Tag Archives: affect on medicare beneficiaries

New 2020 Medicare Costs At A Glance

January 1, 2020 David Higgs

New 2020 Medicare Costs at a Glance

Happy New Year! As I do every new year, I wanted to post the key, new Medicare numbers that will be in effect for 2020. These are the key changes to Medicare’s premiums and coverages. A highlight is the average costs for Part D drug plans have gone done and the infamous “Donut Hole” (aka Coverage Gap) name no longer applies as costs for people who do reach this stage now only pay 25% of the cost for Brand or Generic drugs.

Part A deductible – Will be $1408 up from $1364 (per 60 day Benefit Stay)
Part B Deductible – Will be $198 up from $185 (Annual deductible)
Part B Premium – Will be $144.60 up from $135.50 (Excluding Irmaa)
Part D Maximum Deductible – Will be $435 up from $415 (Some plans don’t have a deductible)
Part D Premium National Average – Will be $32.74 DOWN from $33.19 (Is used to determine Part D Penalty)

Feel free to contact me if you have any questions or need assistance with selecting a Medicare Plan. I don’t charge any fees nor increase your cost.

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare. He can be reached at email: David@ChoicesInMedicare.com or go to website: www.ChoicesInMedicare.com

No More Plan F and MACRA

March 15, 2019 David Higgs

Many of my Medicare clients ask about the news they have heard about Plan F Supplement going away. While that is the gist of what is happening, let me clarify a little more about this change.

Almost 4 years ago, a new federal law (MACRA) announced that effective Jan 1, 2020, first dollar Part B coverage would be phased out. Certain Medicare Supplement Plans (aka Medigap policies) such as Plan F pay the Part B deductible which is $185 in 2019. The new law will mean those Supplements cannot be offered to Newly Eligible Medicare beneficiaries on or after Jan 1, 2020. This means a few things. Beneficiaries that already have a Plan F Supplement can keep it. If beneficiaries who are not “Newly Eligible” have a different Supplement plan, they can still apply for a Plan F (assuming they are healthy enough to medically qualify). Those that are Newly Eligible on or after Jan 1, 2020, will not be able to get a Plan F or similar.

In spite of all that, most of my clients do not select a Plan F. This is primarily due to cost and coverage differences to other Supplement Plan letters. Feel free to call if you have questions about this.

If you want to learn more about this topic, the link below will direct you to more details: https://www.naic.org/documents/cmte_b_senior_issues_related_macra_faq_2018.pdf#page=5

New 2019 Medicare Costs at a Glance

January 4, 2019 David Higgs

As I do every new year, I wanted to post the key, new Medicare numbers that will be in effect for 2019. These are the key changes to Medicare’s premiums and coverages. A couple of the highlights are that the Part B premium only went up $1.50 and the Part B deductible only went up $2.

Part A deductible – Will be $1364 up from $1340 (per 60 day Benefit Stay)
Part B Deductible – Will be $185 up from $183 (Annual deductible)
Part B Premium – Will be $135.50 up from $134.00
Part D Maximum Deductible – Will be $415 up from $405 (Some plans don’t have a deductible)
Part D Premium National Average – Will be $33.19 DOWN from $35.02 (Is used to determine Part D Penalty)

Feel free to contact me if you have any questions or need assistance with selecting a Medicare Plan. I don’t charge any fees nor increase your cost.

Medicare Open Enrollment – AEP

September 30, 2018 David Higgs

It’s that time of year, again. We are coming up on the Annual Election Period (AEP) for Medicare. That means you are going to be seeing a lot of commercials and receiving a lot of mail about making changes. You may be wondering what you should do, if anything.

So, what do you need to do? It depends.

The AEP is the Open Enrollment period for Medicare Advantage Plans and Part D drug plans that occurs every year from October 15th through December 7th. This is the time for those that may want to make changes which will become effective January 1, 2018. Remember that the insurance companies that offer Medicare Advantage Plans and Part D drug plans can change them from year-to-year. You will receive a letter from the insurance company called an Annual Notice of Change (ANOC) that will describe any changes they are going to make for the coming year. If you are happy with the plan and want to keep it, you don’t have to do anything. Just continue to pay your premium (if applicable) and the plan will remain in effect for 2019.

If your prescriptions have changed, you can update them at Medicare.gov. Also, if you have any changes in doctors, you can look to see if they participate with your plan. All of the new Plan information will be available Oct. 1^st in Medicare.gov. You can’t make any changes until October 15th. If you want to make any changes or have questions or need assistance, contact me.

