By Bob Moos
The New Year brings improvements and other changes to Medicare. Here’s a brief rundown of what to expect in 2014.
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 your doctor visits and outpatient hospital care will stay the same -- $104.90 per month. Over the past three years, the premium has remained unchanged or turned out lower than first projected.
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 2014 will also be the same as this past year -- $147. That’s what you pay out of pocket for your 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 price breaks on your generic drugs in the “doughnut hole.”
If you have a Medicare drug plan and reach the coverage gap, you’ll receive bigger discounts on your generic prescriptions – 28 percent in 2014, compared with 21 percent this past year. You’ll also continue to get about 53 percent off your brand-name drugs.
The price breaks are adding up. More than 233,100 Texans with Medicare have saved $201.9 million on their prescriptions in the coverage gap this past year – an average of $866 per person. The discounts will continue to grow until the doughnut hole disappears in 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 not old enough yet for Medicare but need health care coverage, help is here.
If you have Medicare, you don’t need to do anything about the new Health Insurance Marketplace. But if you, a spouse or another family member are too young for Medicare and lacking insurance, this new way of buying coverage may be for you.
Health plans sold through the Marketplace will provide you with affordable and comprehensive coverage. Insurers can no longer deny you coverage, or charge you more, because of a pre-existing medical condition. Enrollment continues until March 31.
You can shop and sign up online at healthcare.gov or by phone at 1-800-318-2596. You can also sit down with a trained counselor and enroll. For a list of counselors in your community, visit localhelp.healthcare.gov or call the 1-800 customer service number.
People with incomes up to $45,960 for individuals and $94,200 for families of four may qualify for tax credits to reduce their premiums. Some applicants may also qualify for help with deductibles, co-payments and other out-of-pocket costs.
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 2014” handbook you recently received in the mail has a complete summary. If you’d like, you can also visit 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.
Moos is the Southwest public affairs officer for the Centers for Medicare and Medicaid Services