What’s New in Medicare
Here is a quick summary of recent Medicare updates and changes.
Part B premium amounts stay level for current beneficiaries
- Most current beneficiaries will pay a Part B premium of $104.90 in 2016. This is the same amount that Medicare charged in 2015.
- People joining Medicare for the first time in 2016 will pay a Part B premium of $121.80.
- People with higher incomes may pay higher Part B premiums. The most that may be paid in 2016 is $389.90.
- The Part B annual deductible is $166 in 2016.
- The Part A deductible is $1,288 in 2016.
- The Part A premium, if you pay it, is $411 in 2016. For most people, Part A is premium-free.
Some Part D plans have split-tier deductibles
- In a tiered formulary, drugs on different tiers carry different out-of-pocket costs. Usually lower-tier drugs cost less.
- Plans with deductibles have generally applied the deductible to all covered drugs. Once the deductible was met, the plan started paying some of the cost for drugs.
- With a split-tier deductible, plans may charge a deductible for drugs on some tiers and not on others. Or the plan may charge one deductible amount for drugs on some tiers and a different deductible amount for drugs on other tiers.
Medicare expands some coverage and services
- Medicare's Blue Button allows you to get access to your personal health information. You can download 12-36 months of claims information for Part A and Part B. You can also get 12 months of claims information for Part D. Visit MyMedicare.gov to use the blue button.
- Blue Button users also have access to health applications and services to help analyze their health information. Visit bluebuttonconnector.healthit.gov to learn more.
- Medicare covers several preventative tests and exams, including new screening tests for lung cancer and colorectal cancer. Discuss screening options with your doctor.
Bigger discounts on prescription drugs during the coverage gap
- The Medicare Part D coverage gap continues to shrink. Your cost-sharing percentage for prescription drugs during the gap is less each year compared to the year before, until the gap closes in 2020.
- In 2016, you will pay 58% of the total cost for generic drugs or 45% of the total cost for brand–name drugs during the coverage gap. You may pay less if your private Medicare plan has additional coverage during the gap.
5-Star Special Enrollment Period
- If one is available in your area, you can switch to a 5-star Medicare Advantage plan through November 30, 2016.
- If your current Medicare Advantage plan includes drug coverage and you switch to a 5-Star Medicare Advantage plan that doesn’t, then you won’t be able to get drug coverage until the next Open Enrollment Period. You also may have to pay a penalty.
- You can only use this Special Enrollment Period one time each year.
- You can read about Medicare’s Star Ratings at Medicare.gov.