One Nation, Under God
One Nation, Under God
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Annual Out-of-Pocket Cap Starting January 1, 2025, your annual out-of-pocket costs for your Medicare Part D Pharmacy plan will be capped at $2,000. This includes what you pay for during the deductible period and as co-pays/coinsurance. After meeting the out-of-pocket limit, you will pay $0 for COVERED part D drugs for the rest of the year. Note that the medication has to be in your plan formulary to be included in the out-of-pocket cap. Medicare Prescription Payment Plan The Medicare Prescription Payment Plan is a new payment option that...
Open enrollment for Medicare Part D (Pharmacy/medications) plans is October 15 through December 7th. If you decide to change plans the new plan will start January 1, 2025. To have a Part D plan you need to have Part A or B of Medicare. If you are new to Medicare, you can enroll in a Part D plan during your initial enrollment period which is 3 months before you turn 65, the month of 65, and 3 months after without incurring a penalty. If you enroll after your initial enrollment period, you will be subject to a penalty that is added to your plan...
Great news: thanks to the new prescription drug law, the Inflation Reduction Act, in 2024 people with Medicare may qualify for even more savings through the Extra Help program. This program helps some people pay their Medicare drug coverage (Part D) costs, like premiums, deductibles, coinsurance, and other costs. In 2024, the program will expand and you may qualify. How does Extra Help lower my costs? In 2024, everyone who qualifies for Extra Help will pay: • $0 for your Medicare drug plan premium. • $0 for your plan deductible. • A reduc...
Around 70 percent of people over the age of 65 will require long-term care services at some point in their life. According to the Administration on Aging (AOA), the average woman needs long-term care services for 3.7 years, and the average man needs those services for 2.2 years. The time for someone with an advanced stage of Alzheimer’s disease may be much longer. One-third of people aged 65 and older may never need long-term care support, but one-fifth will need it for longer than 5 years. Long-term care is the largest out-of-pocket health c...
First what is the difference between Medicare Fraud and Medicare Abuse. Abuse is when Medicare is overcharged or unnecessary services are billed to Medicare. The net effect extra tax-payer funds are spent which depletes the Medicare Trust Fund. Medicare abuse is not always intentional but its effect on the Medicare program is the same. Examples of Medicare abuse are upcoding of a Medicare claim to a more complicated service or for longer time frames or adding billing modifiers for a higher level of service. Other examples include unbundling of...
If you get Social Security Benefits at least 4 months before turning 65, you are automatically enrolled in Part A and B when you turn 65. You will get a Welcome to Medicare packet in the mail which will include your Medicare card. You can decline Part B if you have other creditable health insurance coverage, just check the box on the back of your Medicare card and mail it back. You will then receive a new card with only Part A indicated. NOTE: you will need to remember to enroll in Part B and Part D (pharmacy) prior to losing your creditable...
Turning 65, decisions, decisions... A few months before you turn 65, you should learn about Medicare coverage choices and consider important enrollment times and your coverage options. You should start at least 3 months before you turn 65. Visit Medicare.gov or call the State Health Insurance Program hotline: 1-800-551-3191 to be assigned a counselor near you. Your initial enrollment period (IEP) is three months before you turn 65, the month of your birthday and three months after. Most people w...
Starting January 1, 2023, the start dates for Medicare Part B coverage will change. Coverage will start the first day of the month after a person signs up, if they sign up during the last three months of their Initial Enrollment Period (IEP) or during the General Enrollment Period (GEP). Before this change, if you signed up during the last three months of your IEP, your Medicare Part B coverage started two to three months after you enrolled. If you don’t sign up for Medicare Part B during your IEP, you have another chance every year during GEP...