As your Medicare coverage can change each year, it is important to understand and review your benefits. This Medicare Minute summary, authored by Medicare Rights Center and the SHIP National Technical Assistance Center, helps make sure you understand your Part B premium, deductible and Part D costs for 2017.
Point 1: Understand your Part B premium costs in 2017.
Most people with Medicare pay a monthly premium for Part B. In 2017, the Part B premium is not the same for everyone. The base premium is $134 per month, but most people will pay a lower amount in 2017 because they are protected by something called the hold harmless provision. You will pay the lower premium if:
- You were entitled to Social Security benefits for November and December of 2016, and
- The Part B premium was or will be deducted from those benefits for November 2016 through January 2017.
If you meet these guidelines to pay the lower premium, your 2017 premium will be higher than it was in 2016 by the same amount as your Social Security Cost of Living Adjustment. In 2017, this adjustment is 0.3%. The average Part B premium for those protected by hold harmless is $109, but your premium may be higher or lower. To learn your amount, check your Social Security statement or contact the Social Security Administration at 800-772-1213.
The hold harmless provision does not apply to you and your base Part B premium is $134 if:
- You are new to Medicare.
- You already pay higher Part B premiums because of income.
- You are enrolled in a Medicare Savings Program.
- You were enrolled in a Medicare Savings Program in 2016 but lost the program because your income increased or you did not recertify.
Note that if you are enrolled in a Medicare Savings Program, the program will continue paying your Part B premium.
Point 2: Understand your Part B deductible and coinsurance costs in 2017.
If you have Original Medicare, you will pay an annual Part B deductible of $183 in 2017, up from $166 last year. You will continue to pay a 20% coinsurance amount for most services covered by Part B. The amount you pay for Medicare Advantage Plan deductibles, copayments, and/or coinsurances varies by plan.
Point 3: Review your Medicare Part D costs, benefits, and any changes in 2017.
The national average for Part D premiums in 2017 is $35.63. Your other monthly drug costs may vary based on your plan and which coverage period you are in. Let me explain:
- No plan’s deductible in 2017 can be higher than $400.
- You will pay a portion of the cost of your drugs and your plan will pay the rest until you have accumulated $3,700 in total drug costs for most plans in 2017. This is when you l enter what is called either the donut hole or the coverage gap.
- During the donut hole, your plan does not pay as much for your drugs, so your out-of-pocket costs will often be higher. For most plans in 2017, the donut hole ends when you have spent $4,950 out of pocket on covered drugs. By the way, your premium costs do not count toward this amount.
- After leaving the donut hole, you pay 5% of the cost of each drug, or $3.30 for generics and $8.25 for brand-name drugs—whichever is greater.
If you have questions about your 2017 Medicare premiums, deductibles, and other costs, contact your local Health Insurance Counseling and Advocacy Program (HICAP). If you think your 2017 coverage was changed without your knowledge or consent, contact our California Senior Medicare Patrol (SMP) program to discuss potential enrollment fraud at 1-855-613-7080.
- Determine what your Part B premium is this year by looking at your Social Security statement or calling the Social Security Administration at 800-772-1213.
- Anticipate your Part D plan costs to see when or if you may enter the donut hole this year. Contact your local Health Insurance Counseling and Advocacy Program (HICAP) to see if you’re eligible for any programs that can help with drug costs.
- If you have questions about your 2017 Medicare costs and options, contact HICAP.
- Contact our Senior Medicare Patrol (SMP) at 1-855-613-7080 if you notice suspicious health care charges on your statements and bills or if you think you have been enrolled in a plan without your consent.