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.

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

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

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

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.

Part B Penalty Waiver for ACA Medicare Eligibles

June 9, 2017 David Higgs

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/

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.

Helping seniors transition to Medicare