Changes in Medicare for 2014

I know that open enrollment for health insurance on the new state exchanges will run from October 1 to March 31. Does that mean that open enrollment for Medicare changes this year, too? Also, can I get a new health insurance subsidy to help pay for my Medicare Part D or my medigap coverage if I meet the income requirements?

No to both questions. The October 1 to March 31 open-enrollment period applies only to people buying health insurance on the exchanges, all of whom are under age 65. The open-enrollment period for Medicare Part D prescription-drug plans and all-in-one Medicare Advantage plans (which provide medical and drug coverage through a private insurer) is still October 15 to December 7, 2013, for plans that take effect on January 1, 2014.

The new subsidies don’t apply to people on Medicare, either. You can get a subsidy only if you’re younger than 65 and buy a policy on the exchanges. See Health Insurance Exchanges Gear Up for Action for more information about the exchanges for people under age 65, and see How to Qualify for a Government Health Insurance Subsidy for more information about the tax credits to help pay the premiums for policies on the exchanges.

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You will see only minor changes in Medicare Part D and Medicare Advantage plans in 2014. The “doughnut hole” -- the coverage gap in which you must pay out-of-pocket for your drugs -- continues to shrink. In 2013 and 2014, you get a 52.5% discount on brand-name drugs in the doughnut hole; the federal subsidy for generic drugs in the doughnut hole rises from 21% to 28% in 2014.

Premiums for Part D plans are expected to remain similar to 2013 in 2014, with average premiums rising slightly from $30 to $31 per month, according to the Centers for Medicare & Medicaid Services. You can expect trends that started a few years ago to continue, such as increasing co-payments, smaller pharmacy networks, extra discounts for preferred pharmacies and changes in drug tiers that can boost out-of-pocket costs. Even if your plan’s premiums barely budge this year, investigate how plans in your area cover your prescriptions. Starting in October, you can go to Medicare’s Plan Finder tool to compare the premiums and out-of-pocket costs for your drugs under all of the plans available in your area for 2014. (The new plan information is usually up on the site in early October, but you can’t sign up for a new plan until October 15; the 2013 plans and prices are on the site right now.)

For more information about shopping for Part D and Medicare Advantage plans, see The Best Resource for Comparing Medicare Plans.