By Budd McLaughlin
There’s a little bit of good news for Medicare recipients — particularly Part B coverage.
The plan usually increases as recipients’ income increases. However, this year, Part B deductibles and premiums will stay the same as last year.
Other plans though will likely see an increase this year.
“They should always get their ‘Medicare & You’ handbook out,” said Jennifer Reece, the local coordinator for the State Health Insurance Assistance Program. “If you get your health benefits from original Medicare, the Part A costs generally changes every year.”
Reece said Medicare Part A covers inpatient hospital services, skilled nursing facility services, home health care and hospice; Medicare Part B covers outpatient medical services, such as physician services.
“They should always look through their new ‘Medicare & You’ handbook to understand the benefits and costs for Part A services and Part B services.”
Reece said recipients should have received their handbooks in the fall. If they haven’t, they can contact her at 256-233-6412.
This year, the Part A hospital deductible has increased from $1,184 to $1,216 each benefit period and the hospital coinsurance for days 61-90 has increased from $296 to $304 each benefit period, she said. Skilled nursing facility coinsurance for days 21-100 has increased from $148 to $152 each benefit period.
She also said diabetes medication is covered under Part B, “people mistakenly think it’s under Part A.”
“If they have a Medicare Advantage plan, it provides Part B coverage,” Reece said. “Most people with Medicare, whether they have original Medicare or a Medicare Advantage plan, pay the Part B monthly premium.
“If they have the same Medicare Advantage plan in 2014 as they did in 2013, the plan should have sent them a notice of change/evidence of coverage explaining the changes for this year during fall 2013.”
Reece also said that, unlike original Medicare, Medicare Advantage plans may only cover health care services they receive from providers within their plan’s network.
“Networks are subject to change, so they need to check with their doctor or health-care provider to make sure they are still in the recipient’s network,” she said. “If they have original Medicare, they may see any provider who accepts Medicare.”
Reece reiterated the importance of people checking with the plans directly to find out what changes there may be this year from last year.
“Medicare private drug plans can change the drugs they cover, the rules for coverage, and costs (such as copayments, coinsurances, and deductibles) from year to year,” she said. “People can get their Medicare prescription drug coverage through a Medicare Advantage plan that covers both health and drug coverage, or a stand-alone Part D plan that works with original Medicare.
“Their Part D plan should also send them the annual notice to inform them of their plan’s benefits, costs and covered drugs.”