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Medicare Part B and D Beneficiaries Could Be Hit With Late Enrollment Fees in 2022

4/4/2022

 
Medicare Part B and D Late Enrollment Fees
Some Medicare beneficiaries will be hit with late-enrollment fees in 2022. These charges would be warned of by Congress before they occur, per this recent CNBC article. Here is a summary of the article:
  • Late-enrollment penalties for Part B are 10% of the standard premium per 12 months you were supposed to have been enrolled, but weren't.
  • The Senate bill would require that the government inform people about Medicare enrollment starting at 60 years old. This measure restores a provision that was removed from a 2020 bill dealing with other Medicare enrollment issues.
  • The U.S. Congress recently introduced a bill that aims to prevent a costly cost for some new Medicare beneficiaries: late-enrollment penalties. Bipartisan legislation introduced in the Senate would require that the federal government provide information to individuals about Medicare enrollment rules prior to reaching the age of 65. Many beneficiaries will automatically be enrolled because they are receiving Social Security. However, this is not true for all. Lindsey Copeland is the federal policy director of Medicare Rights Center. She stated that "more people are working later in their lives, delaying Social Security, and not getting auto-enrolled." They might have to be active enrollers and understand what happens if they don’t. We have other stories that offer a financial perspective on life's important milestones.
  • There are 63.3 million beneficiaries to the government insurance program, most of them under 65 years old. The majority of people do not pay any premium for Part A (hospital coverage), and they pay a standard monthly fee ($170.10 in 2022 for Part B (outpatient treatment). According to a 2019 report by the Medicare Payment Advisory Commission, the percentage of seniors who have not yet been auto-enrolled in Medicare has increased over time. In 2016, 40% of those eligible for Medicare at 65 years old had to enroll actively, as opposed to 8% in 2002.
  • Late-enrollment penalties are not applicable to Part A. However, they can be applied to those who sign up for Part B too late. This penalty is 10% of the standard Part A premium for every 12 months you are late enrolling. It can also increase annually as the premium adjusts each year. The penalties can be life-threatening. The Part B penalty only affects a small percentage of beneficiaries (an estimated 776,200 beneficiaries in 2020), but the average penalty increased beneficiaries' monthly premiums by 27% according to the Medicare Rights Center. This would add $45.93 per month to the $170.10 premium for this year, or $216.03.
  • Critics say that Medicare enrollment rules are confusing and easy to misunderstand. If you are able to delay Part B enrollment until you turn 65, if you have qualified insurance through your employer, there are still deadlines you must meet once the coverage ends to avoid penalties for late-enrollment. You can appeal the charges. However, your enrollment error must be due to incorrect information being provided by government officials.
  • Part D, which covers prescription drug coverage, comes with a late enrollment penalty. It is 1% of the national premium ($33.37 in 2022) multiplied by how many months you haven't had Part D or creditable coverage. It lasts as long as you have Part D.
  • The new Senate bill requires that information be included on Social Security statements beginning at 60 years old that details the rules and procedures for Medicare enrollment. This will help older people understand their responsibilities when signing up. As such, they would have to read their Social Security statements several times before enrolling. This is because they are more likely to do so as they get closer to retirement. This measure was included in 2020 legislation, which addressed other issues related to Medicare enrollment. It also addresses gaps between signing up for coverage and actually receiving it. Although the House passed the provision, it was dropped by the Senate.

How Does Medicare Work If You Return To The Work Force?

2/9/2022

 
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The latest feedback on how to best navigate the Medicare system if you return to the work force can be found in a recent article from CNBC.
The CNBC article explains that if the company you work for employs fewer than 20 people, and you wish to enroll in the Medicare health plan, you will need to stay on Parts A or B. If you go to work for a larger company, different rules apply, but there are some things to consider before you sign up for an employer health plan.
There will be new rules and deadlines for you to re-enroll in Medicare.
Read the full article here:
https://www.cnbc.com/2022/01/24/heres-how-to-navigate-medicare-if-you-return-to-work-after-retiring.html​

Medicare Open Enrollment 2022 - How It Works

1/15/2022

 
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When is open enrollment for Medicare Advantage? How does it work? 

How long is open enrollment for Medicare?
Every year from January 1 through March 31 current policyholders of Medicare Advantage (MA) plans are eligible to enroll in a different MA plan.  

How does open enrollment work?
MA, or Medicare C, plans can be changed once a year. Those who currently have this type of managed-care alternative to Original Medicare can choose to keep the same plan, to opt into a different Advantage plan, or to enroll in Medicare A, or Original Medicare. 

If you decide to drop your MA plan in favor of Medicare A you may not be able to buy a supplemental Medigap plan. 

Who is eligible for open enrollment?
This open enrollment period is only for people who already have an Advantage plan.

What are Medicare parts A, B, C, and D?
Medicare A is hospital insurance. Premium-free Part A is available to people who meet the criteria.
To qualify for premium-free Part A:
  • You must already get retirement benefits from Social Security or the Railroad Retirement Board.
  • You're eligible to get Social Security or Railroad benefits but haven't filed for them yet.
  • You or your spouse had Medicare-covered government employment.

Whether or not you have a monthly premium, the benefits are the same, including deductibles and coinsurance. If you choose Part A, you must also:
  • Have Medicare Part B (Medical Insurance)
  • Pay monthly premiums for both Part A and Part B
  • Purchase drug coverage, called Part D, and
  • Consider buying a Medigap plan to pay for common gaps in coverage

Medicare Part B
Part B is optional medical insurance with a monthly premium. After the deductible is met, you’ll typically pay 20% for most doctor services. Included are inpatient hospital stays, outpatient therapies, and durable medical equipment (DME). Enrolling in Part B when you’re eligible for Medicare will save you a late enrollment penalty. 

Medicare Part C
Medicare Advantage plans, (MA or Medicare Part C), is Managed Care, very much like most employer-offered insurance. MA plans combine parts A and B, and 90% of MA plans include drug coverage (Part D). Medigap plans insurance can’t be used for MA plans, as they’re unnecessary. Talk about one-stop shopping!

Medicare Part D
Medicare Part D is available as a separate policy for prescriptions only. Choosing a drug plan at the time you enroll in Medicare, even if you don't currently take medications, will avoid a possible late enrollment penalty if you do eventually need drug coverage; late enrollment penalties will increase your monthly premium. 

The pros and cons
Medicare Advantage Plans may have rules that are different from Original Medicare. However, in keeping with CMS rules, your plan must give you at least the same coverage as Original Medicare. Some services may only be covered in a particular facility or for patients with certain conditions. Some MAs offer more comprehensive plans to fit your needs: many cover over-the-counter medications or gym memberships. 

The takeaway
Carefully research your options; compare your needs to each plan’s offerings before enrolling. Very rare circumstances will permit a change before the open enrollment period begin.

    Ted Czabanowski

    Licensed Insurance Agent in Rhode Island

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