Q:What are the actual changes to Medicare in 2013?There’s been a lot of talk, but I want facts, and I’m confused about my benefits.
A:Medicare is stronger than ever now, and recent events have not changed your benefits. There are some changes for 2013, as there are every year. But Medicare is here for you, and in many ways has better benefits than ever before. Most of the improvements are due to the Affordable Care Act.
For example, Medicare’s wide-ranging preventive services, many of which are provided to you with no out-of-pocket cost now, are unchanged. In fact, Medicare Part B now has improved benefits for those trying to quit smoking in the New Year.Eight face-to-face counseling sessions for smoking cessation are now covered.Part B also offers obesity screening and counseling. In some cases, co-payments apply for these.
In 2013, people with Medicare Part B will also pay less out of pocket, for outpatient mental health treatment. The co-payment is now 35%, down from 50%.For the initial diagnosis, you’ll continue to pay 20%. Medicare pays the rest.
And Medicare Part D (prescription drug) plans are now allowed to cover benzodiazepine and barbiturate medications, such as those used to treat chronic mental disorders, as well as cancer and epilepsy. Prior to this year, Part D coverage was not allowed for these prescription drugs, unless your plan paid the entire cost.
People with Medicare Part D plans will also see a greater discount for their medications, once they reach the coverage gap, or “donut hole.” The discount has increased from 50% in 2012, to 52.5% for brand-name medicines your plan covers, and from 14% in 2012 to 21% for generic medicines, in 2013. These discounts will be applied automatically at your pharmacy or mail-order supplier. You don’t have to ask for them.
Those with Original Medicare will begin to see newly-designed, easier to understand quarterly Medicare summary notices starting later this year. The language is simpler, the print is larger, and there are clear definitions right on the form. There are also step-by-step instructions for you to check the form’s accuracy, appeal anything that is wrong, or report potential fraud in your account. It’s one more way Medicare is safeguarding your benefits – and taxpayer dollars. The new forms will be phased in between February and June, depending on the state you live in.
Medicare premiums and deductibles have increased slightly in 2013. By law, the premium must cover a fixed percentage of Medicare’s expenses.Premium increases are in line with projected cost increases. Medicare Part B premiums have gone up slowly over the past five years – an average of less than 2 per cent per year. The Part B premium for most people in 2013 is $104.90 per month, up $5, and the annual Part B deductible is $147, an increase of $7, compared to 2012. The Part A deductible, if you are admitted to a hospital, is $1,184, an increase of $28.
For more information, call 1-800-MEDICARE, which is, 1-800-633-4227.Medicare’s national toll-free helpline is available 24 hours a day, seven days a week, or visit www.medicare.gov.
Department of Human Services
City of St. Louis
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