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12 Important Changes to Medicare in 2019

Each new year brings at least a few changes to Medicare. 2019 Medicare changes include increases to certain Medicare deductibles, coinsurance or copayments and certain Medicare premiums.

Here are 12 Medicare changes to look for in 2019. Learn how these changes may affect your Medicare coverage.

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1.) 2019 Medicare Part A and Part B Premiums Increased

Most beneficiaries do not pay a premium for their Medicare Part A (hospital insurance) coverage. But those who do pay a Part A premium saw a slight increase in their monthly cost in 2019.

  • The Part A premium went from $232 per month in 2018 to $240 per month in 2019 for beneficiaries (or their spouses) who have worked and payed Medicare taxes for 30 to 39 quarters (7.5 to just under 10 years).
  • For beneficiaries who have worked and payed Medicare taxes for fewer than 30 quarters, the Part A premium increased from $422 per month in 2018 to $437 per month in 2019.

The Medicare Part B premium went up from $134 per month in 2018 to $135.50 per month in 2019. Part B covers doctor’s appointments and certain other outpatient care services, along with qualified durable medical equipment (DME).

Deductibles also went up slightly for Original Medicare (Part A and Part B).

  • The Part A deductible increased from $1,340 per benefit period in 2018 to $1,364 per benefit period in 2019.
  • The Medicare Part B deductible went up from $183 per year in 2018 to $185 per year in 2019.

2.) 2019 Average Part D Premiums Decreased

The Centers for Medicare and Medicaid Services (CMS) projected the average premium for a Medicare Part D prescription drug plan would decrease by $1.09 from 2018 to 2019.

The average Part D premium in 2019 was estimated to be $32.50 per month.1

Medicare Part D is a form of private Medicare insurance that provides coverage exclusively for prescription medications.

3.) 2019 Average Medicare Advantage Premiums Decreased

The CMS also predicted that premiums for Medicare Advantage (Medicare Part C) plans would decrease from 2018 to 2019.

The CMS projected the average Medicare Advantage plan premium in 2019 to be $28 per month.1

Medicare Advantage plans are an alternative to Original Medicare. Medicare Advantage plans provide all the same coverage as Part A and Part B, and many plans offer some additional benefits that Original Medicare doesn’t cover.

Many Medicare Advantage plans provide prescription drug coverage, and some plans may provide benefits such as routine dental, vision and hearing coverage.

4.) 2019 Medicare Advantage Enrollment Went Up

Medicare Advantage enrollment increased in 2019.

According to CMS, 2019 Medicare Advantage enrollment is expected to reach 22.6 million, which would represent an 11.5% increase from 2018.

More than 36% of Medicare beneficiaries are expected to belong to a Medicare Advantage plan in 2019.1

5.) 2019 Is the Last Year Medigap Plan F and Plan C Will Be Available to New Medicare Beneficiaries

Medicare Supplement Insurance (Medigap) Plan F and Plan C will no longer be available to people who become eligible for Medicare after January 1, 2020.

Anyone who is currently enrolled in either plan will be allowed to keep their Plan F or Plan C going forward. Anyone who became eligible for Medicare before January 1, 2020, will still be allowed to apply for Plan C or Plan F after that date.

If you become eligible for Medicare before 2020, you may still be able to buy either Plan C or Plan F after January 1, 2020, but only if either plan is available where you live.

6.) The 2019 Medicare Part D Donut Hole Disappeared for Brand Name Drugs

The Medicare Part D coverage gap, or “donut hole,” is a temporary limit on how much your prescription drug plan will pay for your covered drugs.

The donut hole has been gradually shrinking since 2010.

In 2019, the Medicare donut hole reached the final phase of its reduction for brand name drugs. Part D beneficiaries will now pay 25% of the cost of their brand name drugs during the coverage gap in 2019.

The donut hole for generic drugs will reach its final reduction in 2020.

7.) 2019 Medigap Plan K and Plan L Out-of-Pocket Limits Went Up

There are two Medicare Supplement Insurance plans with an annual out-of-pocket maximum: Plan K and Plan L.

