Medicare -Who Pays and How Much- Part II
(5/17/13)- In a 91-to-7 vote, the Senate confirmed Marilyn Tavenner as administrator of the Centers for Medicare and Medicaid Services (CMS) as we noted in our item dated 4/16/13 below. She had been the acting administrator since December 2011.
The agency provides health insurance to more than 100 million people and spends more than $800 billion a year. Incidentally, the CMS spends more than does the Department of Defense on a yearly basis.
Ms. Tavenner is the first Senate-confirmed administrator since Dr. Mark.B. McClellan stepped down in 2006. The Senate Republican leader, Mitch McConnell of Kentucky was one of the 7 who voted against her confirmation.
Mr. Obama's first choice for the job, Dr. Donald M. Berwick, never won Senate confirmation. The president circumvented Congress by giving Dr. Berwick a temporary recess appointment, which lasted for 17 months in 2010-2011
(4/16/13)- Marilyn Tavenner, who is the acting head of the Centers for Medicare and Medicaid Services, is expected to be confirmed as the program's first administrator in 7 years. For more background information on Ms. Tavenner, please see our item dated 11/29/11 below.
No permanent administrator of the CMS has been appointed in the last 7 years because of the political divide in Washington that has existed the last few years making it impossible to get any nominee acceptable to both parties. Mark McClellan, a Republican, was the last administrator of CMS, when he stepped down in 2006.
It is estimated that there are now100 million Americans in these programs. The agency has a budget of about $820 billion in 2012.
(4/10/13)- As the government comes to face up to the growing cost of Medicare, one of the proposals presented by the 2010 deficit reduction panel chaired by Republican Alan Simpson and Democrat Erskine Bowles is coming to the forefront again, namely that Part A and Part B of Medicare be combined. Although none of the panel's recommendations were adopted, this one seems to be making headway in Washington these days.
Payroll taxes and premiums paid by beneficiaries covered around half of the $548.1 billion in expenditures for Medicare in 2011.
Payroll-tax revenue covers most of the cost of Part A hospital care. This coverage has a $1,184 annual deductible, but beneficiaries do not have to pay further cost sharing on the first 60 days of a hospital stay. Co-payments charges increase sharply thereafter.
Part B has a basic premium set at $104.90 a month this year, and a $147 annual deductible and 20% cost sharing. There are no caps on the amount that s beneficiary pays out-of-pocket..
The deficit-reduction panel recommended that the deductible be combined into a single $500 deductible, and a 20% cost of care until that reached a certain cap.
Under the cap, beneficiaries would pay a much smaller share after the first $5,500 of costs and no more than $7,500 out-of-pocket in total.
The combined effect of the changes could save the U.S. $10 billion in 2015 and $110 billion through 2020.
Under the terms of The Patient Protection and Affordable Care Act, Medicare will cover an annual wellness visit that includes detection of "cognitive impairment". Once diagnosed, patients can be helped with family support, medication management and brain games to help delay further decline.
(12/23/12)- Of the 1.1 billion claims submitted to Medicare in 2010 for hospitalizations, nursing home care, doctor's visits, tests and physical therapy, 117 million were denied. Of those, only 2 percent were appealed. And for those who persevere and do appeal a third time, the OIG found that the judges reversed 56 percent of all unfavorable decisions in 2010.
(11/24/12)- Medicare Part B premiums will rise by $5 per month starting in January to $104.90 per month. This rise in premium will amount to about one fourth of a typical retiree's cost-of-living raise in Social Security payment next year.
The Part B premium, in most cases, is deducted from the beneficiary's Social Security payment.
(11/10/12)- Family physicians will get a slight boost in their Medicare payments for the calendar year 2013. The payments for family physicians will rise by about 7 percent in January under a final 2013 rule that the Centers for Medicare and Medicaid Services (CMS) released htis week. Other practitioners who also provide family care services would get payment increases of about 3 to 5 percent next year.
