Medicare and You 2020: The Annual Medicare Handbook
The Centers for Medicare and Medicaid Services (CMS) issues a handbook every year titled Medicare and You.
A printed copy of Medicare & You 2020 will be mailed to beneficiaries in late September, 2019. You can choose to receive an electronic copy of the book instead of the printed copy.
Since the handbook is over 100 pages long, we’ll break down some of the basic information for you. You can also find instructions on how to download your own free digital copy below.
Parts of Medicare and Your Coverage Options
Medicare & You 2020 includes basic information about the parts of Medicare and your various coverage options, which include: The Medicare & You 2020 handbook from the Centers for Medicare & Medicaid Services (CMS)
- Original Medicare
Medicare Part A and Part B are known together as “Original Medicare” and are provided by the federal government.
Medicare Part A provides coverage for your inpatient care costs in hospitals, skilled nursing facilities, hospice facilities and some home health care services.
Medicare Part B helps cover the costs of your outpatient care, preventive health care and durable medical equipment (DME). Medicare Part B is optional and comes with a monthly premium.
- Medicare Part C
Medicare Part C is also known as Medicare Advantage. Medicare Advantage plans are required to provide at least the same benefits as Original Medicare and are sold by private insurance companies.
Many Medicare Advantage plans also include prescription drug coverage, which Original Medicare doesn’t typically cover. Some Part C plans also cover things like dental, vision and hearing benefits.
Some Medicare Advantage plans are starting to also cover services such as transportation to doctor’s appointments or the grocery store, home improvements to help you age in place and caregiver support services.
- Medicare Part D prescription drug plans
Part D prescription drug plans (PDPs) are sold by private insurance companies. Each Part D plan has a list of the drugs that it covers, called a formulary.
You can get Part D coverage through a Medicare Advantage plan that offers this benefit, or through a standalone Part D plan that you can use alongside your Original Medicare coverage.
- Medicare Supplement Insurance (Medigap)
Medigap plans are sold by private insurance companies and work alongside your Original Medicare coverage to help cover some of the out-of-pocket costs that Part A and Part B don’t cover.
The out-of-pocket Medicare costs that can be covered by a Medigap plan include things like deductibles, copays, coinsurance and more.
You cannot have a Medicare Supplement plan and a Medicare Advantage plan at the same time. You can, however, have a Medigap plan as well as a Medicare Part D prescription drug plan.
The possible combinations of Medicare coverage you might typically have include:
- Part A only
- Part A and Part B
- Part C
- Part A and Part D
- Part A, Part B and Part D
- Part A, Part B and Medigap
- Part A, Part B, Part D and Medigap
- Part C and Part D (if your Part C plan does not include prescription drug coverage)
How Much Does Medicare Cost in 2020?
There are three basic types of costs you may face as a Medicare beneficiary. Please note that costs for calendar year 2020 will not be released until the 4th Quarter of 2019.
- Most people do not pay a premium for Medicare Part A, as long as they or their spouse worked and paid Medicare taxes for at least 40 quarters (10 years).
If you’re required to pay a monthly premium for Part A, it could be as high as $437 per month in 2019.
- The standard Medicare Part B premium in 2019 is $135.50 per month, although higher income earners may pay a higher Part B premium. This increased premium amount is called the Medicare Income-Related Monthly Adjustment Amount (IRMAA).
- Premiums for Medicare Advantage, Part D and Medigap plans may vary, since these types of plans are sold by private insurance companies.
Some Medicare Advantage plans feature $0 premiums. Some Medicare Part D plans feature $0 deductibles. Plan premiums, deductibles, copays/coinsurance and availability can vary depending on where you live.
If you have a Medicare Advantage, Part D or Medigap plan, contact your plan directly to see how your plan costs may be increasing in 2020.
You may be eligible to change your Medicare coverage during the Fall Medicare Annual Enrollment Period (sometimes called the fall Open Enrollment Period for Medicare Advantage and prescription drug plans), which starts October 15, 2019, and lasts until December 7.
The deductible is the amount you must pay out of your own pocket before your plan coverage kicks in.
- Medicare Part A requires you to meet a $1,364 deductible per benefit period in 2019.
