What’s New in Medicare for 2015?

By David Sayen

Gazette Contributor

Good news for people with Medicare in 2015: Part B costs will remain the same as in 2014.

Medicare Part B helps pay for doctor bills, outpatient care, durable medical equipment, and other items. It requires a monthly premium and an annual deductible. I’m happy to report that Part B costs for 2015 will be identical to 2014: $104.90 a month for the premium (for most beneficiaries), and $147 for the deductible.

Most people with Medicare don’t pay any premium for Part A, which helps covers hospital care. But for those who do, the 2015 premium is dropping, from a maximum of $426 per month to $407 per month. The annual deductible is going up a little, from $1,216 in 2014 to $1,260 in 2015. Once you pay the deductible, Medicare covers your first 60 days of hospitalization with no co-insurance.

Thanks to the Affordable Care Act, people with Medicare no longer have co-pays for a long list of Medicare-covered preventive health services.

Preventive shots and screenings are intended to keep you healthy and to detect disease in the earliest stages, when it’s most treatable.

Medicare’s preventive health services include vaccinations for flu and Hepatitis B; screenings for colorectal, breast, and prostate cancer; screenings and counseling for diabetes and depression; cardiovascular disease screenings; and counseling to help you stop smoking or abusing alcohol.

In addition, you can get a one-time “Welcome to Medicare” visit with your doctor, during the first 12 months you’re enrolled in Part B. During this visit you and your doctor can review your medical and social history, and your physician can recommend specific preventive screenings for you, if needed.

Medicare also now covers an annual “wellness” visit with your doctor. This visit is intended to develop or update a personalized plan to prevent disease or disability based on your current health and risk factors.

Another benefit of the Affordable Care Act is that it’s gradually closing the “donut hole,” or coverage gap, in Medicare Part D, the prescription drug program.

The coverage gap begins after you and your drug plan together have spent a certain amount for covered drugs. In 2015, once you enter the gap, you pay 45 percent of the plan’s cost for covered brand-name drugs and 65 percent of the plan’s cost for covered generic drugs until you reach the end of the gap.

However, not everyone will enter the coverage gap because their drug costs won’t be high enough. (There’s a full explanation of the coverage gap in the “Medicare & You” handbook for 2015, which is online at: http://www.medicare.gov/Pubs/pdf/10050.pdf.) The gap is scheduled to be completely closed by 2020.

Finally, Medicare has expanded its “Blue Button” feature to provide better access to your Medicare claims and personal health information.

With the Blue Button you can download 12-36 months of claims information for Part A and Part B, and 12 months of claims information for Part D. This information can help you make more informed decisions about your care and give your healthcare providers a more complete view of your health history.

You can find the Blue Button at www.MyMedicare.gov.

Once you’ve used the Blue Button, there are a variety of health applications and services to analyze your health information. Visit www.bluebuttonconnector.healthit.gov to learn more about these useful tools and how to protect your health information once it’s in your hands.

David Sayen is Medicare’s regional administrator for Arizona, California, Hawaii, Nevada, and the Pacific Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).