Medicare Changes for 2015

What Do You You Need to Know about Medicare Changes in 2015?

By Tucker Thompson

Because of the impact that some of these changes can have on both your healthcare and checkbook, thorough reviews are recommended! Highlights are mentioned below with special emphasis on checklists to help you better understand your choices.

While most Medicare recipients still won’t pay any “monthly premiums” for Part A in 2015, patient responsibilities per benefit period will include a $1260 “deductible” for hospital stays from 1-60 days, and a $152 “coinsurance” after 20 days for skilled nursing facility stays. Part B “monthly premiums” will be $104.90 again this year, with final figures income based. Additional patient costs include a $147 annual deductible and 20% of your Medicare approved bill, the same as last year.

To help offset costs, Medicare supplements or Part C [including Advantage Plans, HMOs, PPOs, PFFS] offer additional coverage seniors can buy. While some plans can save you thousands, others can cost you thousands! When reviewing plans:

  • Make sure your doctors accept the plan.
  • Carefully review the coverage, monthly premiums, deductibles & co-pays.
  • Ask what the maximum, worse case out of your pocket is.
  • Check at least one other company’s plans for comparison!
  • Look at company support systems (an 800#) with or without a local agent.

Prescription Drug Plans [Part D] for 2015 have made changes to their formularies, their premiums, deductibles and co-pays. When reviewing Prescription Drug Plans:

  • Make sure your prescriptions are on the plan’s formulary!
  • Estimate expected annual costs for your prescriptions.
  • Is there an option to save using “mail order” or buying a 90-day supply?
  • What is the monthly premium? Include any deductibles!
  • Are “preferred pharmacies” convenient for you?

For 2015 “the gap/donut hole” is between $2960 and $4700. You are responsible for paying 45% of your brand name drugs and 65% of your generic drugs while in this “gap/donut hole”. The Cost of Living Adjustment [COLA] for Social Security participants is 1.7% for 2015.

With so many moving parts to Medicare, seeking help from an experienced, independent agent who specializes in Medicare plans and is licensed with several companies can be indispensable!


Tucker Thompson CSA, the author, has worked in the insurance field for over 22 years. His time is spent helping individuals review or enroll for new medical, Medicare Supplements, Medicare Advantage Plans, Medicare Prescription Drug Plans, Life and Long Term Care policies.