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The U.S. Medicare Handbook is photographed Thursday, Nov. 8, 2018, in Washington. Seniors in many states will be able to get additional services like help with chores, safety devices and respite for caregivers next year through private ‘Medicare Advantage’ insurance plans. It’s a sign of potentially big changes for Medicare. (AP Photo/Pablo Martinez Monsivais)

The U.S. Medicare Handbook is photographed Thursday, Nov. 8, 2018, in Washington. Seniors in many states will be able to get additional services like help with chores, safety devices and respite for caregivers next year through private ‘Medicare Advantage’ insurance plans. It’s a sign of potentially big changes for Medicare. (AP Photo/Pablo Martinez Monsivais)

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