How Upcoming Changes to Medicare Might Affect You

Medicare is a complicated program that can change significantly from one year to the next. Read about the changes for 2017

If you are already a Medicare recipient or if you are going to become eligible for Medicare soon, you should be aware of the changes the national health insurance program will be facing during 2017. Available for those with disabilities, end-stage kidney disease, and U.S. residents who are 65 years of age or older, Medicare is a complicated program that can change significantly from one year to the next. The most significant changes impact your out-of-pocket expenses. You are going to see higher premiums, higher copays, and higher deductibles in most cases plus you may see limitations on therapy services.

Higher Deductibles and Higher Copays for Medicare Part B

While some of the most obvious changes to Medicare that impact everyone includes an increase in premiums and higher deductibles. The average increase of premiums is about $4 per month, making the average premium about $109 each month. This is an increase of about 4% for most Medicare enrollees. The Part B deductible was $147 in 2015 and rose to $166 in 2016. It will increase to $183 for 2017.

Changes to Medicare Part A Include Premium Increases

Medicare Part A is designed to cover the costs of hospitalization. If you are like the majority of enrollees, you don’t have to pay a premium of Part A. People who haven’t earned 40 quarters of work history are required to pay premiums for Part A coverage. Those premiums are increasing as well. If you have less than 40 quarters of work history, but more than 30 quarters of work history, your premium will be $227 per month during 2017, which is up $1 from 2016. If you are among those who have less than 30 quarters of work history, the premium is increasing from $411 during 2016 to $413 during 2017.

Higher Prescription Drug Plan Costs

If you are an enrollee who has a stand-alone Part D prescription drug plan, you can expect to see an increase of about 9%, which will average $42.10 monthly during 2017 if you keep the same plan you had during 2016. While premiums vary from plan to plan, the top 10 plans range in costs from $16.81 to $71.66 each month. The maximum allowable deductible for Part D plans was $360 during 2016, but will increase to $400 during 2017, which is about 7%.

Medicare Advantage Premiums Decrease

If you are enrolled in a Medicare Advantage plan you can expect to see your premiums decrease. The average premium for Medicare Advantage plans will be around $31.40 per month during 2017, which is a 4% decrease from 2016. These premiums are in addition to Medicare Part B premiums. Medicare Advantage plans sometimes offer additional benefits, such as dental and vision coverage, and there are more plans that offer extra benefits during 2017.

Therapy Cap

In 2017, the Medicare therapy cap is once again increasing. The therapy cap applies to all outpatient therapy, including speech-language pathology, physical therapy, and occupational therapy. This cap includes the 80% that is paid by Medicare and the patient copay. The therapy caps are increasing by 20%. This means the physical therapy and speech-language pathology combined therapy cap is $1,980. The cap for occupational therapy is $1,980. Once you have reached the caps, there is a process for medically necessary therapy costs as high as $3,700. A manual review process can be performed for medically necessary therapy that cost more than $3,700.

Stay Informed

You should always stay current on the changes to Medicare, so you will be aware of how your medical needs and costs are going to be impacted. It is not uncommon to see changes made to Medicare coverage each year, so always watch for your updated benefits guide and read it so you will know how the changes are going to affect you. Most changes impact how much you will be paying out of pocket, so it is detrimental that you understand what is happening so you can prepare yourself for the additional expense. If you have any questions about your coverage, call Medicare at 1-800-633-4227. You can also learn more by visiting .

This article was written by the Outreach Team at Disability Benefits Help. They provide information about disability benefits and the application process. To learn more, please visit their website at or by contacting them at

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