If you have Plan K or Plan L, once you reach the out-of-pocket max in a calendar year, your plan pays 100% of covered costs for the rest of the year.

The Medigap Plan K out-of-pocket limit increased from $5,240 in 2018 to $5,560 in 2019. The Plan L out-of-pocket spending limit went up from $2,620 in 2018 to $2,780 in 2019.

8.) The Deductible for High-Deductible Plan F Increased in 2019

Medigap Plan F offers a high-deductible option. With high-deductible Plan F, you pay an annual deductible before your Medigap plan coverage kicks in.

In 2018 the deductible for high-deductible Plan F was $2,240. In 2019, the deductible increased to $2,300.

High-deductible Plan F can typically offer lower monthly premiums than standard Plan F. You should keep in mind, however, that you will be responsible for more out-of-pocket costs before hitting the deductible if you choose this option.

9.) The Part B and Part D IRMAA Increased in 2019

Higher income earners may pay higher Medicare Part B and Part D premiums than the standard amount. This extra amount is called the IRMAA, or the Income-Related Monthly Adjusted Amount.

The IRMAA is based on your reported income from two years prior (so the 2019 IRMAA is based on your reported income from 2017).  

In 2019, an extra income bracket was added to IRMAA calculations. The table below shows the 2019 IRMAA for Medicare Part B and Part D.

2017 Individual tax return 2017 Joint tax return 2017 Married and separate tax return 2019 Part B premium 2019 Part D premium
$85,000 or less $170,000 or less $85,000 or less $135.50 Your plan premium
More than $85,000 and up to $107,000 More than $170,000 and up to $214,000 N/A $189.60 Your plan premium + $12.40
More than $107,000 up to $133,500 More than $214,000 up to $267,000 N/A $270.90 Your plan premium + $31.90
More than $133,500 up to $160,000 More than $267,000 up to $320,000 N/A $352.20 Your plan premium + $51.40
More than $160,000 up to $500,000 More than $320,000 up to $750,000 More than $85,000 up to $415,000 $433.40 Your plan premium + $70.90
More $500,000 More than $750,000 More than $415,000 $460.50 Your plan premium + $77.40

10.) There Are More Medicare Advantage Plans Available in 2019

The number of Medicare Advantage plans available nationwide was projected by CMS to increase from around 3,100 in 2018 to 3,700 in 2019.

More than 91% of Medicare beneficiaries will have access to 10 or more plans in 2019, up from 86% of beneficiaries in 2018.1

11.) Medicare Advantage Plan Potential Benefits Increased in 2019

2019 Medicare Advantage plans were able to expand the types of benefits they offer.

Some Medicare Advantage plans in 2019 covered things like caregiver support services, home modifications designed for aging in place, home meal delivery, non-emergency transportation and more.

Not all of these benefits are available with all plans. As mentioned above, Medicare Advantage plans are required to cover at least the same benefits offered by Original Medicare.

12.) New Medicare Cards Were Sent in 2019

Medicare issued new Medicare cards to beneficiaries in April of 2018. The final distribution of these new cards wrapped up in April of 2019.

The 2019 new Medicare cards removed Medicare beneficiaries’ Social Security numbers from the card in an effort to protect beneficiaries’ identities and fight against fraud.   

Do You Want to Change Medigap Plans in 2019?

It’s a good idea to review your Medicare coverage each year to make sure that your health coverage needs are still being met by your plan.

A licensed insurance agent can help you compare the 2019 Medigap plans that are available near you.

If you are interested in making Medigap plan changes this year, you can learn more about the application process and find out if it’s the right time for you to change plans.

 

Find Medigap plans in your area.

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1 2019 Medicare Advantage and Part D Prescription Drug Program Landscape. Centers for Medicare and Medicaid Services (Sept. 28, 2018). Retrieved from https://www.cms.gov/newsroom/fact-sheets/2019-medicare-advantage-and-part-d-prescription-drug-program-landscape.

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