2019 Medicare Changes Summary:
- The standard Part B Premium is $135.50/month.
- About 3.5% of enrollees will pay less for Part B.
- New Medicare Part B high-income bracket for enrollees with income above $500,000.
- Medicare Part B deductible increased to $185 for 2019.
- Medicare Part A premiums, deductible, and coinsurance are higher in 2019.
- Part D basic premiums decreasing; more part D plans available, donut hole closing early for brand-name drugs.
- Medicare Part A inpatient deductible for hospital admittance will increase from $1,340 to $1,364.
- The Medicare Part A premium for people with 30+ (but less than 40) quarters of work history, the premium for Part A is increasing from $232/month to $240/month.
- The Medicare Part A premium for people with fewer than 30 quarters of work history, the premium for Part A is increasing from $422/month to $437/month.
- Part A has a deductible that applies to each benefit period (rather than a calendar year deductible like Part B or private insurance plans) is increasing from $1,340 to $1,364*.
*This increase applies to all enrollees, although many enrollees have supplemental coverage that pays all or part of the Part A deductible.
- The Part A deductible covers the enrollee’s first 60 inpatient days during a benefit period. If the enrollee needs additional inpatient coverage during that same benefit period, there’s a daily coinsurance charge. In 2019, it’s $341 per day for the 61st through 90th day of inpatient care (up slightly from $335 per day in 2018). The coinsurance for lifetime reserve days is $682 per day in 2019 (up from $670 per day in 2018).
- For care received in skilled nursing facilities, the first 20 days are covered with the Part A deductible that was paid for the inpatient hospital stay that preceded the stay in the skilled nursing facility (Medicare only covers skilled nursing facility care if the patient had an inpatient hospital stay of at least three days before being transferred to a skilled nursing facility). But there’s a coinsurance that applies to days 21 through 100 in a skilled nursing facility. In 2019, it’s $170.50 per day, up from $167.50 per day in 2018.
- The standard monthly premium of Medicare Part B will increase from $134/month to $135.50/month.
- The annual deductible for Medicare Part B will be $185.
- A new High-income bracket has been added dividing the above $160,000 bracket into two new brackets:
- Above $160,000 and Less than $500,000
- $500,000 or Above
- For stand-alone Part D prescription drug plans, average basic premiums are dropping to a projected average premium of $32.50/month, down from $33.59/month.*
*It’s important to understand that the average basic premium is less than the average enhanced plan premium, so overall average Part D premiums are higher than the average basic premiums.
- There’s also a significant increase in the number of Part D plans available in 2019, but Kaiser Family Foundation notes that is likely due to the fact that CMS eliminated the meaningful difference requirement for Part D plans, allowing a single insurer to offer more plans than they’ve had in the past.
- The good news is that the Affordable Care Act has been gradually closing the donut hole in Medicare Part D. In 2019, enrollees pay just 37 percent of the plan’s cost for generic drugs while in the donut hole. And the donut hole is closing one year early — in 2019, instead of 2020 — for brand-name drugs, which will cost the enrollee just 25 percent of the plan’s cost in 2019 (down from 100 percent before the ACA started to close the donut hole).
- The maximum allowable deductible for standard Part D plans increased from $405 to $415.