Tag Archives: cms changes

Part B Penalty Waiver for ACA Medicare Eligibles

In February, I blogged about the confusion many seniors encounter regarding the decision to move to Medicare if they are on an Individual health plan under the Affordable Care Act (Obamacare).  I noted that even though they can keep their ACA plan, it is rarely beneficial to do so.

The other issue noted was that people on an ACA plan  that are also eligible for Medicare, must elect Part B.  If they do not do so, they will be subject to the Part B penalty.  Very recently, Medicare has announced they will allow people who were impacted by this situation to apply for a waiver.  The deadline is September 30th to get this in.

If you want to read more about this issue, you can see a related article at the following link:  http://khn.org/news/feds-to-waive-penalties-for-some-who-signed-up-late-for-medicare/

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

Medicare and Home Health Care Coverage Change

Many of my Medicare clients ask if Medicare covers home health care.  The short answer is yes, but it has some restrictions.  In the past, one of those restrictions was that the patient’s medical condition would be expected to improve as a result of the home health care.  As a result, that meant that many beneficiaries who have a permanent condition would not be eligible for home health care coverage because their situation was “permanent”.

This restriction has recently been modified to include beneficiaries whose condition would not improve, but would also not worsen.  Beneficiaries who have a condition that can be maintained so that it does not get worse can now be eligible for home health care under Medicare.  There are other restrictions and you can read more about how Medicare covers home health care at the following link to Medicare’s website at:  https://www.medicare.gov/coverage/home-health-services.html

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

Medicare Card Numbers Still Changing

You may recall a few years ago when the government announced they were prohibiting insurance companies to continue using  social security numbers as ID numbers.  However, it you look at your Medicare ID card, the government is the last entity to continue using social security numbers for identification.  As I previously reported, this will end but the process is taking a while.  The latest info I have seen is that new Medicare cards will be going out next year in April and should be completed by the following April in 2019.  If you want to read more about this, a recent article is linked here:  http://www.modernhealthcare.com/article/20170322/NEWS/170329971

Continue to protect your Medicare card and only use when absolutely necessary.  For those who have a Part C, Medicare Advantage Plan, remember that you should not show your Medicare card to any provider or pharmacy.   Only show your Medicare Advantage Plan card.  For those who have a Medicare Supplement Plan, they will continue to show their Medicare card and their Supplement Plan card to providers.

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

New 2017 Medicare Costs at a Glance

With the hectic Medicare Open Enrollment period ended, I wanted to post the key, new Medicare numbers that will be in effect for 2017.   These are the key changes to Medicare’s premiums and coverages.  As I predicted, CMS did not increase the Part B premium as initially indicated and came in just under a 10% increase.

  • Part A deductible – Will be $1316 up from $1288 (per 60 day Benefit Stay)
  • Part B Deductible – Will be $183 up from $166 (Annual deductible)
  • Part B Premium – Will be $134.00 up from $121.80 (Will not apply to existing 2016 beneficiaries who have it taken out of Social Security)
  • Part D Maximum Deductible – Will be $400 up from $360 (Some plans don’t have a deductible)
  • Part D Premium National Average – Will be $35.63 up from $34.10 (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

Medicare Part B Premium Increase for 2017

The latest news on Medicare Part B 2017 premium increase is “stay tuned”.   Congress is still working on this and the final determination won’t come until October 1st at the earliest.  Like last year, there is a strong possibility that the “Hold Harmless” provision will protect  existing Medicare beneficiaries who have their Part B premiums deducted from their Social Security check.  That will leave the others to take a larger load of the increase.

While a 22% increase is being discussed, my guess is it will be negotiated down like last year.  I will keep readers apprised.  If you want to read more on this, I have linked an article here:  http://www.miamiherald.com/news/business/article100185427.html

If you have questions about Medicare, call me, with no cost or obligation.  This is what I do and enjoy it.

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

Proposed Changes to Medicare Payments

CMS, who manages Medicare, has recently announced some proposed changes to how Medicare reimbursements will be made.  These proposals are targeting such areas as:  Hospital Observations status, Physicians, Skilled Nursing Facilities, Part B drugs, etc.  The various proposals are accepting comments in June.  The main goal of the proposed changes is to reward better patient health and cost efficiency.

