Here we are again in the midst of the holiday hustle and bustle. During this very busy season, we want to stop to take a few minutes to wish you a happy holiday and wonderful New Year. At this time of the year, we believe it’s important to reach out with a very BIG thank […]
Thanksgiving is behind us. We survived the stampede on “Black Friday” and “Cyber Monday”. A few of us even already have holiday decorations up. We’re not quite at the holiday “half way” mark. To help you make it across the finish line (into 2019!) happy, healthy, and well rested, we’ve collected these five simple health “hacks” that will help you make it through the holidays.
Let’s review a few key insurance terms to make sure you understand what they mean. And, give us a call, if you have any questions about your coverage. Medicare Part A: Government insurance that covers hospital, rehab, part-time or intermittent skilled nursing care and hospice costs. Part B: Government insurance that covers, doctor visits, ambulance […]
The 2019 Open Enrollment Period runs from Thursday, November 1, 2018, to Saturday, December 15, 2018. This is true for all states that do not have their own health exchange, such as California. Remember, if you don’t act by December 15, you can’t get 2019 health care coverage unless you qualify for a Special Enrollment […]
It’s Medicare Open Enrollment and now is the time to review your coverage for 2019. Think about what has changed in the last year and what your needs will be in the coming year. This will help you find a Medicare plan that suits your needs. Here are five questions to help you determine […]
Now that it’s Medicare’s Annual Election Period (AEP) you can switch your Part D or Medicare Advantage plan. Also known as open enrollment, it happens every year from October 15 to December 7, for a plan taking effect January 1. During Medicare Open Enrollment 2018 you cannot do the following: Join Part B, unless you […]
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.