Changes to your Medicare costs in 2016

~ By Kim Latta,Colorado Division of Insurance ~

Your Medicare coverage can change each year, so it is important to understand and review your benefits and costs.

Point 1: Review changes to your health coverage costs for 2016.
Some costs associated with Medicare Part A have stayed the same for 2016 and some are higher. Remember, Part A covers inpatient hospital services, skilled nursing facility services, home health care, and hospice. You will notice these increases for 2016:

  • A $28 increase in the hospital deductible, now $1,288 each benefit period.
  • The hospital daily coinsurance rates are also higher by either $10 or $14 per day, depending on the number of inpatient days used in a benefit period. It is now $322 per day for days 61-90 and $644 per day for days 91-150 in each benefit period.
  • Your skilled nursing facility coinsurance has also seen a $3.50 increase per day for 2016, and it is now $161 for days 21-100 in each benefit period.

Some costs associated with Medicare Part B have stayed the same for 2016, and some are higher. Remember, Part B covers outpatient medical services, such as physician services. For most people with Medicare, the Part B premium will remain the same at $104.90 per month. However, if you are new to Medicare Part B in 2016, the standard Part B premium will be higher: $121.80 per month. The Part B deductible is now $166: 19 dollars higher than in 2015. There are no changes to the Original Medicare coinsurance rules. You will continue to pay a 20 percent coinsurance for most services covered by Part B.

If you have a Medicare Advantage Plan, contact your plan if you need help understanding your costs and coverage rules.

Point 2: Understand changes to your Medicare Drug costs for 2016.
Medicare Part D (Drug) costs (premium, deductible, coinsurance, and copayments) vary by plan. If your plan has an annual deductible, that cost cannot be more than $360. If your total drug costs exceed $3,310 you will enter the coverage gap. During the coverage gap you will have to pay 45 percent for most brand name drugs and 58 percent for generic drugs. In all plans, after you have spent $4,850 out of pocket you will leave the coverage gap and you will pay 5 percent of the cost of each drug, or $2.95 for generics and $7.40 for brand-name drugs (whichever is greater).

Point 3: Review your options for changing your health coverage in 2016.
If you are enrolled in a Medicare Advantage Plan but are not happy with it, you can switch to Original Medicare during the period from January 1 to February 14 each year and return to Original Medicare and enroll in a Part D prescription drug plan. Leaving a Medicare Advantage Plan and returning to Original Medicare with a stand-alone Part D plan is the only change you can make during this time. For example, you cannot switch from one Medicare Advantage Plan to another, nor can you leave Original Medicare. Those changes are reserved for the annual Open Enrollment Period (October 15th – December 7th each year).

Point 4: Review Your Medicare notices
Billing errors can occur when we change to a new year and new costs. Be sure to review your Medicare Summary Notice to make sure the charges are correct. If you see anything questionable, contact the Colorado Senior Medicare Patrol at 1 800-503-5190 and they will help check your Medicare bills with you and resolve any problems. It’s a free call and a free service.

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