Tag Archives: 2016 medicare changes

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

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.

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 Beneficiaries Should Get in the Habit of Asking

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.

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 Advantage Plan Study Shows Lower Avoidable Hospital Admissions

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

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 Beneficiaries’ Cognitive Health Tied to Heart Health

Here is another reason Medicare Beneficiaries should strive for improved Heat Health:  improved cognitive health.  A recent study released in the Journal of the American Heart Association found that the more heart-healthy steps people attain, the quicker and sharper their thinking skills.  So, not only will efforts to improve heart health help you live longer, but will help your memory and thinking skills.

To see more of the article, click on the following link:  http://consumer.healthday.com/cardiovascular-health-information-20/heart-attack-management-and-prevention-news-365/a-healthy-heart-may-protect-an-aging-brain-709040.html

If you have questions about Medicare, contact David Higgs at David@ChoicesInMedicare.com or go to www.ChoicesInMedicare.com

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

Private Exchanges and Choices In Medicare

Many Retirees and other Medicare eligible beneficiaries will be directed to a Private Exchange to select their health plan benefits.  Typically, large employers and some large Benefits firms are getting into the Private Exchange arena.  The latest entrant is the financial services firm, Fidelity, who has announced this as a strategy.  A Private Exchange is similar to the Affordable Care Act Marketplace Exchange which was designed for people under 65.    An Exchange is merely a website that lists a person’s options and allows enrollment.  By itself, an Exchange is OK but there are some things anyone contemplating their options via an Exchange should be aware of.  I have reviewed some of the Exchanges and found a few common issues:

  1. The Exchange is going to be limited to a few plans from a few carriers. This means that there may be other options which could be lower cost that won’t be available.
  2. The people staffing the inbound phone lines are sometimes not experienced, independent Benefits professionals. Their knowledge can be limited to the training received for that call center role.
  3. Some of the information on the Exchange is either out dated and/or inaccurate.
  4. In many cases where the beneficiary is an employee, the employer contribution will only apply if the employee obtains their benefits through the Exchange. This could mean an employee must limit themselves to the Exchange options even though there may be better options available.
  5. The Exchange experience is not very personable. You are dealing with someone you don’t know in an unknown location.

So what is the alternative?  People like me usually allow you to avoid these pitfalls.  As an independent agent, I represent most or all of certain types of available plans.  For example, I represent all of the Medicare Advantage plans in Central Virginia and 7 of the largest, national Medicare Supplement companies.  In most cases, I can meet face-to-face and establish a better environment when making such important decisions and, at no cost to the client.

If you have questions about your Choices In Medicare, contact me at David@ChoicesInMedicare.com or visit our website:  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