What’s New For Medicare In 2019?

Medicare costs change each year, so if you’re 65 or older, it’s important to understand and review your benefits for the upcoming year. Some new rules affect the cost of prescription drugs covered under Part D (Medicare’s prescription drug benefit) and change the times when you can revise your Medicare health and drug coverage.

Medicare Premiums and Deductibles in 2019

Medicare premiums and deductibles have risen a bit since 2018.

Medicare Part A covers inpatient hospital services, skilled nursing facility services, home health care and hospice, and people who have worked for more than 10 years — about 99% of Medicare beneficiaries — generally do not need to pay a premium. If you have worked between 7 ½  and 10 years, your Part A premium will increase to $240 per month in 2019, and if you have worked fewer than 7 ½  years, your Part A premium will be $437 per month.

The Part A deductible and coinsurances are also increasing this year. The hospital deductible will be $1,364. Beneficiaries must pay a coinsurance amount of $341 per day for the 61st through 90th day of a hospitalization in a benefit period. For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $170.50

Medicare Part B covers physician services, outpatient services, certain home health services and medical items. This year, the standard monthly premium for Part B is $135.50 for individuals with a yearly income below $85,000 ($170,000 for a married couple). If your income is higher than that, you may have to pay an income-related monthly adjustment amount, also known as an IRMAA. In that case, your monthly premium will be between $189.60 and $460.50, depending on your income.

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The Part B annual deductible is $185 in 2019, and you will continue to pay 20% for most Part B-covered services after meeting your deductible in 2019.

Medicare Prescription Drug Costs in 2019

The amount you pay for your prescription drugs on Medicare depends on which Part D prescription drug plan you are enrolled in and which coverage period you’re in. Every Part D plan has a premium; this year, the national average for Part D premiums is $33.19 per month.

Many Part D plans also have a yearly deductible. Deductibles vary from plan to plan, but no deductible in 2019 can be higher than $415. After meeting the deductible, you’ll pay your plan’s regular copays or coinsurances for any drugs you take (if you’re not sure of these amounts, call your plan using the number on the back of your membership card), until the total costs that you and your plan have paid for drugs in a year totals $3,820.

Once you and your plan have together paid $3,820 in drug costs, you will enter what is known as the donut hole or coverage gap. After falling into the donut hole, the amount you pay for prescription drugs increases, until you’ve spent $5,100 in out-of-pocket drug costs for the year. At that point, you enter the coverage phase known as catastrophic coverage. During this period, in 2019, you pay 5% of the cost of each drug, or $3.35 for generics and $8.25 for brand name drugs — whichever is greater.

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