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Medicare & Medicaid News

No Increase in Cost of Medicare Part B in 2014; More Savings in Drug Program

CMS says major savings for Medicare beneficiaries next year; good news for seniors facing small Social Security increase

Oct. 28, 2013 – Senior citizens facing a projected small increase in Social Security for next year got some good news today from the Centers for Medicare & Medicaid Services. CMS says that health care reform efforts are eliciting significant out-of-pocket savings for Medicare beneficiaries, pointing to zero growth in 2014 Medicare Part B premiums and deductibles, and more than $8 billion in cumulative savings in the prescription drug coverage gap known as the “donut hole.”  

Since the Affordable Care Act provision to close the prescription drug donut hole took effect, more than 7.1 million seniors and people with disabilities who reached the donut hole have saved $8.3 billion on their prescription drugs, according to CMS.

In the first nine months of 2013 nearly 2.8 million people nationwide who reached the donut hole this year have saved $2.3 billion, an average of $834 per beneficiary.  These figures are higher than at this point last year (2.3 million beneficiaries had saved $1.5 billion for an average of $657 per beneficiary).  

 

Related Archive Stories

 
 

Seniors Cautioned To Pay Close Attention To Details As Enrollment Begins In Medicare Plans

There’s a likely payoff for those who pay close attention to the details - enrollment open through December 7

By Susan Jaffe, Kaiser Health News

Oct. 16, 2013

Medicare Opens Enrollment for 2014 Plans, Says Plan Prices Holding Steady

See video in story on how to use the Medicare Plan Finder to compare available plans, make your selection; lead video about Open Enrollment period - Oct. 15, 2013

See links to more news on Medicare Open Enrollment for 2014 below this news story.

 
 

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The health care law gave those who reached the donut hole in 2010 a one-time $250 check, then began phasing in discounts and coverage for brand-name and generic prescription drugs beginning in 2011.  The Affordable Care Act will provide additional savings each year until the coverage gap is closed in 2020.

Part B Premium remains at $104.90

CMS said the standard Medicare Part B monthly premium will be $104.90 in 2014, the same as it was in 2013.  The premium has either been less than projected or remained the same, for the past three years.  The Medicare Part B deductible will also remain unchanged at $147.  The last five years have been among the slowest periods of average Part B premium growth in the program’s history.  

“We continue to work hard to keep Medicare beneficiaries’ costs low by rewarding providers for producing better value for their patients and fighting fraud and abuse.  As a result, the Medicare Part B premium will not increase for 2014, which is good news for Medicare beneficiaries and for American taxpayers,” said CMS Administrator Marilyn Tavenner.   

People with Medicare don’t need to sign up for the new Health Insurance Marketplace, as they are already covered by Medicare.  The Marketplace won’t affect Medicare choices, and no matter how an individual gets Medicare, whether through Original Medicare or a Medicare Advantage Plan, they still have the same benefits and security they have now.

Medicare Parts A and B Premiums and Part A Deductible

By law, the standard Part B premium represents roughly one-fourth of the average cost for beneficiaries aged 65 and over, plus a contingency margin to provide for possible variations between actual and projected costs.  Part B covers physicians’ services, outpatient hospital services, certain home health services, durable medical equipment, and other items.

Beginning in 2007, beneficiaries with higher incomes have paid higher Part B monthly premiums.  These income-related monthly premiums, which affect less than 5 percent of people with Medicare, also will remain the same as they were in 2013.

Part A premium drops for those who pay

Medicare Open Enrollment
Oct. 15 - Dec. 7

When people with Medicare can choose their plans for 2014

Click to Medicare Site

CMS also announced today that the Medicare Part A premium, which pays for inpatient hospital, skilled nursing facility, and some home health care services, will drop $15 in 2014 to $426.  Although about 99 percent of Medicare beneficiaries do not pay a premium for Part A since they have at least 40 quarters of Medicare-covered employment, enrollees age 65 and over and certain persons with disabilities who have fewer than 30 quarters of coverage pay a monthly premium in order to receive coverage under Part A.  Beneficiaries who have between 30 and 39 quarters of coverage may buy into Part A at a reduced monthly premium rate which is $234 for 2014, a decrease of $9 from 2013.

The Medicare Part A deductible that beneficiaries pay when admitted to the hospital will be $1,216 in 2014, an increase of $32 from this year's $1,184 deductible.  

