Don’t Go Broke in a Nursing Home

Mr. Peter J. Losavio, Jr. will be giving a seminar at the Zachary Branch Library Conference Room Tuesday October 20th @ 4:00pm and 6:00pm and Tuesday October 27th at 4:00pm and 6:00pm.  To attend this seminar call 1-800-426-6104 to reserve your seat.

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PART 2: POSSIBLE CHANGES IN MEDICARE

Medicare Annual Enrollment Period (AEP)

As you may know, the Annual Enrollment Period for Medicare beneficiaries will be October 15 through December 7.  This is the period during which you may make certain changes in the way you want to receive your Medicare benefits in 2016, including the following:

  • A beneficiary enrolled in Original Medicare (Parts A and B) may enroll in any Medicare Advantage Plan or stand-alone Part D Prescription Drug Plan offered in the service area – with no medical underwriting.
  • A beneficiary enrolled in a Medicare Advantage plan may choose a different plan or return to Original Medicare.
  • A beneficiary enrolled in a Medicare Part D Prescription Drug Plan may choose a different plan.

Note:  The Annual Enrollment Period does not apply to Medicare Supplement policies, which are usually renewed on the anniversary date of the beginning of coverage.  Open enrollment in such coverage applies only when a beneficiary first enrolls in Medicare Part B.  Guaranteed issue (without medical underwriting) applies only at that time and when a beneficiary qualifies for a Special Enrollment Period, e.g., upon the loss of employment-based coverage.

Any beneficiary currently enrolled in a Medicare Advantage plan or Part D Prescription Drug Plan should have already received information from the current plan about any changes to be effective January 1.  No action is needed if the beneficiary is satisfied with the current plan and the scheduled changes.

Effects of provisions of the Affordable Care Act (ACA) continue to impact health insurers who offer Medicare Advantage and Prescription Drug Plans and, in turn, the Medicare beneficiaries enrolled in such plans.  In response to changes in reimbursement from the Centers for Medicare and Medicaid Services (CMS) and benefits costs, most insurers are implementing changes effective January 2016.  Such changes may be in the form of premiums, out-of-pocket costs or both.

The purpose of this notice is only to remind you of your annual options and is not a recommendation that you make any changes.  However, this is a good time to review alternative plans, particularly if your prescription drugs have changed.  If you are affected by Medicare plan changes announced for 2016, you should review them carefully – first of all to ensure you understand them, and then to decide whether you are satisfied with the changes or whether you should consider an alternative plan for 2016.

Even with any changes announced for next year, your current plan may still be the right one for you.

Factors to Consider in Evaluating a Medicare Advantage or Prescription Drug Plan

  • Amount of monthly premium
  • Out-of-pocket costs for services you anticipate receiving
  • Participation of your physicians and other health care providers in plan networks
  • Inclusion of your prescription drugs in Part D plans’ formularies and the tiers/copays to which your products are assigned
  • Your experience with plan administration and customer service
  • CMS Star Rating

Possible Changes in Medicare Costs IN 2016

Although the Centers for Medicare and Medicaid Services (CMS) has not yet announced changes for 2016, the following might be expected, based on preliminary information released:

Monthly Medicare premium – The standard Part B premium of $104.90, which has not changed the past three years, is likely to increase in January 2016 for many beneficiaries.  It is still possible for the Secretary of the U.S Department of Health and Human Services to intervene to temper the increases.  If that does not happen, Medicare premiums could look like this, based on current reports:

  • Beneficiaries receiving Social Security retirement benefits – $104.90 (no change, since retirement benefits are projected to include no cost-of-living increase).
  • Beneficiaries not receiving Social Security retirement benefits and with Modified Adjusted Gross Income (MAGI) below $85,000 for single tax filers and below $170,000 for joint filers – $159.30, a 52% increase.
  • Beneficiaries with MAGI above these thresholds – between $233.00 and $509.80, including Income-Related Monthly Adjustment Amount (IRMAA), compared to a range of $146.90 to $335.70 in 2015. There could also be increases in the IRMAA for Part D.

Part B deductible – Also unchanged the past three years, the current deductible of $147 may increase, but no announcement has been made.  Of course, beneficiaries enrolled in Medicare Advantage and many Medicare Supplement plans would not be subject to payment of this amount.  However, it would undoubtedly be reflected in increased Medicare Supplement premium rates upon renewal.

Part A out-of-pocket costs for inpatient care – These costs – currently $1,260 per stay of 1-60 days, $315 per day for days 61-90, and $630 per day for each of 30 lifetime reserve days – typically rise by modest amounts each year and will likely increase in 2016.

