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.

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

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.

When Should You Enroll in Medicare? You Might be Surprised.

August 5, 2016 David Higgs

One of the most common questions (concerns) when I first speak with my clients is regarding if and when they must enroll in Medicare Part B. This arises as they either read about it, heard it from a friend or received correspondence stating they “had” to enroll but gave no clarifications. I also find many should have enrolled and did not know they needed to enroll. There are several key clarifications.

In short, people who become eligible for Medicare while they are working and on their employer’s health plan (or spouse’s) do not “need” to enroll in Medicare if they work for a company with 20 or more employees. If they work for a company with less than 20 employees, they do need to enroll in Medicare because it will be considered primary coverage to their small company’s health plan. Confused yet?

Regardless of whether or not they need to enroll in Medicare Parts A and B, the first thing I help prospective clients with, is to determine if they should stay on their company’s health plan or move to Medicare. This involves comparing the incremental cost to move from the employer plan to Medicare coverages. In most cases, Medicare coverages (including supplemental) is richer coverage than most employer plans.

A recent article just noted that over 750,000 Medicare beneficiaries have made the mistake of not enrolling when they should have and will be paying penalties averaging 30% for the rest of their lives. As a result of complaints, Congress is considering legislation to help address this problem. What is also interesting, is this figure does not talk about the number of beneficiaries who do enroll in Medicare needlessly and are spending potentially thousands of unnecessary dollars. If you want to read more about this, you can follow the link to the article: http://www.philly.com/philly/health/20160803_How_to_save_big_on_Medicare__Know_when_to_sign_up.html

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

News Update on Mergers (Aetna/Humana & Anthem/Cigna)

July 22, 2016 David Higgs

Lately, there has been a lot of attention in the news to the pending mergers between Aetna and Humana as well as Anthem and Cigna. The latest news is about the federal suits to stop the mergers. The main thing I want my clients to know is that with or without the mergers, their Medicare Plan will remain in place. This will mainly pertain to Medicare Advantage Plans and Part D drug plans. If there are going to be changes, they will occur at the Annual Election Period (AEP) where they can make a change if needed. In addition, if the merger(s) proceed, it will be years not months. As usual, I will help my clients with this.

Feel free to call me with any questions as this process continues. David.

Medicare Beneficiaries Should Get in the Habit of Asking

June 21, 2016 David Higgs

Another constant reminder I recommend all my Medicare clients do is to always ask about prescription alternatives. A recent study showed that doctors are easily influenced by drug company reps in what they should prescribe. In many cases, these prescriptions are for costly Brand name drugs in which there is a lower cost alternative. The study found that in many cases, a $12 complimentary meal to the doctor could end up costing patients hundreds of dollars more than the cost of a suitable equivalent. I am not against the free market and how a company chooses to promote its products, but I want my clients to be aware of their choices. If you want to read more about this study, you can click on the following link: http://well.blogs.nytimes.com/2016/06/20/drug-company-lunches-have-big-payoffs/?_r=0

So, my recommendation to my clients anytime their doctor prescribes something, is to always ask the doctor if there is a generic or lower cost drug available, do they have any samples they can provide and if the drug is totally necessary.

Medicare Advantage Plan Study Shows Lower Avoidable Hospital Admissions

May 26, 2016 David Higgs

A recent study has just been released that shows that Medicare Beneficiaries on Part C Medicare Advantage Plans had about 10% less avoidable hospital admissions than those on Original Medicare. While my clients on Medicare Supplements have more comprehensive coverage than my Medicare Advantage Plan clients, this study is encouraging in showing Medicare Advantage Plan clients also get good medical care and helps stretch their coverage dollars.

If you want to learn more about this study, you can go to the following link: http://www.aafp.org/news/practice-professional-issues/20160517mahospitalization.html

Medicare Beneficiaries, Shop, Shop, Shop!

May 19, 2016 David Higgs

Last month, I posted about how I am always reminding my Medicare Beneficiary clients that they are the Customer. They should ask questions about procedures and how they can save money by doing so. Another recent study validates this.

Researchers at the University of Pennsylvania Health System recently confirmed how much can be saved and how much transparency exists for medical procedure costs. They gave an example of shopping around for a CT scan over a 3 state area and finding a cost variance from $437 to $2239!

Beneficiaries with a Medicare Supplement have less need to shop around due to the coverage. But Beneficiaries with either Part C Medicare Advantage plans or those who only have Parts A and B, can benefit by checking around.

If you want to read more about this topic, you can go to the following link: https://consumer.healthday.com/health-technology-information-18/cat-scan-news-88/out-of-pocket-x-ray-ct-scan-costs-vary-widely-710984.html

Proposed Changes to Medicare Payments

May 6, 2016 David Higgs

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

Medicare Patients are the Customers!

April 14, 2016 David Higgs

I am always reminding my clients, especially my Part C Medicare Advantage clients, that they are the Customer. They can and should ask how and where they can lower their medical costs. If a doctor prescribes a test, they should ask why it is needed and more importantly, where can they get that test done that will cost them the least based upon the specific Plan they have. Most of us are not accustomed to asking our doctors these types of questions. We think “they are the doctor, they should know best.” In many cases they don’t have any idea of the variances in costs for certain medical tests. Costs vary widely based upon where a test is administered and which Plan a patient has.

This is less of an issue for my Medicare Supplement clients; however, this concept of asking, also applies to prescriptions. As almost everyone has a Prescription plan (whether it is a stand-alone Part D drug plan or it is embedded in a Medicare Advantage Plan), there are many variables to lowering drug costs. Here too, ask for lower cost alternatives such as Generics and shop around at different pharmacies. A recent article describing proof that both doctors and patients are missing opportunities to lower costs is linked below:

http://khn.org/news/by-not-discussing-cost-issues-doctors-patients-may-miss-chances-to-lower-out-of-pocket-expenses/

The bottom line is Medicare Beneficiaries should get in the habit of asking questions regarding how, where and when they can save money when something is prescribed. I do it and I recommend my Medicare clients do it.

Helping seniors transition to Medicare