Changes to Medicare in 2020
by Susan R. Tolbert, Licensed Health Agent
As we turn over the pages of the calendar to a brand-new year, Medicare uses this turning point as the new start date for premium increases and plan deductibles/co-insurance increases. As most of you are probably aware the new standard Part B premium for 2020 is $144.60 per month. High income earners will be required to pay an additional premium above the standard Part B premium as they have been required to do in past years as well. Explanation of premiums for high income earners will be addressed in the Question & Answer Feature of this publication.
The Medicare Part B standard co-insurance for medical services remains at 80% covered by Medicare and 20% co-insurance payment for the beneficiary. The Medicare Part B deductible will increase to $198.00 starting in 2020. The chart below will show this change along with the Medicare Part A increases for 2020.
Note: Please keep in mind these changes are to Original Medicare. Individuals on a Medicare
Advantage Plan are not submitting claims to Original Medicare and therefore do not pay according
to this schedule except for the Part B premium. Any plan changes to Medicare Advantage Plans
would have been sent to members by their plan carrier in the fall of 2019 indicating the
effective date of changes to begin on January 1, 2020.
Individuals on Original Medicare but supplementing their plan with a Medicare Supplement Plan
(Medigap policy) will only be affected where their plan requires them to pay any of the respective
deductibles, co-payments or co-insurance.
2020 Premium, Deductibles, and Co-insurance Amounts
| 2019 | 2020 | |
| Part A inpatient hospital deductible (per benefit period) | $1,364 | $1,408 |
| Hospital coinsurance 61-90 days (per benefit period)Days 91 and beyond (lifetime reserve days) |
$341$682 | $352$704 |
| Skilled nursing facility care coinsurance for 21-100 days | $170.50 | $176 |
| Part B deductible for physician services, outpatient hospital services, certain home health services, and durable medical equipment | $185 per year | $198 per year |
The Donut Hole closes more in 2020
On Medicare Part D plans, the third stage, called the coverage gap stage and nicknamed the “donut hole”, will close more in 2020. This means beneficiaries will save more on their prescription drugs when in the donut hole as both brand name and generic medications that are on their plan’s formulary will be at 25% cost to the beneficiary until they reach the fourth stage, called the catastrophic stage, of the drug plan. Some prescription drug plans offer more coverage in the donut hole than this standard Part D coverage.
Changes to Medicare Supplement Plans in 2020
The Medicare Access and CHIP Re-authorization Act of 2015 requires that no Medicare Supplement (Medigap) Plan starting in 2020 be allowed to cover the Medicare Part B deductible. This means that newly eligible beneficiaries turning 65 starting in 2020 will not be able to purchase Medicare Supplement Plan F or Plan C.
Note: These plans are still available to those who have already purchased them or who were eligible for Medicare prior to January 1, 2020.
Some carriers will begin to offer a new high deductible Plan G starting in 2020.