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WELCOME 2020!



Some Medicare Advantage Plans cover services that are not covered by Original Medicare. Common supplemental benefits include dental care, vision care, and hearing aids.

In 2019, Medicare Advantage Plans were granted more flexibility in the supplemental benefits. This includes the ability to offer benefits that are not directly considered medical care and this might include in-home supports and home modifications.

For this year, 2020, plans are now allowed to begin offering supplemental benefits that are not primarily health-related for individuals who have chronic illnesses. These benefits might include meal delivery, transportation for non-medical needs, and home air cleaners. 

Fact: Medicare Advantage Plans, sometimes referred to as Part C, contract with the federal government and are paid a fixed amount per person to provide Medicare benefits. Plans must provide all Part A and Part B services offered by Original Medicare, but can do so with different rules, costs, and restrictions that can affect how and when you receive care. 


Medigap Changes

As a result of federal legislation, individuals who are newly eligible for Medicare on or after January 1, 2020, will not be able to purchase Medigap Plan C or Plan F (including the Plan F high-deductible option). This is because, after such date, the law prevents individuals new to Medicare from purchasing Medigap that pays for the Part B deductible. This law also applies to the three states - Massachusetts, Minnesota, and Wisconsin, that operate their own Medigap systems. However, If you were eligible for Medicare before January 1, 2020, you will not be affected by these Medigap changes and will still be able to purchase Plan C or Plan F.


Donut Hole Closure

Donut Hole is a phase of Part D coverage during which you pay more for the cost of your prescription drugs. In the past, beneficiaries used to pay a high percentage of the cost of their drugs, but over the years this percentage has been decreasing. The donut hole closes completely in 2020, which means that you pay, on average, 25% of the cost of your generic and brand-name drugs.



Part A Costs: Hospital Insurance

Premium

If you’ve worked 10 years or more                                      Free
If you’ve worked 7.5 to 10 years                                         $252 / month
If you’ve worked less than 7.5 years                                   $458 / month

Deductible

For each benefit period                                                        $1,408

Hospital Coinsurance

First, 60 days of inpatient care each benefit period              $0
For days 61-90 each benefit period                                      $352 / day
After day 90 in a benefit period                                           $682 / day
                                                                                Lifetime reserve day


Skilled Nursing Facility-Coinsurance

First 20 days of inpatient care each benefit period              $0

For days 21 – 100 each benefit period                                 $176/day


A benefit period begins the day you start getting inpatient care. It ends when you haven't received an inpatient hospital or skilled nursing facility care for 60 days in a row.

You have 60 lifetime e days that can only be used once and they are not renewable.



Part B Costs: Medical Insurance

Premium

Standard premium if your annual income is                         $144.60 / month
below $87,000 ($174,000) for couple

People with high incomes have a higher Part B premium.

People with limited incomes may be eligible for the Medicare Savings Program for help paying their Part B premium.

Deductible

The Annual amount of                                                                 $ 198 / year

Coinsurance

For the most part B-covered services                                          20%




Part D Costs: Prescription Drug coverage
Premium

The premium varies by Part D plan                                     $ 32.74 / month

People with higher incomes have higher Part D premiums.

Deductible

The deductible varies by Part D plan                                  Up to $ 435 / year

If you have extra help, you will have a low or no deductible.



Part D Coverage Phases

  • Deductible Period
       If your plan has a deductible, you will have to pay the full costs of your drugs (1005) until you meet the amount.
  • Initial Coverage Period
      It begins after you meet the deductible.
      Brand-name drugs: You pay 25%; get 75% discounted 
      Generic drugs: You pay 25%; get 75% discounted
  • Catastrophic Coverage
      Begins when you have paid $6,350  for your covered drugs (does not include the premium).
      Your plan pays 15% and Medicare pays 80%.


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Medicare Part D Costs for 2020

Before 2006, Medicare did not cover prescription medications. There was a limited number of medications that were offered under Medicare Part Band,  and otherwise, you had to pay for your medications out of pocket. In 2003, everything had changed when President George W. Bush passed the Medicare Prescription Drug, Improvement, and Modernization Act (MMA). This is what we now know of as  Medicare Part D , an optional part of Medicare that provides prescription drug coverage. Part D plans are run by private insurance companies and not by the government. However, the federal government sets guidelines on what basic medications are covered and how much you can be charged.  A deductible is the amount of money you spend out of pocket before your prescription drug benefits begin. Your plan may or may not have a deductible. The maximum deductible a plan can charge for 2020 is set at $435. It has increased by  $20 from 2019. Part D
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Benefit Period

The benefit period is the length of time during which a benefit is paid. It   measures your use of  inpatient  hospital and  skilled nursing facility (SNF)  services. This  begins the day you are admitted as an inpatient, or to an SNF, and ends the day you have been out of the hospital or SNF for 60 days in a row. After you meet your  deductible ,  Original  Medicare  will pay in full for days 1 to 60 that you are in a hospital. The remaining days, 61-90 , you will have to pay a  daily coinsurance. If your 90 days of hospital coverage has been consumed but you need to stay longer, Medicare covers up to 60 additional lifetime reserve days and yo u will also have to pay a daily  coinsurance . These days are nonrenewable , meaning you will not get them back when you become eligible for another benefit period. If you run out of days during your benefit period, Medicare will stop paying for your in-patient related hospital costs such as room and board.  To be eligible for a new b
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Comparing Health Care Providers

How do I compare the quality fo Health Care Providers? Medicare collects information about the quality and safety of medical care and services given by most health care providers (and facilities). Check Medicare.gov/quality-care-finder and get a snapshot of the quality of care they give their patients. Some feature a star rating system to help you compare quality measures that are important to you. Find out more by: Talking to your health care provider. Each health care provider should have someone you can talk to about quality. Asking your doctor or other health care provider what he or she thinks about the quality of care other providers give. You can also ask your doctor or other health care provider about the quality of care information you find on Medicare.gov . Having access to quality and cost information upfront helps you get a complete picture of your health care options. You'll be able to compare quality ratings, cost information, and other details to hel
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