Part D coverage gap – The amount of drug cost that sends a beneficiary into the coverage gap and the amount of out-of-pocket cost at which the beneficiary leaves the gap will both rise in 2016.  The percentage of the cost of generics while in the gap will slightly decrease, and the copay amounts paid for both brands and generics once out of the gap will slightly increase.

 

. Medicare Premiums Expected to Rise Steeply for Some, Stay Unchanged for Most

Most Medicare enrollees can expect to pay the same amount for their Medicare Part B coverage (the portion of Medicare that pays for doctors’ services and outpatient care) in 2016 as they do this year ($104.90), according to estimates from the latest Medicare trustees report. But about 1 in 7 enrollees will face a dramatic increase. In 2016, about 70 percent of Medicare enrollees will be protected from an increase because of a “hold harmless” provision in federal law that says their Medicare premium cannot go up from one year to the next by more than the increase in their Social Security benefit. Government officials currently estimate there will be no cost-of-living increase in Social Security benefits next year because inflation has been so low. For about 30 percent of Medicare enrollees, premiums are expected to rise steeply. About 14 percent of enrollees will pay these premiums themselves. The rest will not be directly affected because they are enrolled in Medicaid or a Medicare Savings Program and their premiums are paid by their state. Three groups will see increases:
• People who newly enroll in Part B in 2016 (about 5 percent of Medicare enrollees);
• Medicare enrollees who do not receive a Social Security check — for example, enrollees who delay claiming Social Security benefits because they continue to work (about 3 percent of Medicare enrollees); and
• Higher-income enrollees (people with income above $85,000 or couples with income above $170,000) who pay higher premiums (about 6 percent of Medicare enrollees)

For these enrollees not protected by the hold harmless provision, the Part B standard monthly premium will be $159.30 in 2016, a 52 percent increase. Higher-income enrollees who pay higher premiums will also see a 52 percent increase; their 2016 monthly premiums will be between $223 and $509.80, depending on income. The rise is especially steep because the total increase in premium revenue required in 2016 will be spread among only the 30 percent of enrollees who are not protected by the hold harmless provision, rather than among all enrollees.

Don’t Go Broke in a Nursing Home

Mr. Pete Losavio will be speaking at a  free workshop at Sunrise of Baton Rouge 8502 Jefferson Hwy. Baton Rouge, LA 70809  on Saturday June 27, 2015 at 9:30 am to discuss his new book he co-authored ” Don’t Go Broke in a Nursing Home”.  Please call 1-880-426-6104 to attend.

New Cards for Medicare Recipients Will Omit Social Security Numbers

Concerned about the rising prevalence and sophistication of identity theft, most private health insurance companies have abandoned the use of Social Security numbers to identify individuals. The federal government even forbids private insurers to use the numbers on insurance cards when they provide medical or drug benefits under contract with Medicare.

But Medicare itself has continued the practice, imprinting Social Securitynumbers on more than 50 million benefit cards despite years of warningsfrom government watchdogs that it placed millions of people at risk for financial losses from identity theft.

That is about to change, after President Obama signed a bill last week that will end the use of those numbers on Medicare cards.

“The Social Security number is the key to identity theft, and thieves are having a field day with seniors’ Medicare cards,” said Representative Sam Johnson, Republican of Texas, who pushed for the change with Representative Lloyd Doggett, a Texas Democrat.

The main purpose of the law, adopted with broad bipartisan support, was to overhaul the way doctors are paid for treating Medicare patients. But it makes other changes as well. One section that received little attention says Social Security account numbers must not be “displayed, coded or embedded on the Medicare card.”

Congress provided $320 million over four years to pay for the change. The money will come from Medicare trust funds that are financed with payroll and other taxes and with beneficiary premiums.

In his budget for 2016, Mr. Obama requested $50 million as a down payment “to support the removal of Social Security numbers from Medicare cards” — a step that federal auditors and investigators had been recommending for more than a decade.

More than 4,500 people a day sign up for Medicare. In the coming decade, 18 million more people are expected to qualify, bringing Medicare enrollment to 74 million people by 2025.

New beneficiaries are often surprised, even shocked, to find that their Medicare cards carry their Social Security numbers. Medicare uses them as the primary means of identifying beneficiaries, placing the numbers on benefit cards along with one or two letters or digits that indicate the basis of a person’s eligibility.

In moving to halt the practice, Congress was motivated by the proliferation of electronic health records and a rash of recent cyberattacks, including adata breach at Anthem, one of the nation’s largest insurers.

Medicare officials have up to four years to start issuing cards with new identifiers. They have four more years to reissue cards held by current beneficiaries. They intend to replace the Social Security number with “a randomly generated Medicare beneficiary identifier,” but the details are still being worked out.

