Medicare Blueprint Advisors - March/April 2020

Good News for Those With ESRD

Nothing means more to us than hearing we’ve made a positive impact on our clients’ lives. We’re so grateful for all those who have shared their kind words with us over the years. Here are a few that touched our hearts! What Our Clients Think!

Medicare Advantage Plans Might Be Opening Up

Throughout the history of Medicare’s existence, people with end- stage renal disease (ESRD) have been ineligible for many plans. In fact, those facing ESRD today are only able to enroll in Medicare Parts A and B and are barred from any Advantage plans through Part C. There are a few exceptions, such as when one develops the disease while already enrolled in a plan, but for the vast majority of those struggling with this illness, health care options have been limited. But a new proposal is looking to change this. In February of this year, the Centers for Medicare and Medicaid Services (CMS) made a proposal for removing restrictions on ESRD patients from enrolling in Advantage plans. This is part of the CMS’s efforts to meet the requirements of the Cures Act signed into law in 2016. According to the law, eligible individuals with ESRD will be able to enroll in Advantage plans beginning January 1, 2021. The CMS is still hashing out details on how the medical community can meet the requirements of the Cures Act. As it stands, CMS has proposed that, in exchange for Advantage plan organizations opening up to meeting the medical needs of those with ESRD, Original Medicare (A&B) will take on the costs of kidney acquisitions and transplants for Medicare Advantage beneficiaries. Of course, this arrangement may change as negotiations continue. Regardless of how the details shake out between the CMS and Advantage plan organizations, this is sure to be a welcome change for those facing ESRD and their loved ones. Having more plans to choose from will help them get the quality care they need. We’ll continue to watch this initial proposal as it develops. If you have ESRD and have questions about the options available to you, please feel free to reach out to us at 888-335-9498.

“ Very prompt in answering questions and always helpful.”

–Elizabeth Hamilton, customer since 2017

“Very knowledgeable staff (actually wrote the book on Medicare) who are easily accessible and take the time to explain all options.”

–David Meacher, customer since 2017

“If ever I have questions, time is always taken to get me answers! That makes me feel important. Thank you.”

–Sadie Clark, customer since 2018



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