Medicare 2017: What to Expect
Many beneficiaries could face a large premium increase. We covered this issue on our Aging Wisely blog when it came up for 2016, and it’s being discussed again for Medicare 2017. The government health-care plan’s trustees projected in June that premiums would rise by as much as 22% for wealthier beneficiaries of Medicare Part B. We will keep you updated on this situation and as always, provide all the Medicare 2017 premiums, deductibles and co-pays so you know just what to expect.
There will be changes to many Medicare drug plans. You should ALWAYS review your options during the open enrollment period (October 15th-December 7th) due to plan changes, new options, and your changing health status. Most people could save money.
The standard plan changes are as follows (Medicare D plans vary greatly, this is the standard benefit model set by CMS):
- Initial Deductible will increase by $40 to $400 for 2017.
- The Initial Coverage Limit will increase from $3,310 in 2016 to $3,700 in 2017.
- Out-of-Pocket Threshold: will increase by $100 (from $4,850 in 2016 to $4,950 in 2017).
- The donut hole (coverage gap) begins once you reach your Medicare Part D plan’s initial coverage limit ($3,700 in 2017) and ends when you spend a total of $4,950 in 2017.
In 2017, Part D enrollees will receive a 60% discount on the total cost of their brand-name drugs purchased while in the donut hole. The 50% discount paid by the brand-name drug manufacturer will apply to getting out of the donut hole, however the additional 10% paid by your Medicare Part D plan will not.
For example: if you reach the donut hole and purchase a brand-name medication with a retail cost of $100, you will pay $40 for the medication, and receive $90 credit toward meeting your 2017 total out-of-pocket spending limit.
Enrollees will pay a maximum of 51% co-pay on generic drugs purchased while in the coverage gap (i.e. a 49% discount). That discounted price you pay will count towards getting out of the donut hole.
- Catastrophic Coverage Cost-Sharing (the minimum amount you pay when you reach catastrophic coverage level post donut-hole) will increase to $3.30 for those generic or preferred multisource drugs with a retail price under $66 and 5% for those with a retail price greater than $66. For brand-name drugs, beneficiaries would pay $8.25 for those drugs with a retail price under $165 and 5% for those with a retail price over $165.
How to Make the Best Choice for My Medicare 2017
- Mark time on your calendar (every year) to review your Medicare 2017 options. If one of your relatives helps you, plan the time together and don’t wait until the last minute. Before you do the review gather your current plan information, Medicare card, list of medications (with dosage and frequency), preferred pharmacies, and any special help/supplemental program information.
- Do a little homework. We’ve included some great resources below.
- Be cautious about sales people and large signups targeting seniors at stores, etc. They may want to be helpful but remember their goal is to sign as many people up as possible, so it’s best if you review your own situation (possibly with help) to make an informed choice.
- Get help from an expert. Our care managers can assist you with an objective, personal Medicare review, whether for annual renewal or when you first join Medicare or have major changes. You may even be eligible for special help or other benefit programs and we can help you understand the comprehensive options.
Medicare (2017) Resources
Medicare.gov: Plan finder, learn more about plans and get your Medicare and You guide. More details about Medicare 2017 will be coming out soon, so bookmark this site.
Confused about Medicare v. Medicaid? Read more about Medicaid, Medicare and Who Pays for What.
The Medicare Fact Sheet is created by our Aging Life Care Managers every year and also explains the basics of the Medicare program/terminology. You can download the free 2016 version and sign up for our newsletter to get the latest Medicare 2017 information as it comes out.
Medicare Interactive is a project of the Medicare Rights Center, with free educational resources on key Medicare issues.