What’s New in Medicare
Here is a quick summary of recent Medicare updates and changes.
Part B premium amounts stay level
- Most people will pay a Part B premium of $104.90 and a deductible of $166 in 2016.
- People with higher incomes may pay higher Part B premiums. the most that may be paid in 2016 is $389.90.
- The Part A deductible rose to $1,288 for 2016. It was $1,260 in 2015.
- The Part A premium, if you pay it, is $411 in 2016. For most people, Part A is premium-free.
Some Part D plans introduce 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 a new non-invasive colorectal cancer screening called a fecal occult blood test. Discuss screening options with your doctor.
- Mental health care is now covered at the same rate as other medical services. You pay 20% of the Medicare-approved amount, as long as the provider accepts Medicare assignment.
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.