Medicare Changes for 2020

2020 is right around the corner. If you didn’t already know, some rates are changing for Medicare. Since we know it is hard to keep track of the cost share between your clients and Medicare, below is a cheat sheet to keep in front of you for 2020 rates and coverage. You can also download a pdf version of this grid HERE.

MEDICARE PART A

Part A (Hospital Insurance)	Patient Pays	Medicare Pays
First 60 Days	$1,408	All but $1,408
Days 61-90	$352 a day	All but $352 a day
Days 91-150	$704 a day	All but $704 a day
Days 151 & After	ALL	NOTHING
Part A (Nursing Home)	Patient Pays	Medicare Pays
First 20 Days	NOTHING	ALL
Days 21-100	Up to $176 a day	All but $176 a day
Days 101 & After	ALL	NOTHING

MEDICARE PART B

Part B (Medical)	Premium	Deductible
2020	$144.60	Annual $198

Part B Premium Income Graph / Part D Rx Extra Premium

Single Taxpayer	Married, Filing Jointly	Part B Premium / PDP Extra
Less than or equal to $87,000	Less than or equal to $174,000	$144.66 / Plan Premium
$87k to $109k	$174k to $218k	$202.40 / $12.20 + Plan Premium
$109k to $136k	$218k to $272k	$289.20 / $31.50 + Plan Premium
$136k to $163k	$272k to $326k	$376.00 / $50.70 + Plan Premium
$163k to $500k	$326k to $750k	$462.70 / $70.00 + Plan Premium
$500k +	More than $750k	$491.60 / $76.40 + Plan Premium

MEDICARE PART C

Medicare Advantage Plans

HMO	PPO
Health Maintanence Organization	Preferred Provider Organization
Network Only Must use network of doctors POS option may provide additional flexibility	Utilizes a network of doctors Less expense for in-network doctors, flexible out of network
$0-50+ Premium and low Co-pays on Primary & Specialist visits. Find plans with low co-pays and a low maximum out of pocket	Generally $30-$150+ premiums, low Co-pays on Primary & Specialist visits. Find plans with low-co-pays and low maximum out of pocket

MEDICARE PART D

This is the Part D Standard Model (National Average is $32.50 per month)

Phase	Patient Pays	Plan Pays
Phase 1 – Deductible	Up to $435	All but $435
Phase 2 – Initial Coverage Limit	25% up to $4,020	75% up to $4,020
Phase 3 – Coverage Gap	*25% generic / 25% brand	*All but 25% generic / 25% brand
Phase 4 – Catastrophic Coverage Limit	5% or $3.60 generic / $8.95 brand	All but 5% or $3.60 generic / $8.95 brand

*After your total drug costs reach $4,020, you will pay no more than 25% coinsurance for generic drugs or 25% coinsurance for brand name drug, for any drug tier during the coverage gap.

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Medicare Changes for 2020