| Thu, Feb 26, 2015 @ 09:00 AM

Here’s What’s New for Medicare in 2015

Posted by Medicare Made Clear

medicareA new year usually means new changes. That applies to Medicare insurance as well. Here are the highlights for 2015.

Health Insurance Marketplace and Medicare

The Health Insurance Marketplace, established by the Affordable Care Act of 2010, will have little impact on most Medicare beneficiaries. You will continue to get your health coverage through Original Medicare or a private Medicare plan. However, individuals who buy health insurance in the Marketplace and later become eligible for Medicare need to pay attention to timing when transitioning to Medicare insurance, to avoid coverage gaps and potential enrollment penalties.

Monthly Premiums and Yearly Deductibles

Medicare Part A The Part A deductible went up slightly from $1,216 in 2014 to $1,260 in 2015. Most people with Medicare don’t pay a premium for Part A, but for those that do; their premium went down from $426 in 2014 to $407 in 2015.

Medicare Part B The Part B premium and deductible amounts stayed the same as they were in 2014. For most people, the Part B premium is $104.90 and the deductible is $147. People with higher incomes may pay a higher Part B premium of $335.70, at most.

Medicare Part D There are changes to the coverage gap and to the tiered formulary.

If you enter the drug coverage gap this year, you may qualify for some savings on brand-name and generic drugs. You pay 45 percent of the total cost for covered brand-name drugs and 65 percent of the total cost for covered generic drugs. You may pay less if your private Medicare plan has additional coverage during the gap.

Some Part D plans introduced split-tier deductibles in 2015.

  • In a tiered formulary, drugs on different tiers carry different out-of-pocket costs. Usually lower-tier drugs cost less.
  • Plans with deductibles have generally applied the deductible to all covered drugs. Once the deductible was met, the plan started paying some of the cost for drugs.
  • With a split-tier deductible, plans may charge a deductible for drugs on some tiers and not on others. Or the plan may charge one deductible amount for drugs on some tiers and a different deductible amount for drugs on other tiers.

Coverage for Preventive Tests and Other Medical Services

Medicare covers more copay-free preventive tests and exams, including a new non-invasive colorectal cancer screening called a fecal occult blood test.

Mental health care is now covered at the same rate as other medical services. You pay 20 percent of the Medicare-approved amount, as long as the provider accepts Medicare assignment.

Talk to your doctor about which preventive tests are right for you. See page 61 in Medicare & You 2015 (below) for a checklist of preventive tests.

Medicare Blue Button

Medicare has expanded its Blue Button feature to give you better electronic access to your Medicare insurance claims and personal health information. You can download 12-36 months of claims information for Part A and Part B. You can also get 12 months of claims information for Part D. Visit bluebuttonconnector.healthit.gov to learn more.

The Blue Button feature also lets you:

  • Reference your health records to be reminded when you had your last shot, or the exact date of a procedure.
  • Check the accuracy of your records, monitor changes, and stay aware of your health status.
  • Share with your doctor, when traveling seeking a second opinion, moving, switching insurance, on in case of emergency.
  • Use Apps to help better manage and coordinate your healthcare to achieve your health goals.

Since every plan is different, be sure to review the materials your Medicare health or prescription drug plan sends you, like the Annual Notice of Change (ANOC) for changes in costs and coverage to your particular plan.

For more information, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.


Medicare & You 2015: Medicare.gov

What’s New in Medicare: MedicareMadeClear.com

Medicare 2015 Costs at a Glance: Medicare.gov


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