You could potentially face more than one Medicare Part A benefit period in a year, which means you would need to meet the Part A deductible more than once.
Some Medigap plans can cover the Part A deductible in full.
- Medicare Part B has a deductible of $185 per year in 2019. You must meet this deductible before your Part coverage for outpatient care will kick in.
Medigap Plan C and Plan F each cover the Part B deductible. New Medicare beneficiaries who become eligible for Medicare on or after January 1, 2020, however, will no longer be able to enroll in Medigap Plan C or Plan F.
If you are eligible for Medicare before January 1, 2020, you may be able to enroll in either plan if they are available where you live. If you already have Plan C or Plan F, you will be able to keep your plan.
- Deductibles for Medicare Advantage plans and Part D plans may vary.
- Medigap Plan F features a high-deductible option. Once you meet a deductible of $2,300 for the year in 2019, your Plan F coverage kicks in.
Starting in 2020, Medigap Plan G will offer a high-deductible option.
Medicare Coinsurance and Copayments
- Medicare Part A requires the following coinsurance amounts in 2019 for most inpatient hospital services (after you meet your Part A deductible):
- Days 1-60 in hospital: $0 coinsurance per benefit period
- Days 61-90: $341 coinsurance per day of each benefit period
- Days 91 and beyond: $682 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)
- Beyond lifetime reserve days: You are responsible for all costs
- After you meet your Part B deductible, you typically are responsible for paying a 20% Part B coinsurance of the Medicare-approved amount for covered services.
- Medicare Advantage and Part D plan coinsurance and copayments may vary.
- Medicare Supplement plans can help cover certain Medicare coinsurance and copayments.
Medigap Plan N pays for 100% of your Part B coinsurance costs except for copays of up to $20 for some doctor’s office visits and up to $50 for emergency room visits that don’t result in an inpatient hospital admission.
When to Enroll in Medicare
Some people are automatically enrolled in Medicare Part A and Part B.
You may be automatically enrolled if you’re already receiving Social Security or Railroad Retirement Board (RRB) benefits for at least 4 months prior to turning 65.
You should also be automatically enrolled if you qualify for Medicare before age 65 due to a disability. If you qualify, you’ll be automatically enrolled on your 25th month of receiving Social Security disability benefits or certain RRB disability benefits.
If you have ALS (Lou Gehrig’s disease), your Medicare coverage begins the first month you receive qualifying disability benefits.
If you need to manually enroll in Medicare, the best time to do so is during your 7-month Initial Enrollment Period (IEP), which begins 3 months before you turn 65 years old, includes your birthday month and continues for another 3 months.
You can also enroll in a Medicare Advantage plan or Prescription Drug Plan during this period.
The best time to enroll in Medicare Supplement Insurance is during your Medigap Open Enrollment Period, which begins once you are 65 years old and enrolled in Medicare Part B.
You may be eligible to enroll in, drop or switch Medicare Advantage plans and Part D plans during the Medicare Annual Enrollment Period (AEP), which happens every year between October 15 and December 7.
Getting Help Paying for Medicare
Beneficiaries with limited financial resources may qualify for one of several programs designed to help pay for Medicare costs.
These programs include:
- Medicare Savings Programs (MSPs)
- Extra Help
- State Pharmacy Assistance Programs (SPAPs)
- Pharmaceutical Assistance Programs
- Programs of All-Inclusive Care for the Elderly (PACE)
- Supplemental Security Income (SSI) benefits
You can learn more about the benefits and eligibility requirements of each program in the Medicare & You 2020 handbook.
Your Medicare Rights and Fraud Protection
Medicare beneficiaries are granted a number of rights and protections, which include:
- Protection from discrimination
- The privacy of personal and health information
- The ability to receive information in your native language
- Access to health care providers for medically necessary services
- Learning about treatment options and participating in treatment discussions
- The ability to file appeals regarding decisions about coverage or payment
- The freedom to file complaints about the quality of care
The Medicare & You 2020 handbook also identifies a number of ways you can keep yourself safe from Medicare fraud.
Download a Copy of Medicare & You 2020
If you don’t want to wait to receive your copy of Medicare & You 2020 in the mail, you can download a copy of the handbook.
There are multiple formats, including:
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Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.