Paula L. Ercolini, a 70-year-old Medicare beneficiary in Sharpsburg, Ga., outside Atlanta, said she wished that her Medicare card did not include her Social Security number.

“The Social Security number has the potential to open up your files, your life to hackers and thieves,” she said. “But you almost have to provide it when you go to new doctors. They won’t see you if you don’t.”

The card itself tells beneficiaries: “Carry your card with you when you are away from home. Let your hospital or doctor see your card when you require hospital, medical or health services under Medicare.”

Ann H. Rossie, 81, of Seattle, said she worried that having Social Security numbers on Medicare cards “makes us all vulnerable if our wallet is stolen.”

“Changing to another number will be a humongous job,” said Ms. Rossie, a former Social Security claims representative. “But Medicare needs to recognize the terrible impact on anybody whose identity is stolen. It destroys your self-esteem, and it can take years to re-establish your identity and credit.”

Members of Congress said the use of Social Security numbers on the cards provided a case study of bureaucratic inertia.

Since 2004, the Government Accountability Office, an investigative arm of Congress, has repeatedly urged officials to curtail the use of Social Security numbers as identifiers. In 2007, the White House Office of Management and Budget told agencies to “eliminate the unnecessary collection and use of Social Security numbers” within two years.

In 2008, the inspector general of Social Security called for immediate action to remove the numbers from Medicare cards, saying their display “unnecessarily places millions of individuals at risk for identity theft.” In that same year, the Defense Department and the Department of Veterans Affairs began carrying out elaborate plans to remove Social Security numbers from their identification cards.

But the Department of Health and Human Services, which supervises the agency that administers Medicare, has “lagged behind other federal agencies,” the Government Accountability Office said.

Senator Susan Collins, Republican of Maine and chairwoman of the Senate Special Committee on Aging, said she was puzzled by the delays. “This still does not appear to be a priority” for Medicare administrators, she said.

Medicare officials said their top information technology specialists had been preoccupied with efforts to build and repair HealthCare.gov, the online system for buying health insurance under the Affordable Care Act, which was overcome by technical problems soon after it began operating 18 months ago.

An internal report cites concerns about “the budgetary and logistical challenges of removing Social Security numbers from Medicare cards.” The agency depends on more than 200 computer systems and pays more than a billion claims a year from 1.5 million health care providers.

AARP, the lobby for older Americans, and the National Committee to Preserve Social Security and Medicare said they supported the new prohibition.

“Older adults are targeted by fraud artists, who use their Social Security numbers to get loans and credit cards,” said Amy E. Nofziger, manager of the fraud prevention program at AARP.

In one case described by Stephen R. Wigginton, the United States attorney for the Southern District of Illinois, a hospital employee and a former employee were convicted of stealing personal information from the charts of older patients and then using the data to apply for credit cards in the victims’ names.

The former employee was caught on camera at a store using a credit card obtained with the personal information of a 90-year-old woman who had been admitted to the hospital from an assisted living center.

New Cards for Medicare Recipients Will Omit Social Security Numbers

Concerned about the rising prevalence and sophistication of identity theft, most private health insurance companies have abandoned the use of Social Security numbers to identify individuals. The federal government even forbids private insurers to use the numbers on insurance cards when they provide medical or drug benefits under contract with Medicare.

But Medicare itself has continued the practice, imprintingSocial Security numbers on more than 50 million benefit cards despite years of warnings from government watchdogs that it placed millions of people at risk for financial losses from identity theft.

That is about to change, after President Obama signed a bill last week that will end the use of those numbers on Medicare cards.

“The Social Security number is the key to identity theft, and thieves are having a field day with seniors’ Medicare cards,” said Representative Sam Johnson, Republican of Texas, who pushed for the change with Representative Lloyd Doggett, a Texas Democrat.

The main purpose of the law, adopted with broad bipartisan support, was to overhaul the way doctors are paid for treating Medicare patients. But it makes other changes as well. One section that received little attention says Social Security account numbers must not be “displayed, coded or embedded on the Medicare card.”

Congress provided $320 million over four years to pay for the change. The money will come from Medicare trust funds that are financed with payroll and other taxes and with beneficiary premiums.

In his budget for 2016, Mr. Obama requested $50 million as a down payment “to support the removal of Social Security numbers from Medicare cards” — a step that federal auditors and investigators had been recommending for more than a decade.

More than 4,500 people a day sign up for Medicare. In the coming decade, 18 million more people are expected to qualify, bringing Medicare enrollment to 74 million people by 2025.

New beneficiaries are often surprised, even shocked, to find that their Medicare cards carry their Social Security numbers. Medicare uses them as the primary means of identifying beneficiaries, placing the numbers on benefit cards along with one or two letters or digits that indicate the basis of a person’s eligibility.