The increase for family physicians is affected in part by an administration plan to provide a separate payment to physicians or practitioners who coordinate the care for patients in the 30 days after the patient is released from a hospital or skilled nursing facility. The goal is to reduce problems that can occur after a patient is discharged.
(10/16/12)- The results of a recent study that examined how effective are the Medicare reimbursement rates which were tied into the reduction of hospital-acquired infections found that they have no impact in reducing the infection rate.
The policy went into effect in 2008 and examined the change on bloodstream and urinary-tract infections related to catheters. The results of the study were published in the New England Journal of Medicine. It was funded by the Agency for Healthcare Research and Quality.
The policy was supposed to ensure that hospitals did not get paid additional money for infections that were deemed avoidable. The study covered the period of time from January 2006 through March 2011.Grace Lee was the study's lead author.
After the policy change there were "no significant changes" in the rates of any of these conditions nor of a third condition, ventilator-associated pneumonia.
(8/24/12)- Republican vice-presidential nominee Representative Paul Ryan's plan to revamp Medicare would not change the present system for those 55 and older. Those younger than 55 would be given the option of staying with the present system or to enroll in a privately run health-insurance plan.
In cutting an estimated $716 billion over 10 years under the terms of the Patient Protection and Provider Act through cuts in payments to providers, and elimination of "the doughnut hole", the Ryan plan opposes this type of solution towards "saving Medicare". He would not cut back on payments to providers to the extent that Obama would.
(8/4/12)- Any Medicare beneficiary can tell you that his/her Medicare card contains their Social Security number on it. As we all know, that is an open invitation to have that number stolen. Five years after first being told to have that number removed from the cards, Medicare officials say that they need at least 6 more months to figure out how much it will cost to replace our Medicare cards.
The Government Accounting Office estimates that there are as many as 48 million Medicare card holders who will need to have their cards replaced.
(7/20/12)- Most individuals covered by an employer's health plan opt out of Part B, since the premium runs about $1,199 for most people, but can be much higher if your adjusted gross income runs into the high brackets.
When you stop working, you can sign up for Part B during a special enrollment period that lasts eight months following your final day of employment.
The clock for the eight months period of time to be eligible to enroll starts running when you leave the job.
(7/17/12)- Medicare Part A covers hospital stays and has a deductible of $1,156 this year, that covers hospitalization for up to 60 days. You do not pay any premiums for Medicare Part A. From days 61 through days 90 of an in-hospital stay there is a co-payment of $289 a day, and co-payments for days 91 through 150 of $578 a day.
Medicare Part B is optional medical insurance that covers doctors' bills, lab tests and outpatient care. The basic premium is $99.90 a month, although it can be as high as $319.70 for an individual earning $214,000 or more a year. The deductible is $140 a year, and co-pays are 20% of Medicare approved amounts
(5/14/12)- This year's medical care costs for a 65-year-old retired couple would come to about $240,000 to cover medical costs through retirement, according to a report from Fidelity Investments. That is a 4% increase from last year's estimate. The original report from Fidelity in 2002 estimated the cost to be $160,000. It is based on the couple being in the traditional Medicare plan rather than in an HMO or Medicare Advantage plan.
The estimate is based on the life expectancies of 17 more years for the male and 20 years more years for a female.
The estimate takes into account Medicare premiums, deductibles and co-insurance for medical costs as well as for prescription drugs. It also includes possible costs for routine vision and hearing exams, eyeglasses and hearing aids.
It does not include potential costs for dental services, over-the-counter drugs or long-term care.
(5/12/12)- According to StateHealthFacts.com, a Kaiser Family Foundation website, there are 47,672,971 Medicare beneficiaries in the United States. California has the most at 4,806,469, followed by Florida at 3,390,801, Texas at 3,044,936, New York at 3009,756 and Pennsylvania at 2,290,509.
