New Benefits At-a-Glance

WebMD Medical Reference

Many changes have been made to Medicare in recent years. Some changes apply now. Others will go into effect over the next few years. Here's how it breaks down:

2005

  • Anyone enrolled in Medicare can apply for a drug discount card up through December, 2005. These can save you 10% to 25% on prescriptions.
  • You may also qualify for a credit to pay for prescriptions. Single people who make $12,919 a year or less and married couples with an annual income of $17,320 or less are eligible.
  • If you applied by March 2005, you got the full $600 credit. After that month, the later you apply, the smaller the credit. People who applied between April 1 and June 30 received a $450 credit; people who apply between July 1 and September 30 will get a $300 credit; people who apply between October 1 and December 31 will get a $150 credit. This credit can be used until May 15, 2006 or until someone signs up for a Medicare Prescription Drug Plan - whichever comes first.
  • Medicare pays for a "welcome physical checkup" when you enroll in Medicare Part B, covering office visits. You must get the checkup within six months of enrolling in Medicare.
  • Blood tests to screen for heart disease are covered for the first time. This includes cholesterol tests.
  • Tests to screen for diabetes are covered for the first time.
  • Your deductible for Medicare Part B is $110. The fee goes up every year to keep pace with inflation.

2006

  • Medicare Advantage (formerly Medicare + Choice) will include preferred provider plans, in addition to managed care health plans. Most Medicare Advantage plans will also provide prescription drug coverage.
  • People in traditional Medicare will choose a drug insurance plan from the companies offering insurance in your area.
  • Premiums for drug insurance will cost about $32 per month. Of the first $2,250 in drug costs, you pay the first $250 as a deductible and 25% of the remaining $2,000.
  • You pay 100% of the next $2,850 in drug costs.
  • After you have paid a total of $3,600 in drug costs, you pay only either 5% for brand name drugs or $2 per prescription for generic drugs.
  • Fees may be waived or reduced for single people whose incomes are less than $14,355 a year and assets are $11,500 or less and for couples whose joint income is less than $19,245 and whose assets are $23,000 or less.

2007

Monthly premiums for Medicare Part B will go up for single people making $80,000 or more a year, and married couples making $160,000 or more a year. Rates are based on a sliding scale, and will be phased in over five years. For example, if you make more than $200,000 a year as an individual -- or more than $400,000 as a couple -- you would pay 80% of your costs. At present everyone pays 25% of costs no matter what their income.


Reviewed by Cynthia Haines, MD, August 2005.

SOURCES: Centers for Medicare and Medicaid Services. Medicare.gov web site. National Council on the Aging web site.

© 2005 WebMD Inc. All rights reserved.


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Last Editorial Review: 12/9/2005