Open enrollment for Medicare beneficiaries begins on October 15 and ends December 7. This is the time of the year when Medicare beneficiaries need to review their current health insurance coverage primarily for prescription drugs through Medicare Part D.
For those individuals who are currently enrolled in a Medicare Advantage Plan and want to change plans or return to original Medicare, now is the time to make that change as well.
One major change will be a Social Security Cost of Living Adjustment (COLA). Depending on the amount of the COLA, you will likely see a change in the Medicare Part B premium that is charged each month. Some beneficiaries may see a decrease in their Part B premium, as overall costs to the Medicare program have decreased and by federal law, the Part B premium must also decrease.
Not all of the 2018 changes in deductibles, copays and coinsurance have been released. Part C and D premiums and copays will vary based on the plan.
More about Part D
The standard benefit for Part D has been released. The annual deductible will be $405. After the deductible is paid, you pay 25 percent of the next $3,345 costs of prescriptions. If the total cost of the prescriptions exceeds $3,750 (a deductible of $405 plus $3,345 of initial coverage), you enter the “donut hole,” or the coverage gap.
When the plan and you pay out of pocket an additional $3,758, you will be eligible for catastrophic coverage. After the annual cost of the drugs exceeds $7,508, most costs will be paid by Medicare, with you
paying a small copay. When you are in the donut hole, you will pay 44 percent of the cost for generics and 35 percent for name-brand drugs, plus a dispensing fee.
Other new changes
In 2018 and 2019, Medicare will be issuing new Medicare cards to all beneficiaries. The new cards will have a unique number, different from your Social Security number, to prevent fraud and abuse. Medicare will start issuing these cards in April.
As usual, Colorado will see some consolidation of Medicare Advantage Plans (Part C) and Prescription Drug Plans (Part D), as well as some players leaving the market and some new players coming in. New rates for 2018 will be released on October 1 at www.medicare.gov or by calling 1-800-MEDICARE.
High income earners making more than $85,000 in adjusted gross income will see some significant increases in their Part B and Part D premiums.
Beneficiaries who continue to work have many choices to make about their health insurance. Some of the choices are guided by federal law and others are driven by the employer. Most beneficiaries will automatically receive Medicare Part A at age 65. But decisions are necessary for Part B and Part D.
Beneficiaries who continue to work may 1) enroll in Part B and D at age 65, 2) keep their employer coverage with Medicare B paying either primary or secondary, 3) delay enrollment in Medicare Part B and D, or 4) in some instances continue to be enrolled in the marketplace plan.
If you are staying in the labor force, getting accurate information and filing the correct paperwork is critical to avoid paying Part B and Part D penalties in the future. Experience has shown that friends, employers, navigators, insurance companies and sometimes government officials give inaccurate information, leaving beneficiaries without insurance coverage for months, as well as costing them significant penalties for the rest of their life.
It is important to research your situation to make the right decision for you.
To learn more about all the changes, join the Colorado Gerontological Society for a free Medicare Monday educational program.
October 16, 9:30-11:30 a.m. The Commons of Hilltop Grand Junction
November 7, 9:30-11:30 a.m. Bill Heddles Recreation Center Delta
Reserve your space at www.senioran swers.org or call 1-866-294-3971. Medicare experts will be available to answer questions. On the website, you can also sign up to take a “New to Medicare” class online. Counselors will take individual appointments as well. For more information, call 303-333-3482.