What to know about Medicare in 2015

 

Last updated 1/5/2015 at Noon

The New Year always brings a few changes to Medicare. Here’s a brief rundown of what to expect in 2015.

The best news is that there are no changes in Medicare’s Part B premium and deductible.

The standard premium for the part of Medicare that covers doctor visits and outpatient care will remain at $104.90 per month in 2015, just where it’s been for the last two years. That means more of your Social Security cost-of-living adjustment will stay in your pocket.

A small number of people with Medicare – about 4 percent – pay surcharges on their Part B premiums because their annual incomes exceed $85,000. They, too, will see no increase in their premiums for physician visits and outpatient services.

The Part B deductible for 2015 will also be the same as in 2014 -- $147. That’s what you pay out of pocket for doctor appointments and outpatient care at the beginning of each year before your Medicare coverage kicks in and helps to cover costs.

You’ll get bigger discounts on your drugs in the “doughnut hole.”

If you have a Medicare drug plan, the health care law is shrinking the coverage gap, or “doughnut hole,” and what you must pay out of pocket when you’re in it. For 2015, the gap begins once you and your drug plan together have spent $2,960.

When you reach the doughnut hole, you’ll receive bigger discounts on your brand-name drugs – 55 percent in 2015, instead of 53 percent this past year – and larger price breaks on your generics -- 35 percent in 2015, instead of 28 percent previously.

The discounts will continue to grow, year by year, until 2020.

If you’re dissatisfied with your Medicare Advantage plan, you can quit it beginning Jan. 1.

If you’re unhappy with your private Medicare Advantage health plan, an annual “disenrollment” period allows you to return to the traditional fee-for-service Medicare program between Jan. 1 and Feb. 14. You can also pick a drug plan to go with your new coverage.

A word of caution here: There are a few things you can’t do during the six-week disenrollment period. You can’t switch from one Medicare Advantage plan to another. Nor can you switch from the traditional Medicare program to an Advantage plan. Most people will need to wait until the annual enrollment period in the fall to make either of those changes.

If you’re one of the few Medicare beneficiaries who pay a Part A premium, your monthly bill will shrink a little in 2015.

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice services and some home health care. Most beneficiaries, or their spouses, have worked long enough to qualify for premium-free Part A coverage. For the 1 percent who must pay, their monthly premium will drop from $426 to $407 in 2015.

The Part A deductible that beneficiaries pay when admitted to the hospital will increase modestly – from $1,216 to $1,260. Once you meet your deductible, Medicare covers the full cost of your first 60 days in the hospital – there’s no co-payment.

Medicare’s websites will make it easier for you to compare health care providers.

Medicare’s “compare” websites – found at www.medicare.gov -- are good places to begin your research when looking for a nursing home, hospital, home health agency, dialysis facility or physician. This year, Medicare will make the websites even simpler to use.

The nursing home compare and the physician compare websites already display star ratings and have proved especially popular with consumers. Similar star ratings will be added in 2015 to help you compare hospitals, home health agencies and dialysis facilities.

You now have access to your personal health information through Medicare’s “blue button.”

Having ready access to your Medicare claims data gives you a better understanding of your health information and greater control. It also makes it easier to share your medical history with your doctors, caregivers or anyone else you choose.

Visit mymedicare.gov to use Medicare’s “blue button” today. You can download 12 to 36 months of claims information for Medicare Parts A and B and 12 months of claims information for Part D to your computer or mobile device.

As I said, this is just a quick look at Medicare’s more noteworthy changes. The “Medicare and You 2015” handbook you recently received in the mail has a complete summary. If you’d like, you can also visit www.medicare.gov and download a free digital version of the handbook to your e-reader.

Make the most of your Medicare benefits by staying informed.

By Bob Moos/Southwest public affairs officer for the U.S. Centers for Medicare and Medicaid Services

 

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