(12/25/11)- President Barack Obama signed the law that would extend for two months the cut for an employee's share of the Social Security payroll tax at the current level of 4.2% of wages through February 29, 2012. In the absence of Congressional action, the tax would have reverted to the 6.2% level. Employer's share of the tax will remain at 6.2%
Under the law, the federal government will also continue to pay unemployment insurance benefits under current policy through February 29, 2012.
Medicare will continue to pay doctors at current rates for two months, thus averting a 27% cut that was due to take place on January 1, 2012
(11/29/11)- Dr. Donald M. Berwick announced that he would be stepping down as administrator of the Centers for Medicare and Medicaid Services at the end of the month. His temporary recess appointment was due to expire at the end of the year.
President Barack Obama first nominated Dr. Berwick in April 2010 but he never received a Senate confirmation hearing. His nomination had been strongly opposed by at least 40 Republican Senators.
Mr. Obama said he would nominate Dr. Berwick's principal deputy, Marilyn B.Tavenner, to succeed him as administrator.
Ms. Tavenner started in the medical field as a nurse who then joined the Hospital Corporation of America as a nursing supervisor, then becoming an executive with the company and eventually she became the president of HCA's outpatient services group. She was a past secretary of the Virginia Department of Health and Human Resources, and has also served on the boards of the American Hospital Association and the Virginia Hospital and Healthcare Association.
(11/3/11)- Most Medicare beneficiaries will pay $99.90 a month in premiums in 2012, which is a $3.50 increase over the $96.40 premium that most beneficiaries had been paying for Part B for the past three years.
A law had prevented most Medicare premiums from rising if Social Security payouts stayed flat, which has been the case since 2008. With an increase of 3.6% in cost-of-living for Social Security beneficiaries announced by the Social Security Administration last week, an increase in Medicare premiums thus came into play.
Individuals in the higher-income group (individuals who earn over $85,000 a year, or couples earning over $170,000 a year) paid higher Medicare premiums in each of the past three years to make up for the freeze for lower-income recipients. Their premiums will fall next year. About 5% of Medicare beneficiaries now pay higher premiums based on income, but this proportion would eventually rise to 25% under a deficit-reduction plan proposed by President Obama last month.
All Medicare beneficiaries will see lower deductibles next year for medical treatment. The annual deductible will be $140, down $22 from the current rate. Deductibles for Part A hospital treatment will rise by $24, putting them at $1,156 a stay.
(9/30/11)- President Obama's new deficit-reduction plan which aims at reducing the deficit by more than $3 trillion over 10 years, beyond the $1 trillion in saving already assumed under the debt limit law signed in August will impose "a lot of pain".
The proposal would require new beneficiaries to pay higher deductibles before Medicare coverage of doctors' services and other outpatient care kicks in. The plan would increase the deductible, which is now $162 a year, adjusted for inflation, by a further $25 in 2017,2019 and 2021.
In addition it would increase Medicare premiums by about 30% for new beneficiaries who buy private insurance to help fill gaps in Medicare.
About 5% of the 48 million Medicare beneficiaries now pay higher premiums because of income levles. The proportion would eventually rise to 25% under the proposal.
The plan would lower Medicare payments to teaching hospitals, and would also start charging co-payments to frail homebound older people who receive home health services. It would reduce the growth of federal payments to states for treating low-income people under Medicaid.
It would reduce the projected growth of Medicare in the next 10 years by $248 billion and by $72 billion from Medicaid and other health programs.
Medicare and Medicaid insure more than 100 million beneficiaries and account for nearly one-fourth of all federal spending. The proposed savings would cut less than 3% of what the government expects to spend on the programs in the next 10 years.
(6/18/11)- Aetna Inc., one of the nation's largest health insurers announced that federal regulators had lifted the sanctions on the company that had prevented it from marketing Medicare plans and enrolling new beneficiaries.
