Medicare in 2014: What you need to know

It’s the start of a new year, which is a time of review and reflection for many people. Now also is a good time to look at the Medicare changes that will happen this year and a good time to talk about Medicare as an important source of health coverage for readers who will be turning 65.

Q: What will 2014 bring for Medicare beneficiaries in terms of changes in out-of-pocket costs?

A: While prices for everything seem to go up every year, the good news for Medicare beneficiaries is that premiums for Medicare Part B will remain the same for 2014, holding steady at $104.90 a month. The Part B deductible also remains unchanged at $147 a year.

Q: What if I have Medicare Part D prescription drug coverage?

A: Those with Medicare Part D will see a $15 drop in their deductible, from $325 in 2013, to $310 in 2014. And the “doughnut hole” (coverage gap), which has been getting smaller each year since 2011, will continue to get smaller too. In 2014, the doughnut hole will be $158.75 smaller than it was in 2013, another step closer to the goal of eliminating this coverage gap by 2020.

And while you’re in the doughnut hole, you’ll pay less than half (only 47.5 percent) of the cost of name-brand drugs. The discount for generic drugs also goes up this year: People with Part D will pay 72 percent of the cost of generic drugs, down from 79 percent in 2013.

Q: What else will 2014 bring for Medicare beneficiaries?

A: The Affordable Care Act added a strong emphasis on preventive care to Medicare. The start of a new calendar year means that a whole range of free preventive services are again available to Medicare beneficiaries. Annual services (those you get once every 12 months) include a wellness visit with your primary care physician, a mammogram or prostate cancer screening and a flu shot.

Other preventive services are available for free too, including screenings for abdominal aortic aneurysms, bone mass measurements and diabetes screenings. A list of free preventive services is available on the Medicare website at ventive-and-screening-services.html.

Q: What if I’m turning 65 in 2014? How do I sign up for Medicare?

A: The answer to that question depends on whether you are getting Social Security benefits.

If you are getting Social Security, you should receive materials from the Social Security Administration (or from the Railroad Retirement Board, if you are a railroad retiree) about your Medicare options a couple of months before your 65th birthday.

When you turn 65, you’ll automatically be enrolled in Medicare Parts A and B, with an option to decline Part B. If you want to decline Part B, be careful: Unless you have other health insurance (such as coverage through a spouse’s policy), there’s a big penalty for signing up later. And you should research your options for Medicare Part D so you’re ready to choose a drug plan.

If you are not receiving Social Security, you have to proactively sign up for Medicare, with the same options for Part B as just described.

Whether you are receiving Social Security or not, you have an alternative to signing up for traditional Medicare: You can sign up for a Medicare Advantage plan instead. Medicare Advantage plans are private plans that include the coverage you’d get under Medicare Parts A and B, and they may include drug coverage too.

Your best sources of information on your options are:

The Social Security website

The Medicare website

You also can get free, in-person help from your State Health Insurance Assistance Program (SHIP). Call 800-MEDICARE to get a referral.

Q: What are key dates to keep in mind for 2014?

A: If you didn’t sign up for Part A or B when you first became eligible, you can sign up during the general enrollment period, which runs from January 1 to March 31, 2014. Remember, you may pay a higher premium for enrolling late.

If you have a Medicare Advantage plan, you have until Feb.15, to leave your Medicare Advantage plan and move to (or back into) traditional Medicare.

Between Oct. 15 and Dec. 7, 2014, you can change your Part D drug plan, join a Medicare Advantage plan, and exercise other Medicare coverage options.

Pollack is executive director of Families USA.