You can check back on this blog for updates once these proposed changes have been finalized or go to CMS.gov.

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 address:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com

CMS Finalizes 2017 Medicare Advantage Payment

CMS has just released their 2017 Medicare Advantage plan capitation rate.  On average, the payment will increase by .85%.  You may recall that Medicare Advantage plans, also known as Medicare Part C, are one way Medicare Beneficiaries can get their Medicare.  This shifts the risk and responsibility for a Beneficiary’s Medicare claims from Medicare to the private insurance company offering the Medicare Advantage plan.

This slight increase probably means most plans will not have to change their benefits much.  We will know in October when all 2017 plans will be published.  The increases fluctuate from year to year.  If you want to know more about this news story, click on the link below.

http://www.bloomberg.com/news/articles/2016-04-04/u-s-increases-2017-medicare-advantage-rates-less-than-expected

If you have questions about Medicare coverages or the difference between Medicare Advantage plans and Medicare Supplements, contact me at:  David@ChoicesInMedicare.com or go to www.ChoicesInMedicare.com website.

Medicare Telehealth Bill

Earlier this month, a bipartisan bill was introduced in both the Senate and Congress to allow Telehealth services to be covered by Medicare.  The Medicare Telehealth bill would allow seniors to “see” a doctor from the convenience of their home via computer or smart phone device.  This could be extremely beneficial for seniors who are less mobile but have minor illnesses and just need a prescription.  Telehealth has been growing over the last few years and now could be extended to cover seniors.  It would be a “win-win” solution as it would save Medicare billions of dollars and provide conveniences to Medicare beneficiaries.  Stay tuned over next few months for progress on this bill.

To read more about this bill, click on the following link to the article:  http://www.bna.com/lawmakers-introduce-medicare-n57982066990/

We here at Choices In Medicare help people transition into Medicare.  If you have questions or need assistance obtaining Medicare Supplemental coverages, contact us at:  David@ChoicesInMedicare.com or go to our website at:  www.ChoicesInMedicare.com

Happy New Year! – New Medicare #’s to Know in 2016

It is New Year’s Day in 2016 and that means new Medicare numbers to know for this year.  In most years, CMS, who manages Medicare, increases some of the costs associated with Medicare Part A, Part B and Part D coverages.  The following shows some of the key numbers that have increased for 2016.

  • Part A deductible – Will be $1288 from $1260 (per 60 day Benefit Stay)
  • Part B Deductible – Will be $166 from $147 (Annual deductible)
  • Part B Premium – Will be $121.80 from $104.90 (Will not apply to existing 2015 beneficiaries who have it taken out of Social Security)
  • Part D Maximum Deductible – Will be $360 from $320 (Some plans don’t have a deductible)
  • Part D Premium National Average – Will be $34.10 from $33.13 (Is used to determine Part D Penalty)

While none of these are dramatic, it is still important to be aware of the changes.  Also, even with these increases, Medicare coverage and any applicable Supplemental coverages you may have is great coverage.

You can read more about this topic at Medicare.gov website by clicking on the following link:  https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2015-Press-releases-items/2015-11-10.html

If you have questions about your Choices in Medicare, please contact me at David@ChoicesInMedicare.com or go to www.ChoicesInMedicare.com

CMS Announces 2016 Changes to Medicare Part B Premium/Deductible

I reported this past July that CMS (who manages Medicare) announced there were possible, significant increases coming to Medicare recipients for their Part B premium and deductible.  This past Wednesday, Nov 11th, they announced that they have finalized the amounts of the increases.

The good news is they significantly scaled back the amounts of the increases.  2016 Part B premiums will increase from $104.90 to $121.80 for many people.  It will include those that newly enroll in Part B, those that don’t currently collect Social Security and higher income recipients primarily.  This increase will not affect approximately 70% of recipients that are currently on Part B and have the premium deducted from their Social Security check.

Part B deductibles will increase from current $147 to $166.  After several years of no increases, this will be much more tolerable than the initial amount proposed.

To read more about it, you can go to the CMS website linked here:  https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2015-Press-releases-items/2015-11-10.html

If you have any questions about Medicare insurance coverages, feel free to email David@ChoicesInMedicare.com or go to www.ChoicesInMedicare.com.