Medicare Supplements aka, Medigap policies, are not impacted by the AEP. They are guaranteed renewable as long as premiums are paid.

As always, call me with any questions, any time about your Medicare coverages. I will help you sort through the info and options. Thanks, David.

Medicare and HSA: Part 2

July 23, 2018 David Higgs

I have blogged before about the issue for people who have any Part of Medicare while they are working and on an employer group health plan that includes an HSA. In short, you can’t contribute to an HSA account while having even premium-free Part A of Medicare due to IRS regulations. Medicare-eligibles who are faced with this situation have another element to consider and which I was not aware. When someone delays enrollment in Medicare due to continuing to work past 65 have another potential surprise. The Social Security department will make Part A retroactively effective up to 6 months. This means that even if they knew to delay enrolling in any Part of Medicare while having an HSA, they could still be hit with penalties and taxes for the retroactive credit!

You can research this if you want to learn more. Or, feel free to call me if any questions about this nuance or anything else related to Medicare.

Make Sure You Pay the Lower Drug Cost

May 21, 2018 David Higgs

One thing most people are not aware of is that they should always pay the lower cost of either the copay or actual cost of their prescriptions. As an example, if the actual cost of a drug is $5 and their drug plan’s copay is $10, they should only pay the lower $5 cost. People can pay the higher cost if they are not aware of the actual cost and if the pharmacy attendant is not paying attention. It can also occur due to other nefarious reasons.

CMS (who manages Medicare) just announced a renewed effort to insure Medicare beneficiaries get the better deal. They have told Part D drug plan sponsors they will suffer compliance actions if they do not comply.

If you want to read more about this issue, you can go to an article linked here: http://www.healthcarefinancenews.com/news/part-d-plan-sponsors-face-compliance-action-drug-gag-orders-cms-warns

Let me know if I can help with Medicare questions.

New Medicare Cards Beginning April 2018

March 5, 2018 David Higgs

As I noted last year, Medicare has been working on issuing new Medicare Cards which will begin arriving in mailboxes next month. The primary purpose for this project is security. Social Security numbers will be replaced with a Medicare Beneficiary Identifier. Finally! They have been working on this project for years and made all insurance companies make this change years ago.

Medicare beneficiaries do not have to do anything. As long as their address is current in Medicare’s system, their card will arrive without request some time over the next year. Once received, the old card should be destroyed and begin using the new card immediately.

One caution is to be aware of scammers who will try to take advantage of this event. To learn more about this issue, I have included a link to an article that describes more about the new cards and process.

https://www.aafp.org/news/practice-professional-issues/20180301medicarecards.html

Feel free to contact me if you have any questions or need assistance with selecting a Medicare Plan. I don’t charge any fees nor increase your cost.

New 2018 Medicare Costs at a Glance

January 8, 2018 David Higgs

With the New Year just starting, I wanted to post the key, new Medicare numbers that will be in effect for 2018. These are the key changes to Medicare’s premiums and coverages. As I noted in July, CMS did not increase the Part B premium or Part B deductible for 2018 as expected. Below are the key, new numbers:

Part A deductible – Will be $1340 up from $1316 (per 60 day Benefit Stay)
Part B Deductible – Will remain at $183. Yippee! (Annual deductible)
Part B Premium – Will also remain at $134.00 for new beneficiaries. (Will not apply to many existing beneficiaries who had already taken out of Social Security) And does not apply to high income earners.
Part D Maximum Deductible – Will be $405 up from $400 (Some plans don’t have a deductible)
Part D Premium National Average – Will be $35.02 DOWN from $35.63. (Is used to determine Part D Penalty)

Feel free to contact me if you have any questions or need assistance with selecting a Medicare Plan. I don’t charge any fees nor increase your cost.

Why Step Therapy When You Have Already Proven Need?

December 17, 2017 David Higgs

Many times in meetings with my Medicare clients, they are concerned about having to go through Step Therapy again if they change plans. I usually then give a quick reminder of the beneficial reasons for Step Therapy that will lower costs for all involved, including my client.

A recent article by Dr. Harry Gewanter went deeper into the pros and cons of Step Therapy. The good news is generally about 80% of people who have already gone through Step Therapy are able to avoid having to repeat Step Therapy with the help of their doctor. The other 20% of the time is still a problem which is getting more attention. The 2018 Virginia General Assembly will hopefully be addressing this next year. A link to Mr. Gewanter’s article follows:

http://www.richmond.com/harry-l-gewanter-let-doctors-and-patients-decide-the-best/article_7f629382-6fca-5c13-be68-76765afe4af5.html

Helping seniors transition to Medicare