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There are changes to Medicare premiums in 2017.
In the face of low Social Security Cost-of-Living Adjustments (COLA) and because of the Medicare hold-harmless provision, premium increases cannot exceed the 0.3 percent increase in Social Security benefits. If you are within the hold-harmless group, you were paying $104.90 in 2016 and will pay $109.00 in 2017.
In general, you are in the hold-harmless group if your Medicare Part B premium is deducted from your Social Security benefits each month.
The beneficiaries not in the hold-harmless group will see an increase of ten percent to $134.00 for 2017. The annual Part B deductible will increase $17 to $183.
For those that pay for their Medicare Part A, premiums will increase 5 percent $413. Other changes to Medicare Part A are noted in the table below:
Part A Deductible and
Coinsurance Amounts for 2016-2017by Type of Cost Sharing
2016 2017
Inpatient hospital deductible
$1,288 $1,316
Daily coinsurance for
61st-90th Day
322 329
Daily coinsurance for
lifetime reserve days
644 658
Skilled Nursing Facility
coinsurance
161 164.50
Some changes are also in store for Medicare Part D prescription drug plans. The average cost of the monthly prescription drug plan has increased slightly to approximately $34. The Part D deductible for 2016 was $360. In 2017 it goes up to $400. There are 20 plans offered by 11 companies in North Dakota. Two plans by Cigna continue to remain under a Center for Medicare and Medicaid Services sanction. This means they cannot market or sell their products to beneficiaries until they make sufficient changes.
Medicare supplements or Medigap plans - Understand the basics
You might hear Medigap plans referred to as Medicare supplements or supplemental health insurance. A Medigap policy is standardized supplemental health insurance that pays for part or all of the Original Medicare cost-sharing you owe. The costs that Medigap plans cover include deductibles, coinsurance amounts and copays. For example, a Medigap plan pays for your Part B coinsurance charges, meaning that it will pay for the 20 percent coinsurance you normally owe when you receive Medicare covered physician services.
It is important to know that Medigap policies only work with original Medicare Parts A and B. If you get your Medicare benefits from a private Medicare plan, known as a Medicare Advantage Plan, you cannot purchase a Medigap. In fact, if you already have a Medicare Advantage Plan, it is illegal for anyone to sell you a Medigap policy unless you are switching back to original Medicare.
Congress has made some changes that will impact Medigap plans starting Jan. 1, 2020. The Medicare Access and CHIP Reauthorization Act of 2015 states that newly enrolled beneficiaries may not purchase Medigap plans type C or F, which cover Part B annual deductibles. Beneficiaries currently on plans may keep them.
Medigap plan types and premiums
There are ten types of Medigap policies, referred to as "plans," named after letters of the alphabet. Though the coverage offered within each plan is set by federal law, insurance companies do not have to offer all 10. Regardless of the company selling them, plans with the same letter must offer the same benefits. Each company may charge a different monthly premium for the same lettered plan. By shopping around each year, you may find a plan that offers the same benefits for less premium.
There are three ways that insurers price Medigap plans.
Community rated pricing: Monthly premium is based on where you live. For example, people who live in the same county pay the same premium regardless of their age.
Issue age rated pricing: Monthly premium is based on the age you are when you first purchase the policy. Premiums can increase because of inflation, but not because you get older.
Attained age rated: Monthly premium is based on your current age. For example, a company may set one premium for people between 65 and 70 years old, and a higher premium for people 71 to 75 years old.
Contact your State Health Insurance Counseling program (SHIC) to learn how to compare Medigap policy coverage and prices.
When can you buy a Medigap policy?
Under federal law you only have the right to buy a Medigap if you are 65 or older and you buy your policy during a protected time. The protected enrollment times are during your Medigap Open Enrollment Period or when you have a guaranteed issue right.
Your Medigap Open Enrollment Period lasts for six months, starting with the month you are both 65 and enrolled in Medicare Part B. Companies must sell you a policy at the best available rate and cannot deny you coverage. You can buy the Medigap plan of your choice when you are in your Medigap Open Enrollment Period.
You have a guaranteed right for 63 days after you lose or end certain kinds of health coverage. Medigap companies must sell you a policy at the best available rate and cannot deny you coverage. Depending on the reason, you may be restricted to only purchasing certain plans. However, when you have a guaranteed issue right, insurance companies cannot impose a waiting period before covering pre-existing conditions.
Where can I go for assistance with Medicare issues?
If you have any questions, issues or problems related to Medicare, please call the State Health Insurance Counseling (SHIC) program at 1-888-575-6611. We provide free and unbiased counseling to any Medicare beneficiary. We can also be found on the internet at www.nd.gov/ndins/shic.