Aetna currently has about one million Medicare Advantage and drug plan beneficiaries and is seeking to expand in this area. The company also announced that it had purchased the Medicare supplement business of Genworth Financial Inc. for about $290 million. Medicare supplement businesses provide protection against out-of-pocket expenses incurred by Medicare beneficiaries.
The Centers for Medicare and Medicaid Services (CMS) had imposed the sanctions in April 2010, saying the company had not complied with rules about changing drug-plan designs. Aetna did not meet requirements to make sure seniors could continue on their medications during changes to the Aetna plans in 2009 and 2010.
Some Aetna customers who were prescribed drugs on the company's 2009 formulary that were no longer on the formulary the following year did not receive a one-time 30-day transition supply of the drugs as required by the CMS.
(3/18/11)- As noted in our item dated 7/9/10 below, President Obama appointed Dr. Donald M. Berwick as administrator of the Centers for Medicare and Medicaid Services (CMS) as a "recess appointment". That appointment is good through the end of the year unless confirmed by the Senate. The Senate Finance Committee has never held a session to take up this matter and none are presently scheduled.
In a letter to the White House that was signed by 42 Republican senators, the request was made to withdraw the nomination. Some Democratic senators have also indicated that they do not support Dr. Berwick's appointment to the position. It is not clear at this time whether or not the president will continue to back Dr. Berwick's nomination.
His principal deputy, Marilyn B. Tavenner has emerged as a candidate to succeed him. She is the former Virginia secretary of health and human resources with extensive management experience, and the Republicans have not indicated that they would oppose her nomination. Ms. Tavenner is a former nurse who worked for more than two decades at the Hospital Corporation of America, first as a nursing supervisor, then as a hospital executive and subsequently as president of the company's outpatient services group.
(12/10/10)- The Senate unanimously approved a yearlong measure that averts the 25% pay cut that doctors who treat Medicare patients were facing.
In order to pay for the extension, the measure requires individuals to repay excess federal subsidies for health insurance if their income rises. Under the law, the subsidies for people earning up to 400% of the federal poverty level are calculated based on a person's expected earnings.
Repayment of those subsidies is required if a person's income exceeds expected levels, but the repayments are capped at $250 for an individual, or $400 for a family. The law passed by the Senate removes those caps and replaces them with a sliding repayment scale.
(12/4/10)- The House of Representatives approved by a voice vote a measure that had been passed by the Senate that would delay cuts to physicians fees under Medicare payments due to go into effect on December 1. The measure temporarily delays the cuts until January 1, 2011.
The formula for physicians' payments under the Medicare law requires that their fees must be cut when expenditures exceed certain levels. Since the law was enacted there has never been a general cut to the fees from physicians, since many doctors have threatened to leave Medicare if their payments are cut.
(11/11/10)- A recent ruling from the Federal District Court in Pittsburgh went against Medicare officials in setting limits as to what costs Medicare coverage extends to in a skilled nursing facility.
In the case in question, 80-year old Wanda Papciak was placed in a skilled nursing facility after undergoing hip replacement surgery. Medicare officials terminated her coverage after 5 weeks of receiving physical therapy, occupational therapy and skilled nursing coverage.
The Medicare officials terminated her coverage saying that her condition had not improved nor was it likely to get better.
The court reversed the termination of coverage saying she needed skilled nursing care "to maintain her level of functioning" and to prevent her condition from worsening.
Medicare officials argued that Ms. Papciak was receiving only "custodial care", for which the program does not pay. "There must be an expectation that the beneficiary's condition will improve materially in a reasonable and generally predictable period of time, based on the physician's assessment." Medicare officials argued that Ms.Papciak had reached her "maximum functional capacity."
Her attorney, Stella L. Smetanka, a clinical professor of law at the University of Pittsburgh argued that "the services were needed to prevent further deterioration".
The court ruled that skilled care might be reasonable and necessary even if the person's condition is stable and unlikely to improve.
The government has not indicated whether or not it would appeal the decision.
