During the Medicare annual enrollment period, Oct. 15 to Dec. 7, all Medicare beneficiaries have the option to change their Medicare plans for the coming year to better match their needs. This includes anyone using original Medicare, Medicare Advantage or Part D prescription drug plans.
Medicare is not part of the Health Insurance Marketplace. Anyone with Medicare is considered covered and won’t face penalties for being uninsured under provisions of the Affordable Care Act (ACA). Medicare annual open enrollment runs Oct. 15 to Dec. 7. (Note: Health Insurance Marketplace enrollment is from Oct. 1, 2013, through March 31, 2014, according to the U.S. Department of Health & Human Services (HHS).)
Medicare recipients reaching the drug donut hole will benefit from lower costs. The gap in prescription drug coverage starts when someone reaches the initial coverage limit, estimated at $2,850 in 2014. It ends when they have spent $4,550, when catastrophic coverage begins. (These are reductions of $120 and $200, respectively, from 2013.) During the donut hole, all costs are covered by individuals out of their own pocket.
In 2014, those who reach the donut hole can receive a 52.5 percent discount on brand-name drugs and 28 percent discount on generic drugs (an increase from 21 percent in 2013).
Under catastrophic coverage, they are responsible for a co-pay of $2.55 for generic or preferred multisource drugs (down from $2.65 in 2013) with a retail price up to $51 and $6.35 for all other drugs (down from $6.60 in 2013) with a retail price up to $127. For 2014, however, beneficiaries are responsible for a 5 percent cost-sharing fee for drugs over those retail prices.
Medicare Part B premium changes are expected
In each of the past three years, Part B premiums have increased. The 2013 monthly premium for Medicare Part B (medical insurance) was $104.90, an increase from $99.90 in 2012. In addition, because Part B premiums are based on the beneficiary’s income and those income levels are frozen at 2010 levels, more individuals could see their premiums change. Information on the standard Part B premium for 2014 should be available by the time Medicare annual open enrollment begins Oct. 15.
Prescription drug Part D plans will see slight changes in deductible and premiums
The Part D initial deductible decreases by $15 to $310. HHS also recently reported the Part D monthly premiums will remain relatively stable, at $31 for a basic prescription drug plan in 2014. This is close to the reported average premium of $30 for the past three years (2011-13). Part D premiums are subject to the same income-based thresholds as Part B.
Changes anticipated for Medicare Advantage plans
Not all plans change every year, but common changes include costs, such as premiums, deductibles and co-pays, and changes to covered procedures, tests, medical facilities and other provisions. Some plans may be eliminated, which means beneficiaries will need to select a new plan or default to original Medicare Part B. Enrollment in Medicare Advantage plans continues to grow with 14.4 million people enrolled, an increase of more than 1 million from 2012, according to the Kaiser Family Foundation.
Most Medicare participants will receive their Annual Notice of Change (ANOC) and Evidence of Coverage (EO) from their current Medicare Advantage and Part D providers by Sept. 30.
It’s crucial people review materials as soon as they receive them and asses their current healthcare needs.
Healthcare costs are a critical line item in most people’s budget, and especially so for seniors and people with disabilities.
Believing your current plan will continue to cover your needs in the same way can lead to unexpected and costly surprises.
Medicare specialists such as Mintco Financial Independent Advisors are available to help consumers and their family members review Medicare plans and choices for 2014 coverage.
For many people, this can be a time-consuming, confusing and complex evaluation process, especially when comparing Part D plans or Medicare Advantage plans.
For an evaluation of Medicare options, call a Mintco Financial Medicare Advisor specialist at 813-964-7100 ( Ask for Lloyd Schneider) or visit Click Here for Annuity Quote
Employers also can use Mintco Financial Medicare Advisors for their employees who are retiring and transitioning to Medicare. Call 813-964-7100