What Is New In Medicare?



Changes In Deductible

Medicare’s new deductible is $310, compared to 2009’s $295, a fifteen-dollar increase. After the recipient’s deductible is met, the recipient pays 25% of his or her covered costs up to his or her total prescription costs, meeting the Initial Coverage Limit.

Reassignment of Low-Income Subsidy Eligible Individuals

Designated Low-income Subsidy recipients will be reassigned from their PDP programs that currently have premiums which are exceeding the benchmark set forth by LIS to PDPs with premiums that are level with or are below the benchmark. This plan took effect on January 1, 2010. CMS will continue to mail recipients whom are affected and plan to increase plans which are losing membership and to help recipients figure out how to ensure maximum benefits from their plans.

Changes In Initial Coverage Limit

Medicare’s new Initial Coverage Limit is $2,830, compared to 2009’s $2,700, a $130 increase. After the $2,830 coverage is met, the recipient will begin paying 100% of his or her prescription costs–the ‘Donut Hole’–up to the Out-of-Pocket Threshold, an exciting new change to a recipient’s Medicare plan.

Changes in Out-of-Pocket Threshold

Medicare’s new Out-of-Pocket Threshold is $4,550, compared to 2009’s $4,350, a $200 increase. $4,550 is the maximum amount a Medicare recipient can pay before Catastrophic Coverage kicks in and covers the rest of the costs accrued.

Retroactive Auto-Enrollment of Full Benefit Dual Eligible Individuals

CMS will implement a plan to assign new FULL BENEFIT DUAL ELIGIBLE INDIVIDUALS WITH RETROACTIVE COVERAGE to a single contractor for the retroactive periods in which he or she is eligible for. A competitive solicitation was conducted by CMS, and they are implementing a random system to assign these eligible recipients with qualifying PDPs.



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