Medicare Announces Higher Rates

Several days ago, CMS announced an increase for Medicare Part B premiums for most new and existing Medicare beneficiaries amounting to about 1.1%.  For high income earners in 2018, the increase amounts to about 7.4%. Additionally, Medicare’s Part B deductible is set to increase from $183.00 annually to $185.00 annually.

There are three distinct parts to original Medicare: Part A, Part B, and Part D.  Medicare Part A is your hospitalization and skilled nursing facility care. Part A comes automatic for individuals who had work history of at least 40 quarters during one’s lifetime (10 years of work history) and, typically carries no monthly plan premium.  

It is important to note you should contact the social security administration at least 90 days before your 65th birthday to enroll in Medicare even if you decide to continue working and carry your employers’ insurance plan.  Medicare still needs to document your participation under your employers’ insurance plan. Once you retire and end working full time, you may enroll in Medicare Part B without penalty and activate Part B the moment the group insurance ends.

What is Medicare Part B Premium?

Medicare Part B is your Medical insurance under original Medicare and carries with is a standard monthly premium.  Part B covers doctors’ visits, surgeries, durable medical equipment, and the like. In 2018 the standard Medicare part B premium for new and recent enrollees is 134.00 monthly.  CMS just announced this will rise by 1.1% to 135.50 monthly. For higher income earners over the 170,000 AGI thresholds, this amount can incrementally rise to as high as 460.50 monthly in 2019.  

Check with one of our insurance brokers at I H S about your income if you’d like a detailed dollar figure on Part B premiums. Some seniors will pay far less than these amounts under the “hold harmless” provision.  This provision essentially grandfathers older seniors on Medicare under the old part B pricing model if they do not receive a sizable increase in their social security benefits.

Medicare Part B Deductible

In addition to increases in premiums for those on Medicare, CMS has also announced an increase in the Part B medical insurance deductible for 2019.  This deductible is set to increase to 185.00 from 183.00 in 2018. Unlike the part A hospital deductible, the part B medical deductible is an annual deductible regardless of utilization.  What this means is even if you have 5 surgical procedures in one year, the deductible will not exceed 185.00 for 2019.

Medicare supplement insurance plans are designed to cover some of these dollar amounts left off by Medicare.  The plan F covers the co-insurance and deductibles A and B that Medicare leaves for you to pay. If you have a plan G, the most you’d pay would be this part B deductible of 185.00. Contact us today for price quotes on Medicare supplement plan F, G, and N to see what plan might fit your needs best.

Medicare Part A Hospital Deductible

CMS has also announced an increase to the Medicare Part A hospital deductible.  Unlike the Medical deductible that is annual, the hospital deductible could be assessed each time you’re admitted to the hospital.  In 2018, this deductible is $1,340.00 dollars and, CMS has increased this deductible to: $1,364.00 dollars for 2019. Most Medicare Supplement policies will cover this hospital deductible along with the coinsurance amounts for your lifetime reserve days under original Medicare in full, leaving you with little if anything to pay.  Check with our Medicare agents on specifics related to your part A and B benefits under Medicare.

Medicare Advantage Premiums

Medicare Advantage premiums are slated to decrease slightly in 2019 on average nationally.  Medicare Advantage plans replace the original Medicare program and are offered by private insurance carriers who contract with CMS/ Medicare to offer your Medicare benefits.  Last month CMS announced Medicare Advantage plan premiums, on average, will decline slightly while benefit choices will increase. Medicare Advantage plans combine all three Medicare parts into one policy option and are known as Medicare Advantage Prescription Drug policies (MAPD).  

Many of these plan options not only combine prescription with the hospital and Medical but, have additional benefits original fee-for-service Medicare does not offer. Some of these benefits include: Silver Sneakers gym memberships, dental, vision, and transportation benefits to and from providers facilities.  It is important to note one must maintain paying Medicare part B premiums in order to participate in Medicare Advantage. However, there are typically less monthly plan premium costs associated with MAPD than there are with original Medicare and supplemental insurance.

New Regional MAPD Plans

Many MAPD carriers have rolled out new, more richly designed MAPD plans in certain areas in Texas and across the country.  For instance, seniors living in Harris county Texas and several other regions across the Lone Star State will be able to enroll into an MAPD PPO plan that’s 0 monthly plan premiums.  Not only is there no monthly plan premium under this plan, but Aetna will even give back 104.00 dollars per month toward your social security benefit!

This is a huge win for seniors in these areas because this 104 give back will essentially eliminate most, if not all the part B premium, leaving you with very little in the way of cost under Medicare.  Now, you might be asking yourself, how is this possible? This sounds too good to be true! Nothing is free in this world, right? The reason the Medicare Advantage carriers can offer all these benefits for free is because original Medicare is transferring payments to the private insurance carrier each month in exchange for the private insurance companies’ agreement to pay 100% of all your hospital and Medical bills.  

With original Medicare the government is on the hook for 100% of your medical and hospital bills subject to your copays and deductibles. Medicare Advantage plans off load this exposure from Medicare in exchange for a fee. This fee can run anywhere from 700 monthly to as much as 1000 monthly from CMS! This subsidy from the government is what allows the advantage plan to offer you such rich benefits and actually reimburse you the lions share of your part B premium.  To check your eligibility under these MAPD plans, visit www.medicare.gov or give us a call today to speak with one of our licensed insurance agents.  

Learn More About 2019 Medicare Premiums and Deductibles

Our brokers can enter your medications into the Medicare site to quickly determine which part D or MAPD plan is right for you based on the Medications and doctors you currently participate with.