Tag Archives: medicare insurance plans

National Check Your Meds Day and AEP

October 13, 2017 David Higgs

A pharmacy trade group association has declared Oct. 21st, National Check Your Meds Day. I think this is a great idea especially with Medicare’s Annual Election Period (AEP) right around the corner beginning Oct. 15th and ending Dec. 7th each year.

Many people and especially seniors, take a large number of medications. While many are needed, many are not needed as they are duplicates doing double duty with other medications that do the same thing. The worst case scenario is some of the medications can be lethal when taken with other medications. You would think this can’t happen because the doctor should know better. Unfortunately, many times the doctor does not know what else someone is taking. Some people have several doctors treating different medical conditions and not aware of other prescriptions.

So, everyone that is taking more than several medications should take advantage of this special day to proactively have them all checked. It is as simple as taking all of your prescriptions (the actual bottles) to your pharmacy for a review. They can tell you if there are any potential problems and perhaps check with your doctor about any issues raised.

This is good timing because you should also check your Medicare Part D drug plan for any changes. Your Annual Notice of Change booklet from your Drug plan will alert you to the plan changes effective the coming Jan. 1st. Also, your prescriptions could have changed and worth taking a look at your options.

This is what I do for clients day in and day out. Let me know if I can answer any questions. David Higgs

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 D Drug Plan Premiums Lower for 2018!

August 4, 2017 David Higgs

Here is something you don’t see very often. CMS who oversees Medicare has projected that the average Medicare Part D Drug Plan premium is expected to decrease in 2018! Based upon the bids by insurers for their 2018 Drug Plans, the national average premium is about $1.20 less than 2017 national average of $34.70.

This is in spite of the fact that Medicare Drug costs are rising faster than other Medicare costs primarily due to high-cost specialty drugs. So, while this is not a lot, it is a change in the trajectory which is good.

You can read more about it at the article linked here: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2017-Press-releases-items/2017-08-02-3.html

2018 Medicare Part B Premium and Social Security Cola Projections

July 14, 2017 David Higgs

The trustees who oversee Social Security and Medicare have announced their projections for the 2018 Social Security Cost of Living Adjustment (Cola) and Medicare Part B Premium. At this point they are projecting a 2.2% increase in the Social Security Cola. They are also projecting no increase to the current $134/month Part B Premium. (High income earners pay more and some people who already had Part B pay less.)

This is good news for seniors especially compared to the last few years with little to no Social Security Cola increases. I will update this topic when the final amounts are announced. this fall.

Interesting Stats on Medicare Costs and Coverage

May 16, 2017 David Higgs

Many times when meeting with clients, they want to know if they really need Supplemental coverages such as a Medigap Plan (Supplement) or a Medicare Advantage Plan instead of just going with Medicare Parts A and B alone. So what many Medicare beneficiaries really want to know is, what kind of out of pocket costs will they have if they don’t enroll in Supplemental types of coverages. I recently came across some interesting statistics that address this issue.

Using averages of all Medicare beneficiaries, they will have out of pocket medical costs a little over $3,000 per year (not including premiums). If you exclude those costs not covered by Medicare, I estimate you arrive at about $1,200/year in 2016 dollars. That is less than the average Medigap policy cost (looking at all ages, sexes and plans). One might conclude that on average, they would likely spend more in Medigap premiums than they would receive in benefits. However, with a Medigap policy, they cap their out of pocket exposure for medical costs. Medicare Advantage Plans also cap exposure. Remember that 2 of the largest out of pocket costs Medicare beneficiaries risk are the Part A Inpatient Hospital deductible(s) ($1316 per benefit stay in 2017) and the uncapped 20% Part B outpatient exposure.

To me, this data reinforces the need and value of insurance. Having a Medigap policy or a Medicare Advantage Plan not only helps cover out of pocket medical costs, but it protects your financial assets. It allows you to have the peace of mind we hear about so often.

If you would like to read more about this topic, I have linked to a website that covers this topic in more detail: http://www.commonwealthfund.org/publications/issue-briefs/2017/may/medicare-out-of-pocket-cost-burdens

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

April 28, 2017 David Higgs

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

Medicare Card Numbers Still Changing

March 29, 2017 David Higgs

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.

Medicare Eligible Seniors Who Also Have an ACA Plan Should Consider Their Options.

February 2, 2017 David Higgs

Seniors who either already have Medicare or who will soon become eligible for Medicare and also have an ACA Health Plan (aka “Obamacare Plan”), should carefully consider their coverages. This creates a lot of confusion for seniors in this situation as there is no single source to confirm what they should do. In general, having both will duplicate coverage and be more expensive than just having a Medicare Supplement or Advantage Plan. A recent article that describes some of the issues is linked below.

http://khn.org/news/officials-warn-some-older-marketplace-customers-to-switch-to-medicare/

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 2017 Medicare Costs at a Glance

January 3, 2017 David Higgs

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.

Causes of Drug Price Increases and What Can You Do About it?

September 21, 2016 David Higgs

We are all affected by drug price increases. There are many reasons for this phenomenon but several factors have been more significant. While we all want to know why this is happening, we also want to know what can we do.

As noted before, this issue arises a lot with my Medicare clients. So, what can my clients do about it? I have blogged before about some easy things to do such as: ask your doctor for samples, shop around different pharmacies, ask for generics, etc. I find the biggest thing to do is to compare your plan options. If you are on a stand-alone Part D drug plan, you should shop each year. If you are on a Medicare Advantage plan, you will need to consider both Plan medical benefits and drug copay costs. Of course, I help my clients each year with these comparisons. It usually starts with keeping drug lists current in Medicare’s comparison site where I can then help decipher the options including all costs (premium, deductible and copays).

A recent article goes into more detail on causes of increases. A link to that article follows: http://khn.org/news/candidates-decry-high-drug-prices-but-they-have-few-options-for-voters/

The main takeaway for me was, people need a good Independent Agent who specializes in Medicare. If you have questions about Medicare, call me, with no cost or obligation. This is what I do and enjoy it.

Medicare Part B Premium Increase for 2017

September 8, 2016 David Higgs

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.

Helping seniors transition to Medicare