Medicare Pilot Program: What It Is and How to Enroll
Last Updated : 09/27/20193 min read
Medicare pilot programs may give you a chance to get benefits not currently covered under Medicare. If you’ve never heard of Medicare pilot programs, here’s how they work, why you might want to consider joining one, and how to enroll.
What is a Medicare pilot program?
Medicare pilot programs were set up under the Social Security Act.
The Center for Medicare and Medicaid Innovation uses Medicare pilot programs to test new ways of improving patient care and lowering Medicare, Medicaid, and Children’s Health Insurance Program costs. So, how do Medicare pilot programs work, exactly?
Medicare pilot programs are short-term projects that test changes in payment methods, quality of care, or benefits. Also known as “demonstrations” or “research studies,” Medicare pilot programs are usually offered by the Medicare program for only a short time. They’re typically limited to specific groups of people in certain locations.
Medicare pilot programs let the Medicare program stay nimble and test the effectiveness of new ideas on a smaller group before unleashing them to the entire program. They can try out new ways to manage chronic illnesses, lower costs, and improve patient care.
Should I enroll in a Medicare pilot program?
One reason you might consider joining a Medicare pilot program is that it could give you temporary access to new benefits not currently covered under Medicare.
Keep in mind that not all Medicare pilot programs are offered in every location. Even if one is available in your area, you may not be eligible. Your costs and benefits for the Medicare pilot program may be different from what you normally pay through Medicare. Since participation is voluntary, you’re allowed to leave the Medicare pilot program for any reason and at any time.
Examples of Medicare pilot programs
One previous Medicare pilot program tested whether nursing call centers would lower emergency room visits and health-care costs. The Medicare pilot program found that even though the nursing call centers were expensive for the Medicare program, they didn’t really affect patient care – which may be one reason why Medicare doesn’t currently cover nursing support hotlines or call-based health coaches.
An ongoing Medicare pilot program called the Medicare Care Choices Model tests whether terminally ill Medicare patients would be more likely to get hospice care if they were allowed to continue receiving curative treatments. A 2016 report found that fewer than half of deceased Medicare beneficiaries had enrolled in hospice care before passing. Those who did get hospice only used services for a short time, averaging about 17 days.
Under current hospice rules, Medicare patients who decide to get hospice must agree to stop any treatment that is meant to cure their terminal illness (although treatment for comfort or to treat symptoms is allowed).
How to enroll in a Medicare pilot program
Medicare pilot programs vary when it comes to where they’re offered and who is eligible. If you’d like to learn more about Medicare pilot programs offered in your location and whether you might be eligible, contact Medicare at 1-800-MEDICARE, 24 hours a day, seven days a week in all U.S. time zones.
Hopefully, you now have a better understanding of how Medicare pilot programs work. If you’re interested in taking a look at plan options that could save you money, you can do that from this page as well. Just enter your zip code into the plan finder tool to get started.