The deductible covers beneficiaries' costs for up to 60 days of Medicare-covered inpatient hospital care in a benefit period. Beneficiaries must pay $304 per day for days 61 through 90 in 2014, and $608 per day for hospital stays beyond the 90th day.  For 2013, per day payment for days 61 through 90 was $296, and $592 for beyond 90 days.  For beneficiaries in skilled nursing facilities, the daily co-insurance for days 21 through 100 in a benefit period will be $152.00 in 2014, compared to $148.00 in 2013.

The income-related monthly premium rates, which will remain the same as they were in 2013, are shown in the following table:

Beneficiaries who file an individual tax return with income:

Beneficiaries who file a joint tax return with income:

Part B income-related monthly adjustment amount

Total monthly Part B premium amount

Less than  or equal to $85,000

Less than or equal to $170,000

$0.00

$104.90

Greater than $85,000 and less than or equal to $107,000

Greater than $170,000 and less than or equal to $214,000

$42.00

$146.90

Greater than $107,000 and less than or equal to $160,000

Greater than $214,000 and less than or equal to $320,000

$104.90

$209.80

Greater than $160,000 and less than or equal to $214,000

Greater than $320,000 and less than or equal to $428,000

$167.80

$272.70

Greater than $214,000

Greater than $428,000

$230.80

$335.70

 

Monthly premium rates to be paid by beneficiaries who are married, but file a separate return, are as follows:

Beneficiaries who are married but file a separate tax return from their spouse:

Part B income-related monthly adjustment amount

Total monthly Part B premium amount

Less than or equal to $85,000

$0.00

$104.90

Greater than $85,000 and less than or equal to $129,000

$167.80

$272.70

Greater than $129,000

$230.80

$335.70


States have programs that pay some or all of beneficiaries' premiums and coinsurance for certain people who have Medicare and a limited income. Information is available at 1-800-MEDICARE (1-800-633-4227) and, for hearing and speech impaired, at TTY/TDD: 1-877-486-2048.

  • CMS Principal Deputy Administrator Jonathan Blum’s blog Medicare beneficiaries’ out-of- pocket savings: http://blog.cms.gov/.

  • State-by-state breakdown of savings in the coverage gap pdf

  • Notices to be published on October 30, 2013.

  • For more information about the 2014 Medicare Part B premium, and Medicare generally, please go to www.Medicare.gov.

Medicare Open Enrollment 2014 - Related Archive Stories

 

Good Summary of Your Medicare Coverage Options as Open Enrollment Begins

Window for making changes to your Medicare coverage opens October 15, closes December 7

Oct. 14, 2013 - With the Medicare’s open enrollment period opening on Tuesday, this is a good summary of the basics about Medicare health insurance – what is available to keep you healthy with plans that meet your needs. It is by Pamela Yip, a business writer for the Dallas Morning News, who regularly covers Medicare. Click to Dallas Morning News

Analysis Finds Good News on 2014 Medicare Prescription Drug Premiums

Overall stable or lower cost options available to seniors finds HealthPocket study

Oct. 11, 2013

Medicare Advantage Plan Out-of-Pocket Caps for 2014 Look Good For Consumers

Drug plans with low cost-sharing limits and no premiums available: HealthPocket

Oct. 11, 2013

AARP Offers Tips, Guidance on Choosing Plans During Medicare Open Enrollment

Changes can be made to Medicare plans from October 15 through December 7; Distinction between Medicare and Affordable Care Act open enrollment is important

Oct. 10, 2013

Consumer Reports Ranks, Scores Medicare Advantage, Other Health Plans for 2014

CR finds that higher cost does not mean better care; complete report in magazine, rankings free online, Medicare open enrollment starts October 15

Oct. 5, 2013

Understanding the Difference between Medicare and the Health Insurance Marketplaces

Marketplaces are for people who do not have insurance, people on Medicare are insured by Medicare

By Ron Pollack, Executive Director, Families USA

Oct. 1, 2013

Senior Citizens Need to Get Ready for Medicare Open Enrollment

Seniors covered by Medicare do not need to buy health insurance on the Health Insurance Marketplace - Medicare Open Enrollment starts October 15

Oct. 1, 2013

As Medicare Open Enrollment Nears More Seniors Opting for Quality Medicare Advantage Plans

Open enrollment begins October 15 and ends on December 7; period when those in Medicare can choose new health and drug plans

Sept. 19, 2013


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