Solutions for Seniors

2017 & 2018 Changes:

Since the implementation of the Affordable Care Act in 2013 we will continue to see annual changes with the Medicare medical and prescription plans.

- Premiums, deductibles, copays, and out of pocket maximums may increase with some of the Medicare Advantage plans. There continues to be standard premium increases with the Medicare Supplement (Medi-Gap) plans. Some carriers reset their premium increases in January and some will offer one premium update per year.

- Increase of the Part D prescription deductible to $400 (2017) and $375-$405 (2018). Many preferred generics at zero copay remain.

- Reduction in benefits - such as copay increases on doctor visits, hospital admission fees, outpatient services, skilled nursing, and durable equipment copay changed to coinsurance.

- We continue to see reduction in the number of physicians servicing Medicare eligible members.

- 2018 Medicare ID card changes. Beginning in April 2018, new Medicare cards without Social Security numbers will be sent to beneficiaries, according to CMS, meeting a deadline set by Congress to replace all the cards by April 2019. The new cards will use a unique, randomly assigned combination of letters and digits that will be known as the Medicare Beneficiary Identifier (MBI).  The MBI will be an 11-character code. Through December 2019, providers will be allowed to use either the MBI or the old HICN.   Source: National Service Group Compliance Bulletin 

 

What is Medicare:

Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities, and any age with permanent kidney failure (also known as End-Stage Renal Disease or ESRD). Medicare covers many health care services and supplies, but there are many costs (gaps) it does not cover. 2

Different parts of Medicare:

- Part A (hospital insurance) - helps covers inpatient care in hospital and helps cover skilled nursing facilities, home health, and hospice care.  The monthly premium is zero for most members if they have paid into Social Security.
- Part B (medical Insurance) - helps covers doctor’s services and outpatient care, other medical services that Part A does not cover (like physical and occupational therapists), and some home health care. The monthly premium for this benefit is $134 for 2017 and increases approximately 5% every year.
- Part C (Medicare Advantage Plans) – health coverage options (like PPOs and HMOs) run by private companies approved by and under contract with Medicare.  Includes Part A and Part B, and usually includes other coverage like prescription drugs.
- Part D (Medicare prescription drug coverage) – a prescription drug option run by private insurance companies approved by and under contract with Medicare

We know that Medicare, with all its “parts” can get somewhat confusing. On top of that, when it comes time to choose a Medicare Advantage or Supplement plan that is right for you, the possibilities can seem endless. It is important to review your health care needs every year. If you are dissatisfied with your current plan’s cost and coverage or customer services you have options for change.

If you are just starting to investigate senior plans or have questions about your current coverage please call us or Contact Us if you would like to discuss your options.

Deductibles:

2018 Part A $1340 Part B $183

2017 Part A $1316 Part B $183

2016 Part A $1288 Part B $166

2015 Part A $1260 Part B $147

Eligibility:

Enrolled in Medicare A & B
Guaranteed issue rights

Enrollment Periods:

Annual Election Period: October 15 to December 7
Medicare Disenrollment Period: January 1 to February 14
Initial Coverage Enrollment Period (ICEP):  Within 3 months of your 65th birthday, and 3 months after your birthday month
General Enenrollment Period: January 1 - March 31    If you did not sign up for Part A and/or Part B (for which you must pay premiums) when you were first eligible, you can sign up. Your coverage will begin July 1. You may have to pay a higher Part A and/or Part B premium for late enrollment.    

Special Election Period: when circumstances apply such as moving into a new area, change in Medicaid eligibility, full and partial dual eligibility.  Within 60 days of losing your group health coverage.
Open Enrollment Period for Institutionalized Individuals (OEPI): a continuous period for individuals who move into, reside in, or move out of an institution.  OEPI ends two months after the month the individual moves out of an institution.

 

Source: 1 Anthem, Senior Marketing Done Right 8-2011
            2 Choosing A Medigap Policy: A Guide to Health Insurance for People with Medicare
Disclaimer:  The information provided on this internet page is for educational purposes. Consult Medicare and You Handbook for additional information.

Resources:

Medicare 1-800-MEDICARE or TTY users call 1-877-487-2048

Websites:

www.medicare.gov
www.blueshieldca.com
www.anthem.com/ca
www.healthnet.com/medicare 
www.aetnaseniorplans.com  and www.coventry-medicare.com
www.aarpmedicareplans.com 

www.silverscripts.com

www.silverandfit.com

www.silversneakers.com

 

 

 

Contact us today for a free, no obligation, discussion regarding your needs. Contact Us >>