By Nila Morgan
For Senior Voice 

What's new in Medicare for 2019?

 

January 1, 2019



Welcome to 2019! There are a number of changes in Medicare this year of which you will want to be aware.

New Medicare cards

The New Medicare card mail-out for Alaskans began April 1, 2018 and ended June 30. If you have not received your new card, please contact the Medicare Information Office (800-478-6065) or 1-800-Medicare, so that they can determine why your card has not arrived. It is possible an address update is needed. However, you do not need to panic, as the old card is still usable until Dec. 31, 2019. If you have received your new card, then you are encouraged to destroy your old card as it has a Social Security number on it.

Cost changes

There are a number of changes in costs in Medicare for 2019.

Part A. Most beneficiaries will continue to receive Premium Free Part A at no monthly cost, but for those who must pay for Part A, the cost has slightly increased. For those who have 30 to 39 work credits on file with Social Security, the cost will increase from $232 to $240. For those


who have less than 30 work credits, the cost will increase from $422 to $437. The Part A deductible has also changed, from $1,340 in 2018 to $1,364 in 2019. The Hospital Coinsurance for days 61 through 90 will move from $335 per day to $341 per day and the coinsurance for days 91 to 150 will change from $670 per day to $682 per day.

Part B. The standard premium for Part B will be $135.50 a month, up from $134 in 2018. The Part B annual deductible will creep from $183 in 2018 to $185.50 in 2019. The standard co-payment for Part B services and products will remain at 20 percent after Medicare pays 80 percent for medically necessary out-patient products and services if you see a provider or supplier that takes Medicare assignment.

The therapy cap is gone

The hard cap on therapy limits has been eliminated. Medicare has removed the limit on how much Medicare will pay for therapy services in one calendar year, including physical therapy, occupational therapy and speech-language pathology services. Your therapist or therapy provider will still need to provide documentation that your services are medically reasonable and necessary when they reach certain thresholds. In 2019, that threshold will be $2,040 for occupational therapy and $2,040 for speech-language pathology and physical therapy combined.

There is an increase in the number of Medicare Part D prescription drug plans available for 2019. There were 19 plans to choose from in 2018; this year there will be 22. The lowest monthly premium available will decrease from $20.40 to $15.50. There are actually two plans with monthly premiums of less than $18. The most expensive monthly premium for a prescription plan in 2019 will be $97.


Smaller ‘donut hole’

The ‘donut hole’ coverage gap period has closed for brand-name drugs, which means that after the you and your prescription plan have paid out a total of $3,820 for the year, you will only pay 25 percent of the cost of brand name drugs and 37 percent for generic drugs until you have spent $5,100. Then you enter the Catastrophic coverage level. In this coverage level you pay a co-pay of $3.30 per generic medication and $8.25 per brand-name, or 5 percent of the drug’s total cost, whichever is greater. Medicare and the Medicare prescription plan pick up the rest of the cost.

For those with lower income and assets, there are seven prescription plans that offer the Extra Help subsidy and will have a $0 premium for those who qualify.

Annual enrollment period, Jan. 1 through March 31

If you have not signed up for Medicare Part A and B during your initial enrollment period or during a special enrollment period, you can still sign up during the General Enrollment Period between Jan.1 and March 31 each year. The coverage will begin July 1, 2019. You could be charged a penalty if you have not had coverage through an employer. The penalty will be calculated for every 12 months you went without coverage from when you turned 65 to July 1, when your Medicare coverage begins. The penalty is based on 10 percent of the current Part B premium. In 2019 the penalty would be $13.50 for every 12 months you went without coverage.


If you have questions about any of the above topics, the state Medicare Information Office happy to help. If you need help paying for Medicare, you can contact them to see about the Medicare Savings Program. If you would like more information or to be screened for the Extra Help Program, also known as the Low Income Subsidy, contact the Medicare Information Office toll-free statewide at (800) 478-6065 or in Anchorage (907) 269-3680, or The Social Security Administration at 800-772-1213.

Nila Morgan is a Certified Medicare Counselor who works at the Anchorage Senior Activity Center.

 
 

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