In moving to halt the practice, Congress was motivated by the proliferation of electronic health records and a rash of recent cyberattacks, including adata breach at Anthem, one of the nation’s largest insurers.

Medicare officials have up to four years to start issuing cards with new identifiers. They have four more years to reissue cards held by current beneficiaries. They intend to replace the Social Security number with “a randomly generated Medicare beneficiary identifier,” but the details are still being worked out.

Paula L. Ercolini, a 70-year-old Medicare beneficiary in Sharpsburg, Ga., outside Atlanta, said she wished that her Medicare card did not include her Social Security number.

“The Social Security number has the potential to open up your files, your life to hackers and thieves,” she said. “But you almost have to provide it when you go to new doctors. They won’t see you if you don’t.”

The card itself tells beneficiaries: “Carry your card with you when you are away from home. Let your hospital or doctor see your card when you require hospital, medical or health services under Medicare.”

Ann H. Rossie, 81, of Seattle, said she worried that having Social Security numbers on Medicare cards “makes us all vulnerable if our wallet is stolen.”

“Changing to another number will be a humongous job,” said Ms. Rossie, a former Social Security claims representative. “But Medicare needs to recognize the terrible impact on anybody whose identity is stolen. It destroys your self-esteem, and it can take years to re-establish your identity and credit.”

Members of Congress said the use of Social Security numbers on the cards provided a case study of bureaucratic inertia.

Since 2004, the Government Accountability Office, an investigative arm of Congress, has repeatedly urged officials to curtail the use of Social Security numbers as identifiers. In 2007, the White House Office of Management and Budget told agencies to “eliminate the unnecessary collection and use of Social Security numbers” within two years.

In 2008, the inspector general of Social Security called for immediate action to remove the numbers from Medicare cards, saying their display “unnecessarily places millions of individuals at risk for identity theft.” In that same year, the Defense Department and the Department of Veterans Affairs began carrying out elaborate plans to remove Social Security numbers from their identification cards.

But the Department of Health and Human Services, which supervises the agency that administers Medicare, has “lagged behind other federal agencies,” the Government Accountability Office said.

Senator Susan Collins, Republican of Maine and chairwoman of the Senate Special Committee on Aging, said she was puzzled by the delays. “This still does not appear to be a priority” for Medicare administrators, she said.

Medicare officials said their top information technology specialists had been preoccupied with efforts to build and repair HealthCare.gov, the online system for buying health insurance under the Affordable Care Act, which was overcome by technical problems soon after it began operating 18 months ago.

An internal report cites concerns about “the budgetary and logistical challenges of removing Social Security numbers from Medicare cards.” The agency depends on more than 200 computer systems and pays more than a billion claims a year from 1.5 million health care providers.

AARP, the lobby for older Americans, and the National Committee to Preserve Social Security and Medicare said they supported the new prohibition.

“Older adults are targeted by fraud artists, who use their Social Security numbers to get loans and credit cards,” said Amy E. Nofziger, manager of the fraud prevention program at AARP.

In one case described by Stephen R. Wigginton, the United States attorney for the Southern District of Illinois, a hospital employee and a former employee were convicted of stealing personal information from the charts of older patients and then using the data to apply for credit cards in the victims’ names.

The former employee was caught on camera at a store using a credit card obtained with the personal information of a 90-year-old woman who had been admitted to the hospital from an assisted living center.

Medicare Premiums, Deductibles and Copayments for 2014

Medicare premiums, dedutibles and copayments for 2014

Basic Part B premium: $104.90/month(unchanged)

Part B deductible: $147 (unchanged)

Part A deductible: $1,216 (was $1,184)

Co-Payment for hospital stay days 61-90: $304/day(was $296)

Co-Payment for hospital stay days 91 and beyond: $608/day (was $592)

Skilled nursing facility co-payment, days 21-100:$152/day (was $148)

Medicare spending slowdown

The Congressional Budget Office (CBO) is unable to explain a recent decline in Medicare costs.  According to the CBO’s report, however, the Great Recession was not the cause in Medicare spending slowdown.  It states that spending on Medicare increased by 7.1% from 2000 to 2005, then dropped by 3.8% from 2007 to 2010.  Hospital inpatient spending growth was cut by more than half during that time to 1.7%, and hospice spending increased slowed drastically to 2.3%, less than one-sixth of their previous rates.  Physician services and outpatient care hikes were more muted.

According to the report, the CBO does not believe that the decline in home values, significant losses, financial assets and slower growth in income caused the elderly to use less medical services.

Read more at the Wall Street Journal’s MarketWatch.