Medicare Advantage Plans are contracted with the government to provide health services to Medicare beneficiaries, and these plans receive payments from the government to help cover the cost of care. They are also called Medicare Part C and do not require medical underwriting to get the plan. These plans are rated up to Five Stars that measure their effectiveness in addressing their members’ health concerns. Four and Five-Star rated plans indicate a high level of efficacy in evaluating and rectifying health issues. The Centers for Medicare and Medicaid rate the plans using a list of measures, i ..read more

 Signing up for Medicare Part B when you are still working.  If you are working for a company with 20 or more employees when you turn 65 and covered under group health insurance, you can delay enrolling in Medicare until you retire without incurring any penalties.  You have the option of going on Medicare or staying on your employee health plan.  As long as your group health plan is considered “creditable” (as good as what Medicare offers), you can remain on it until you either leave the company or retire.  Not getting a Part D Drug Plan when you become eligible.  ..read more

The standard monthly premium for Medicare Part B will decrease in 2023 to$164.90, a savings of $5.20 from 2022’s premium of $170.10. The Part B deductible will also decrease to $226.00, a savings of $7 form the 2022 deductible of $233. The change was precipitated by a May 2022 report from the Centers for Medicare and Medicaid Services (CMS) that recommended excess reserves in the Supplementary Medical Insurance Trust Fund (SMI) be passed on to Part B beneficiaries. This savings will be offset, however, by an increase in the Part A deductible and coinsurance amounts. The Part A deductible will ..read more

If you have a Medicare Advantage Plan and want to get back into a Supplemental Plan without going through medical underwriting, Blue Shield is having an Underwriting Holiday from now until November 30, 2022. Why is this the perfect time to switch? Since the Underwriting Holiday overlaps with AEP (Medicare’s Annual Enrollment Period), you would be able to get a Stand-Alone Part D drug plan to go with your Supplemental plan (since supplemental plans don’t include drug coverage). From October 15 to December 7, you can sign up for a drug plan with an effective date of January 1, 2023. People chang ..read more

As Annual Enrollment for Medicare Advantage and Prescription Drug plans approaches, it is time for Medicare beneficiaries to take stock of their current plans to determine if a change would benefit them.  Plan members should be receiving their Annual Notice of Changes in the mail to see what modifications (if any) are being made for 2023. But with the influx of new Medicare Advantage plans with myriad benefits, how do you choose the right one for you? Below is a checklist of items you want to consider when trying to make a decision if you are new to Medicare or just considering makin ..read more

The proposed White House Budget for 2023 has some key healthcare considerations the Biden administration has long wanted to address.  Paramount among them is a five-year $81.7 billion investment in pandemic preparedness.  The focus would be in research of vaccines and treatments for biological threats like COVID-19. Prevention and technology to combat new illnesses that might arise in the future are also targeted for increased funding. Investment in research to combat cancer is also a high priority for President Biden who hopes to reduce the cancer death rate by 50% over th ..read more

The No Surprises Act went into effect January 2022 as part of the Consolidated Appropriations Act of 2021.  The purpose of the Act is to address surprise or balance billing that health plans charge when you use out-of-network providers.  It prohibits insurers from charging higher rates or denying claims for care obtained from out-of-network providers for emergency services, and in some cases, certain services provided by out-of-network clinicians at in-network facilities.  It stipulates that the health plan must cover these services as if they were in-network. The Act also requi ..read more

Most people sign up for Medicare to begin the first day of their 65th birthday month.  You can get Medicare prior to your 65th birthday if you are disabled or have permanent kidney failure.  If you are still working and have a group employee health plan, you can postpone signing up for Medicare until you retire.  You won’t be charged a penalty on your Part B premium as long as your group plan is creditable (or coverage that is as good or better than Medicare).  When you do retire, you have eight months to sign up for your Part B beginning with the month after your group hea ..read more

Most people know that the Medicare Annual Enrollment Period is October 15 through December 7.  The barrage of commercials featuring aged sports icons and actors not seen on television in decades starts in early October and doesn’t end until well after the holidays.  But there is another enrollment period called the Open Enrollment Period (OEP) from January 1 through March 31 in which you can still change your Advantage Plan if you are not happy with your previous choice.  This coincidentally coincides with the Medicare General Open Enrollment Period in which you can sign up for ..read more

Medicare recipients are facing more choices than ever before this Annual Enrollment Period (AEP) as carriers roll out plans with rich benefits, zero dollar premiums, and even reimbursements on Part B premiums.  So how should you narrow down the many options?  Here are some things to look for when contemplating a plan change. Look beyond the gimmicks.  A plan might have a lot of benefits, but if your doctor isn’t in the network, or if the network is so skinny you will have trouble finding providers, it might not be worth all the “extras”. Look at your ANOC, Annual Notice of Chan ..read more