(9/16/10)- Dr. Donald Berwick, administrator of the Centers for Medicare and Medicaid Services, in a speech at a Medicare and Medicaid conference sponsored by America's Health Insurance Plans, the lobby for the health care industry said the agency faced huge challenges under the new health care law.
The law will expand the Medicaid insurance program for the poor to 16 million additional Americans and cut more than $400 billion in provider payments for the Medicare program for the elderly over a decade.
(8/10/10)- In a report that was issued by the Medicare trustees, it was determined that the Medicare hospital trust fund would be exhausted by 2029, 12 years later than last year's projection.
The trustees predicted that the Social Security trust fund would be exhausted in 2037, the same year as projected last year.
Because inflation remains low, the report said, Social Security beneficiaries will probably not receive a cost-of-living (COLA) increase adjustment in 2011, just as they did not receive one this year.
Social Security commissioner Michael J. Astrue stated, that continuing tax revenue would still be sufficient to pay more than 75% of benefits even after exhaustion of the trust fund.
For the first time, money flowing out of the Social Security program this year exceeded money flowing in. A combination of high unemployment, meant less funding coming into the program, and an aging population leading to more people becoming beneficiaries under Social Security was the main reason for this to happen.
Many are calling for an increase in age for eligibility for Social Security entitlement, or reduced benefits. A bipartisan panel, created by President Obama, is due to make its recommendations to him by December 1, as to the steps that should be taken to ensure the solvency of Social Security.
The trustees report on the solvency of Medicare assumes that Medicare will cut payment rates for doctors' services by 23% on December 1, and by a further 6.5% on January 1, as required by the law, but this has never happened before, nor will it happen on those date either, based on past history.
(7/9/10)- President Obama will bypass Congress and make a "recess appointment" making Dr. Donald M. Berwick head of the Centers for Medicare and Medicaid Services (CMS). Please see our item dated 6/8/10 below for more on this matter.
As a recess appointee, Dr. Berwick will have all the powers of a permanent appointee, but as called for under the Constitution, his appointment will expire at the end of the next session of Congress, in late 2011
(6/26/10)- It took them a while, but on Thursday the House, voting 417 to 1, approved the six-month suspension of the required Medicare 21.5% cut of payments to medical professionals that we discuss in our item dated 6/20/10; 6/14/10 et. al. below.
This charade that goes on every year must come to an end. This time however it will be extra costly since Medicare personnel will have to review all claims submitted after June 1, wherein the required cuts took place.
(6/20/10)- Even though the Senate passed the legislation needed to prevent the cut in payments to doctors under Medicare law, it was too late to prevent Medicare from processing the cuts to doctors who have already submitted their June claims. That is because the House has yet to act on the legislation that would have prevented the cuts, and the House can not act on the matter until next week at the earliest.
That means that doctors, nurse practitioners, physical therapists and other providers who billed after May 31,under the Medicare's physician fee schedule will have to resubmit their claims if they want to be made whole. The billings affected by the cut cover the early part of this month. Congress had previously acted in delaying the cuts that were required until the end of May.
The bill passed by the Senate delays the cuts until the end of November, when the elections are out of the way. The Senate approved the measure by a voice vote Friday night, after failing to pass a larger package of fiscal measures the night before. It did not have the required 60 votes to end a Republican filibuster.
The bill passed by the Senate would increase payments to medical providers by 2.2%, and costs about $6.5 billion. It would be paid for through a series of health care and pension changes that both the Democrats and Republicans had agreed to.
(6/14/10)- In our item dated 10/19/09 in Part I of this article, we discuss the fact that the formula for payment to doctors under the Medicare law calls for a cut of 21.5% effective June 1, 2010. There has never been a cut in doctors' payments, even when the formula called for one, in the history of Medicare.
Under pending legislation, this cut would be blocked, and would be replaced by a 2.2 percent increase, at a total cost of $23 billion for the balance of this year, and an additional increase of 1 percent next year.
