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For those who are close to Medicare or who are already covered by it, now is the time to review the health benefits.
Philip Moeller – author of a much-loved Medicare book titled "Get What You Need for Medicare: Maximize Your Coverage, Minimize Your Costs," and a Medicare blogger for the "PBS NewsHour" website – is familiar with the fine print of the program that has captured a lot in what it calls the "no one said me" syndrome.
Last year, Moeller almost made a costly mistake. He had the opportunity to check his Medicare Part D drug coverage plan only one day before the end of the Medicare opening season. He discovered that an essential drug he needed had been removed from the list of drugs covered by his plan.
"It would have cost me $ 20,000 a year to buy the drug on my own," said Moeller, who went to great lengths to find another plan to cover the drug and who was register just in time.
That is the complexity of Medicare that almost everyone can be trapped. Every day, approximately 10,000 baby boomers reach the age of 65, allowing them to join the 58.5 million Americans already enrolled in the National Seniors Health Insurance Program. . Medicare now accounts for 15% of all federal spending, according to the Congressional Budget Office. Costs are expected to increase by almost 5% per year over the next decade, according to the Henry J. Kaiser Family Foundation.
At this rate, Medicare Part A, which covers hospital care, acute care in a specialized nursing facility, palliative care and some home care, will exceed its trust fund in 2026. For this reason, the Medicare costs are a big priority. In 2018, new enrollees began paying premiums based on Medicare Part B income, which includes doctor visits, laboratory work, outpatient surgery, and preventive care and testing.
Several changes are coming in 2019, including the Medicare Part D drug benefit and some Medicare Advantage plans, offered by private insurance companies and known as Medicare Part C. (See "Get Ready!"). yourself to changes next year ". below. )
That is why it is more important than ever for Medicare beneficiaries – and anyone who is nearing the age of 65 – to start looking at all the details right now, during the period of time. Open Medicare registration, which started on October 15th and ends on December 7th. time of year when changes can be made to a plan without penalty. There are many different diets that can work better or worse depending on your state of health and your finances. Experts say you should choose a plan that not only supports your current health needs, but also what they could be in 10 years from now.
Here are some other important elements of Medicare:
1. Most people qualify for Part A "no premium" by paying their Medicare taxes through payroll deductions for at least 10 years. Part B premiums range from about $ 134 per person per month to $ 429 per month for those earning about $ 160,000 or more than $ 320,000 for a common tax return. The cost of Medicare Advantage Part C plans varies depending on the company offering the plans and benefits covered. Another thing to know: Medicare covers most costs, but not all. For 2018, the part A franchise that a patient must cover will raise $ 1,340 for each admission to the hospital during the year. For extended hospital stays of more than 61 days, the additional charge is $ 335 or more per day.
2. You must register for Medicare when you reach the age of 65 through the Social Security Administration, unless you already receive a Social Security contribution or receive benefits. retirement from the railway. In this case, the registration may have been done for you. The stopwatch actually starts three months before your 65th birthday and ends three months after the month of your birth. Register online or by mail, but many experts advise to register in person at a social security office. Walk-in visits are allowed, but it will be quicker to make an appointment in person or by phone by calling 800-772-1213.
Late registration can result in costly penalties. How many? Up to 10% more per year for each missed year. You may also be faced with a delay in the start of coverage, leaving you with a health insurance deficit. A word of caution: If you work at a large employer and plan to continue working, you do not have to subscribe immediately to Parts B, C or D, as long as you can keep an insurance plan. during work. You will have eight months after your retirement to register. Check with your employer and the SSA before you turn 65.
3. Given the possibility of penalties or delay in coverage, experts say you should not wait until the last minute to register. A few months before retirement, ask your Human Resources department about the end of your employer's health coverage. Some insurance plans stop at midnight on the last day of employment, which may leave you without coverage. As you prepare to retire, ask your employer to fill out a federal form, which will verify that you have taken out uninterrupted and trustworthy health insurance.
