Upcoming Medicare Changes

Upcoming Medicare Changes

A few weeks ago, President Trump signed a budget deal that includes changes to Medicare:

  1. Medicare’s Independent Payment Advisory Board has been nixed. It was authorized by the Affordable Care Act to review higher Medicare expenses but no board members were ever named.
  2. The rules for Medicare’s Part D drug plans were changed. The coverage gap (or donut hole) in these plans has been shrinking for years under the Affordable Care Act and was supposed to end in 2020. At that time, consumers in the gap would pay no more than 25 percent of the costs of their drugs. However, the end date was moved up a year to 2019.
  3. Consumers who have spent a lot on drugs and have entered the so-called catastrophic phase of Part D plans will pay no more than a few dollars for each prescription or, for costly drugs, no more than 5 percent of the drug cost. While this percentage will not change, the responsibility for paying the other 95 percent of the cost will be borne even more heavily by the government and is expected to save pharmaceutical companies billions of dollars. This is a more significant change as taxpayers could ultimately be on the hook for those higher government expenses.
  4. Medicare’s caps on covered expenses for outpatient therapy have been officially repealed. People with persistent therapy needs have bumped against these caps for more than 20 years, and Congress has regularly eased those rules. While claims above current cap levels may be subject to review, people who legitimately need extensive therapy will not have to depend on year-to-year congressional fixes.
  5. Medicare’s high-income premium surcharges will be even higher for wealthier enrollees. Those making more than $500,000 a year ($750,000 for couples) will pay 85 percent of the actual costs of Part B and D in 2019, up from 80 percent this year. Most Medicare enrollees pay premiums that equal about 25 percent of these costs.
  6. Congress also made numerous and potentially far-reaching changes to the rules for Medicare Advantage plans. That includes allowing such plans to pay for limited long-term care expenses – something that, until now, has not been covered by Medicare.

If you need help clarifying any of these changes and how they affect you, please call us today at 419-482-0280. The Beacon Associates team can explain Medicare in a simple, straightforward manner.

Information gathered from President Trump signed Medicare Changes