President Barack Obama in his weekly radio address has called for approval of the increase, and expressed a desire to deal with the formula in a more realistic way in the future.
If you increase the deficit that Medicare is operating under, the premium that beneficiaries pay for belonging to Part B would have to be substantially increased next year to alleviate this problem.
(6/8/10)- Department of Health and Human Services (HHS) secretary Kathleen Sebelius strongly backed President Barack Obama's choice of Dr. Donald Berwick (63 years of age) to become the next head of the Centers for Medicare and Medicaid Services (CMS). That position has been vacant since 2006 after Democrats blocked the confirmation of the Bush administration's nominee.
Several Republicans have indicated that the strongly oppose the nomination.
The American Medical Association plans to send letters of support for the nomination to Congressmen, and 116 health-related groups have already signed a letter to Senate leaders supporting his nomination.
Dr. Berwick delivered the commencement address at the Yale School of Medicine, where his daughter was among the graduates. He is a Harvard Medical School pediatrician and health-quality advocate
(4/5/10)- President Barack Obama has selected Dr. Donald Berwick to become the new head of the Centers for Medicare and Medicaid Services. This position has been vacant for the last years.
Dr. Berwick runs the Boston-based Institute for Healthcare Improvement and is a pediatrics and health-policy professor at Harvard University.
He has focused on improving patient safety, and increased usage of technology in the medical field. He has also worked as an executive at a Massachusetts health-maintenance organization.
Under the terms of the recently enacted health-care reform act, Medicaid coverage will greatly expand coverage starting in 2014. The program is expected to add 16 million Americans by the end of the decade.
One of the biggest hurdles facing Dr. Berwick is the fact that even though more Americans will be covered under the Medicaid program, more than $400 billion in cuts must be instituted in the coming decade.
(1/25/10)- Under Medicare law Part B premiums are required to cover about 25% of the average cost of Medicare Part B services incurred by the enrollees. There are about 42.3 million Americans covered by Medicare Part B, of which about 73% also receive Social Security payments.
Under the Social Security Act's "hold harmless" provision, Medicare can not pass along to Social Security beneficiaries a premium hike that is higher than the increase they would receive through Social Security's annual cost-of-living increase.
For the year 2010 and most likely for the year 2011, there was no cost of living increase (COLA) for Social Security beneficiaries
Since Medicare Part B premiums would not cover the 25% cost of Medicare, the remaining 27% of those covered by Medicare and not receiving Social Security payments must make up for the difference. This group unfortunately includes those Medicare Part B beneficiaries who are joining for the first time.
The affected beneficiaries include the 3% of Medicare Part B recipients who are celebrating their 65th birthday this year, and also the 2% who started collecting Social Security earlier than their "full retirement age". This also includes however, those who postponed getting their Social Security payments past their "full retirement age", since it meant an increased lifetime payment for each year they delayed receiving their payment until they reached the age of 70.
For those falling into this category, Medicare Part B premiums are $110.50 per month instead of the $96.40 per month for lower income beneficiaries. Higher income earners will also be paying higher premiums because of this quirk in the law.
(1/11/10)-The following is the 2010 schedule of what a Medicare beneficiary pays during a skilled nursing facility residency (From Medicare and You-2010):
Under Part A- the following is what a Medicare beneficiary must pay during a hospital stay:
Under Hospice Care:
Medicare doesn't cover room and board when you get hospice care in your home or another facility where you live (like a nursing home)"
Under Part B:
Premiums for Part B will stay the same as for 2009, although higher income beneficiaries will be paying a higher premium than the $96.40 a month level. For new enrollees in Medicare the premium will be at least $110.50 per month. Please see our item dated January, 2010 to see why this situation arose.
For individuals who earn $85,000 or less and for couples who earn $170,000 or less the premium for Part B is $96.40 per month for Medicare Part B coverage.
