Coming Soon: Medicare Changes in 2019

Millions of Americans rely on Medicare to help them with their healthcare needs. It provides basic
health insurance to senior citizens (aged 65 and older) and other qualified individuals.
In an effort to deliver the best service as efficiently as possible, the program constantly updates its
policies – and next year is no different. Here’s what you need to know about your Medicare coverage
going into 2019.

Medicare Part A: Changes to Premiums, Deductibles, and Coinsurance

For 2019, Medicare Part A will be undergoing changes with its premiums, deductibles, and coinsurance. As a refresher, Part A covers hospital insurance. Most people are automatically eligible for it at age 65 and there are no premiums. However, there is a premium for those who don’t have 40 quarters of work history.

That premium will be $240/month for people who have between 30 and 40 quarters of work history. For those with less than 30, it’s going to be $437/month.

Part A deductibles will also see an increase in 2019 that will affect all enrollees. From $1,340, it’s going up to $1,364 for each benefit period. This deductible only covers the first 60 days of inpatient hospital care. If additional care is needed, there’s a coinsurance charge of $341/day for days 61-90. Beyond that, it’s going to be $682 per day.

For beneficiaries that will be receiving care in a skilled nursing facility (SNF), the coinsurance charge will be $170.50/day for days 21-100. Note that for Medicare to cover SNF care, the patient will need to have been admitted to a hospital for at least 3 days prior to the transfer to the SNF. The first 20 days are covered by the Part A deductible that should have been paid for during that hospital stay.

2019 Changes: Medicare Part A 2018 2019
Part A Premium for those with between 30 and 40 quarters of work history $232/month $240/month
Part A premium for those with less than 30 quarters of work history $422/month $437/month
Part A Inpatient Deductible $1,340/benefit period $1,364/benefit period
Coinsurance charge for days 61-90 of inpatient care $335/day $341/day
Coinsurance charge for days 90 and beyond of inpatient care $670/day $682/day
Coinsurance charge for days 21-100 of skilled nursing facility care $167.50/day $170.50/day

Medicare Part B: New High-Income Bracket and Changes to Premiums and Deductibles

Medicare Part B covers medical insurance for things like outpatient care and visits to your doctor. For 2019, the standard monthly premium for this will be $135.50/month. 3.5% of Part B beneficiaries will pay less than that amount because of the statutory hold harmless provision that prevents their Social Security checks from being reduced due to the increase in premiums.

Part B premiums scale depending on income. Introduced for 2019 is a new high-income bracket that covers enrollees with an income of $500,000 or more. For those in this bracket, they’ll be paying $460.50/month for Part B premiums. You can find the premiums that each bracket will have to pay here.

As for the Part B deductible, it has increased to $185/month in 2019. There are enrollees that have additional coverage that pays for the Part B deductible. Among these are Medigap plans C and F. But due to the Medicare Access and CHIP Reauthorization Act of 2015  (MACRA), they can only be sold through 2019. The goal of MACRA is to lower utilization by having enrollees share some out-of-pocket costs. Current enrollees can keep their existing Plan C and F but the plans will no longer be offered to new enrollees.

Here’s a comparison of the Part B changes between 2018 and 2019:

2019 Changes: Medicare Part B 2018 2019
Part B standard premiums
(Premiums scale depending on income bracket.
Click here to view all income brackets.)
$134/month $135.50/month
Part B Annual Deductible $183/month $185/month
Starting in 2019, the disenrollment period (which was from January 1 to February 4) for Medicare Advantage will be replaced by its own open enrollment period. This will last from January 1 to March 31 during which enrollees can update their Advantage plan or drop it altogether and enroll in original Medicare.

Medicare Part D: Higher Deductible, Lower Average Basic Premium, and More Affordable Prescriptions

Also called the Medicare prescription drug benefit, Medicare Part D is an optional program that covers prescription drug insurance.

Another premium that’s expected to decline is the average monthly premium basic Medicare prescription drug plan. It is estimated to go down to $32.50/month in 2019 (from $33.59/month in 2019). However, the initial deductible for prescriptions will go up from $405 in 2018 to $415 in 2019.

Thanks to the Affordable Care Act, the donut hole in Part D is slowly being closed. Starting in 2019 enrollees in the donut hole only need to pay 37% of the plan’s cost for generic drugs and only 25% for brand-name drugs.

Telemedicine: Reaching Those Who Need It Most

Many seniors with mobility issues find it difficult to travel for their doctor’s appointments. They may even choose to postpone or skip their health assessments.

To address this, Medicare offers a telehealth program that lets patients communicate with their doctors from the comfort of their home. This allows doctors to evaluate whether a patient needs further care by communicating via phone or video conference.

From 2019, patients who have end-stage renal disease receiving home dialysis and those undergoing treatment for a stroke can have their telehealth services covered.

Each year, there’s bound to be some changes with Medicare. It’s important to keep up if you don’t
want to get caught off-guard with your healthcare.

Let The Benefit Link guide you through the Medicare maze. For over 27 years, we’ve helped seniors
with their coverage concerns. Because we’re independent of any insurance agency, we provide
objective advice that fits your specific needs. Give us a call today at (844) 482-2910.

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