Your Care Do you intend to keep the same doctor? Some doctors take original Medicare but don’t participate in Medicare Advantage Plans. Other doctors do the opposite. Ask your doctor’s office what coverage they accept before you make a decision about switching to a different physician. Do you realize that each Part D prescription plan […]
Here’s a list of some examinations and screenings Medicare recipients now get for free.
Many people mistakenly think Medicare can help. However, the government’s health insurance program for seniors will only cover care in a skilled nursing facility for a limited period after a hospitalization. It doesn’t pay for ongoing, custodial (non-skilled) care. The other alternative is a
No one likes to think about “what if” when it comes to protecting your family. What if something happens to you? What if something happens to your partner or parents? You need to consider how your family would do financially if the “What If” happens. Where would the money come from to pay for your […]
The Centers for Medicare and Medicaid Services announced that, starting in 2020, Medicare prescription drug plans can take advantage of a tool, called an indication-based formulary, that expands the choices of products they can cover, allowing plans to opt for cheaper drugs in certain cases. The announcement Wednesday is the latest part of the Trump administration’s blueprint aimed at lowering prescription drug costs that have spiraled upward in recent years.
BACKGROUND ON THE PART D COVERAGE GAP AND LEGISLATIVE CHANGES SINCE 2006
Under the original design of the Medicare Part D benefit, created by the Medicare Modernization Act of 2003, when Part D enrollees’ total drug spending exceeded the initial coverage limit (ICL), they entered a coverage gap. Enrollees who did not receive low-income subsidies (LIS) were required to pay 100 percent of their drug costs in the coverage gap until their out-of-pocket spending reached the threshold amount that qualified them for catastrophic coverage. (The coverage gap does not apply to beneficiaries who receive low-income subsidies.) In 2007, the first full year of the Part D benefit, 8.3 million Part D enrollees (32 percent of all enrollees) had total drug costs above the initial coverage limit and in the coverage gap (Figure 1). This total includes 3.8 million non-LIS enrollees who were required to pay 100 percent of their drug costs out of pocket in the coverage gap.
QWhat should I expect to happen to costs and coverage for my employer's health insurance plan for 2019?
AYou can expect the cost of medical and drug benefits to rise by 5% in 2019, according to the annual health care survey by the National Business Group on Health.
This would be the sixth consecutive year with a 5% increase, with premiums and out-of-pocket costs for employees and their dependents averaging $14,800 next year. Fortunately, employers continue to cover 70% of that tab, on average, with workers picking up the rest.
More than 20 years ago the Health Insurance Portability & Accountability Act (HIPAA) became law. Today, as a result of this law, we assume our private health information will always be protected. Before HIPAA When you think of HIPAA it may feel like privacy overkill to you. Yet, before HIPAA was law, more than one-third […]
Health care costs are one of the biggest concerns for retirees. For most American retirees, Medicare is their primary health care plan. Medicare is complicated, and understanding it is crucial to making smart decisions to help control health care costs. Unfortunately, research shows that many people don't. For instance, a report from The American College of Financial Services showed that only roughly 25% of those ages 60 to 75 could pass a retirement income literacy quiz that included a number of questions about Medicare.
Many of our clients have asked, why is Medicare Plan F going away? The short answer is the government believes that folks that have a Plan F utilize their Supplement insurance more than their counterparts that do not have the Medicare deductible covered. Since Plan F covers that deductible, it is going to be phased out for new enrollees.
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The Centers for Medicare and Medicaid Services (CMS) recently announced that the 2019 projected national average weighted monthly premium for Medicare Part D prescription drug plans will decrease to $32.50 from the 2018 average premium of $33.59. This average premium was calculated using stand-alone Medicare Part D prescription drug plans (PDPs) and Medicare Advantage plans with prescription drug coverage (MAPDs) combined and weighted by enrollment – so you may find that 2019 stand-alone Medicare Part D plans actually have a higher average premium when not considering the $0 or low-premium MAPDs.
Are you approach your 65th birthday or thinking about switching from a Medicare Advantage Plan to Medicare Supplement Plan (also known as a Medigap policy)? If so, here are seven things to consider. First, you must have Medicare Part A and Part B. If you have a Medicare Advantage Plan, you can apply for a Medigap […]
You wake up with a horrible headache, fever and dizzy. You feel sick all over. You think you should see a doctor or a nurse but it’s Sunday and your primary physician doesn’t have office hours today. Who do you call for to get treatment? Do you call 911 for an ambulance to take you […]