4. If you have put money into a Health Savings Account (HSA), you must stop these payments before the start of Medicare or Social Security benefits. HSAs are tax-free accounts in which people pay pre-tax dollars through their work. They are used to pay for medical expenses such as health insurance deductibles. The rules of the Internal Revenue Service prohibit Medicare beneficiaries from contributing to HSAs. If you continue to do so while on Medicare, you risk severe tax penalties.
But you can use any remaining money in the HSA after you sign up for Medicare or your Social Security participation. Please note that: Part A without bonus is antedated for six months from the date you applied for Medicare or Social Security. This means that once set up, it covers the costs of the previous six months. Therefore, the Centers for Medicare and Medicaid Services (CMS) advise you to no longer contribute to your HSA at least six months before applying for Medicare to avoid paying tax penalties.
5. If you are enrolled in Parts A and B, consider taking out Medigap Supplemental Insurance. Medigap plans, offered by private insurers, can help cover the annual Part A and B deductibles, as well as the additional costs of extended hospital stays and other excess costs beyond what Medicare pays. About 14 million Americans subscribe to a Medigap plan, according to the American Association for Medicare Supplement Insurance. Some of these plans also cover medical expenses incurred during a trip abroad. The Medigap coverage can be used by any doctor or hospital accepting Medicare.
6. Medicare Advantage Plans – Medicare Part C – may work better for you than subscribing to different parts of Original Medicare. Discover how they work. Each year, more than 20 million Americans subscribe to these private insurance plans. Because they combine parts A, B and D into one and they can also provide coverage for vision care and dental care, some people find them easier to use and, in part, function of the chosen plan, less expensive. If you are enrolled in a Medicare Advantage plan, you do not need a Medigap plan. Advantage plans usually require you to stay in their network of doctors and hospitals to control costs. Your choice of plans will depend on where you live. some places have 20 or more plans available, others only have one or two.
7. The cost of drugs can be an important part of health care costs in retirement. There are many prescription drug coverage plans in Part D. It is helpful to review the list of medications offered by each. Find one that suits your needs. Be sure to review the list of medications each year during the open registration period. If a prescription drug plan that you need is removed from your plan, you can replace it without penalty. You can also set up a custom drug form on CMS.gov to compare Part D drug plans.
Beyond the annual premium, Part D coverage requires users to pay an annual deductible, which in 2018 could not exceed $ 405 per person per year.
8. If this is confusing, you can find more information at the following address: Medicare.gov, CMS.gov/medicare/medicare.html and AARP.org/health/medicare-insurance.
Get ready for the changes next year
Among the planned changes in Medicare in 2019 are:
The annual D deductible will increase from $ 10 to $ 415. The "black hole" coverage gap will continue to narrow for branded prescription drugs covered by Part D of the insurance. (This change will come into effect for generic drugs in 2020.) The hole in the donut means that once your drug coverage reaches the annual limit of $ 3,820 for 2019, you are then responsible for the cost of the drugs.
What has changed is that you will get an "exceptional discount" of 75% on branded drugs until your expenses reach the limit of $ 5,100 a year. Then the Part D Drug Plan will resume payment for your prescription drugs. So, if you need a brand-name drug costing $ 100, you will only pay $ 25 and $ 95 will be deducted from your personal expenses for 2019.
Effective January 1, new Medicare beneficiaries will no longer be able to purchase two of the Medigap supplemental insurance plans now available. Medigap C and F plans do not require additional fees for recipients. Both plans will continue to operate, but as no new members are added, current members will likely see premiums increase as the pool of people sharing the costs of these plans decreases.
Some Medicare Advantage plans will begin to offer lifestyle support services, such as home delivered meals, installation of toilet support bars and transportation for doctor's appointments . Previously, the costs of these services had to be paid for. These services will only be covered if they are prescribed by a health professional.
Squires, a former editor of Washington Post Health who now blogs on www.sallysquires.com, is expected to start using Medicare on Jan. 1.
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