Every year there are changes within the different aspects of Medicare in terms of premiums and cost sharing Medicare beneficiaries are responsible for. It can be challenging for seniors to keep up with all the changes from year to year and that is exactly where we can help! There are a few key facts that may affect you during 2015.
First of all premiums for some parts of Medicare will change. The Part B premium will remain the same at $104.90 for participants whose modified adjusted gross income is below $85,000 for single or married filing separate tax status and $170 for couples who file jointly. For most people, Medicare Part A is free however, for the few people that pay for Part A the premium is being reduced from$426 to $407, down $19 from 2014. Medicare participants who have worked and paid into Medicare at least 40 quarters during their lifetimes are automatically eligible for Medicare Part A at no charge.
While the premium changes have been in the favor of Medicare participants, the inpatient hospital deductibles have not, they have actually increased $44 to $1260 for 2015. Daily coinsurance amounts will also rise $11 up to $315, lifetime-reserve daily deductibles have gone up $22 to $630, and skilled-nursing facility daily co pays rose $7.50 to $157.50.
There continues to be 3 parts to Medicare’s prescription drug coverage – The Initial coverage, The Coverage Gap and The Catastrophic coverage. The Initial coverage grew from $2850 to $2960. In this phase, you might have a deductible and then you pay a copay or cost share and the plan pays the remainder of the drug cost. You will be in this level of coverage until the combined total cost reaches $2960 for covered medications purchased through contracted pharmacies. In the Coverage gap, you will pay 45% of the cost for covered “name brand” medications and 65% of the cost for generics. In most instances you will get a rebate for 52.5% of the name brand cost towards your out-of-pocket maximum. You will stay in this coverage level until the total amount you have paid including the rebate reaches $4700 up $150 from 2014. Once in The Catastrophic level, most people will pay 5% of the RX cost.
Medicare in general is very confusing for most as a whole, but when the plans, premiums, and deductibles continue to change from year to year it adds more confusion for those already struggling to understand Medicare and the different parts. Being aware of the changes for 2015 can help you be prepared for the rest of the year.