The start of a new calendar year brings with it all sorts of changes and this is true with Medicare, as well. Let’s start with a look at premiums for Original Medicare (Part A and Part B).For 2018, most people will pay a monthly premium of $134 for Medicare Part B coverage. Remember that Part A coverage has no premium if you paid into Social Security Medicare for at least ten years. If you paid in for less than ten years, you will have to pay a premium. The premium amount will depend on the number of years you did pay in.
With Original Medicare you will also have deductibles and co-insurance to pay for services. The 2018 Part A per-benefit-period deductible is $1,340. A benefit period begins when a person is admitted into the hospital as an inpatient and ends 60 days after the person’s last inpatient day. If you go back into the hospital during that 60-day period, you are still under the same benefit period and will not owe another deductible. If you go in more than 60 days after your last inpatient day, you will owe another deductible. The deductible will cover up to 60 days of inpatient care. If you are in the hospital for longer than 60 days, you will pay $335 per day for days 61 through 90 and it will rise to $670 per day for days 91 through 150. Days 91 through 150 are called “Lifetime Reserve Days” and those days are not replaced, once used. If you need skilled nursing care, you will receive the first 20 days of care at no cost. From day 21 through day 100, you will pay $167 per day.
The Part B deductible is an annual deductible and it will remain at the 2017 amount of $183 for 2018. For most Part B services you will pay 20% of the Medicare allowed amount once your Part B deductible has been met, if you get services through providers who accept assignment of Medicare. This means that the provider accepts the Medicare allowed amount as the full amount due. Medicare then pays 80% of that amount and the beneficiary is expected to pay the remaining 20%. If a provider accepts Medicare payment, but does not agree that the Medicare allowed amount is the full amount due, Medicare allows the provider to bill you an additional 15% of the Medicare allowed amount. And you are responsible for that amount in addition to the 20%.
If you are in a Medicare Advantage plan but have decided that you really don’t want to be in one, you can cancel your Medicare Advantage plan during the Medicare Advantage Disenrollment Period, which occurs between January 1 and February 14. During that time you can go back to Original Medicare and pick up a Prescription Drug Plan. You can also purchase a Medicare Supplement (AKA Medigap) plan, if you can find a company who will sell you one. You may be subject to medical underwriting for the Medigap, unless you are in the Medigap Open Enrollment Period or have a Guaranteed Issue into a Medigap plan.
For persons who are under 65, changes to the Idaho rules on Medigaps will give you an Open Enrollment period into any Medigap plan for a six-month period beginning with enrollment dates of January 1, 2018, or six months after your Original Medicare becomes effective, whichever is later. Insurers cannot make people under 65 pay more than 150% of the rate for a similar plan quoted for a 65-year-old.