For individuals earning $85,001 up to $107,000, or couples earning from $170,001 to $214,000 the premium will be $134.90. For individuals earning from $107,001 to $160,000, or couple earning from $214,001 to $320,000 the premium is $192.70. For individuals earning from$160,001 to $213,000, or couples earning from $320,001 to $426,000 the premium is $250.59 and for individuals earning $213,001 or above and couples earning $426,001 or above the premium is $308.30
New enrollees in Part B will pay 15% more than that, $110.50 a month.
Benefit Period
A " benefit period" starts when the beneficiary first enters a hospital and ends when there has been a break of at least 60 consecutive days since inpatient hospital or skilled nursing care was provided. There is no limit to the number of benefit periods covered by Part A during a beneficiary’s lifetime; however, inpatient hospital care is normally limited to 90 days during a benefit period and co-payment requirements ($267 each day)apply for days 61 through 90. If a beneficiary exhausts the 90 days of inpatient hospital care available, he or she can elect to use days of Medicare coverage from a non renewable "lifetime reserve" of up to 60 total additional days. Once used up the 60 days is gone forever. You are responsible for the co-insurance amount of $438 per day while using up this 60 day "lifetime reserve".
(11/2/09)- Most Medicare eligible beneficiaries should have received their copy of the 2010 "Medicare and You" handbook, which is issued by the government to help you understand any changes made in Medicare and Medicare Advantage plans.
As a quick reminder, there is Medicare Part A, which covers hospitalization and is provided at no charge to enrollees, and Medicare B, which covers fees from doctors and other health care providers, and requires a monthly premium. Premiums for Part B will stay the same as for 2009, although higher income beneficiaries will be paying a higher premium than the $96.40 a month level. For new enrollees in Medicare the premium will be at least $110.50 per month. Please see our item dated January, 2010 to see why this situation arose.
For individuals who earn $85,000 or less and for couples who earn $170,000 or less the premium for Part B is $96.40 per month for Medicare Part B coverage.
For individuals earning $85,001 up to $107,000, or couples earning from $170,001 to $214,000 the premium will be $134.90. For individuals earning from $107,001 to $160,000, or couple earning from $214,001 to $320,000 the premium is $192.70. For individuals earning from$160,001 to $213,000, or couples earning from $320,001 to $426,000 the premium is $250.59 and for individuals earning $213,001 or above and couples earning $426,001 or above the premium is $308.30
New enrollees in Part B will pay 15% more than that, $110.50 a month.
Straight Medicare covers about 35 million beneficiaries, and they need not do anything if they feel their coverage is sufficient. If however, a beneficiary wants to have prescription drug coverage he or she must enroll in Part D. About 17.5 million Medicare beneficiaries have enrolled in Part D coverage.
Since there will not be an increase in the Social Security cost-of-living increase in 2010, premiums will remain the same for Part B coverage.
The annual enrollment period for Medicare begins on November15th and runs through December 31, 2009. Insurers have been sending out their promotional material since October 1.
If you did not sign up for Medicare Part D when you were first eligible to be covered by it, you will be assessed a 1% penalty per month if and when you do sign up, unless you had creditable prescription drug coverage under another plan.
To see more about Medicare Advantage, please see our article on this topic. There are about slightly less than 11 million Medicare beneficiaries who belong to Medicare Advantage plans.
If you need assistance in making your choices you can go to the Medicare site or call or visit your State Health Insurance Assistance Program, known as SHIP, which is run by the government. Counselors provide information and help you compare plans at no charge. To find the SHIP in your state, to to www.hapnetwork.org/ship-locator.
To see Part I of the article Medicare -Who Pays and How Much-Part I
FOR AN INFORMATIVE AND PERSONAL ARTICLE ON PRACTICAL SUGGESTIONS WHEN SELECTING A NURSING HOME SEE OUR ARTICLE "Selecting a Nursing Home"
By Allan Rubin
e-mail: hrubin12@nyc.rr.com or allanrubin4@gmail.com