Biden, meanwhile, has taken a much different stance on Medicare, with plans to improve the government-run program by implementing various changes including age-eligibility requirements, the reduction of prescription costs, and inclusion of dental, vision and hearing benefits.

As it stands, beneficiaries become eligible at age 65 but Biden wants to lower that to 60, making enrollment optional for the first five years. While this may be met with a positive response, the issue here is that it’s undescriptive of what that means. Currently, when you age in at 65, you’re automatically eligible for Open Enrollment, meaning the condition of your health won’t impact your acceptance into Medicare. Additionally, if beneficiaries don’t enroll when they’re first eligible, and don’t have credible coverage, they will be penalized in the form of increased premiums once they do enroll. What isn’t clear about Biden’s plan is whether beneficiaries will be able to participate in Open Enrollment once they turn 60 or if they will have to wait until they turn 65.

This also could have an impact on Medigap plans since your ability to enroll in a Medigap plan during Open Enrollment begins when you receive a Part B effective date, which is determined when you enroll in Medicare. However, you must be 65 to take advantage of Medigap. If it is in fact lowered to 60, and Medigap plans change Open Enrollment eligibility to require participation in Part B at age 60, how will that impact premiums? Will beneficiaries who enroll in Medicare prior to 60 not be eligible for a Medigap plan until 65? If that is the case, those beneficiaries will not have any supplemental coverage to fill gaps in coverage for their first five years in the program.

Another concern from beneficiaries is the rising prescription drug costs, which is something Biden has stated he’d like to reduce. Should this be successful, we could potentially see the removal of the rebate system, which prescription drug companies rely on for higher list prices. Removing this system could force these companies to adhere to transparency laws which ultimately would prevent price gouging.

Lastly, Biden has also claimed that he wants to include dental, vision, and hearing plans in Medicare
coverage. While this sounds great, there could be an increase in everyone’s premiums should these benefits be added. A stand-alone dental, vision, and hearing plan only costs a few dollars a month, so if premiums with these benefits included exceed that price, beneficiaries could end up paying more per month.

Biden’s proposed plans will certainly improve beneficiaries’ access to health care, however, we will need to wait for more detail on the logistics and structure to fully determine if this will benefit beneficiaries financially as well.

Lindsay Engle is the Medicare Expert and Organic Growth Manager at Elite Insurance Partners and MedicareFAQ.com