Double Whamming Coming our Way (community, drug, single, benefit)
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
I plan to retire this year. In December, I'll be at FRA, age 66. If I turn on SS at that time, will avoid the Medicare premium increase?
This wouldn't work because your first check would not be issued until January 2016. You need that Medicare premium deducted from a SS check issued in 2015.
I have had Medicare refuse lab tests that were paid for in the past. I have had my specialized doctor drop out of Medicare completely. To me, this is a reduction in Medicare benefits.
It is getting harder and harder, where I live, to find a Medicare doctor who is open to new patients. And harder still to find a Medicare Advantage provider who is.
Does the hold-harmless law have any impact on Medicare Advantage? Some Medicare Advantage plans want the $104.90 plus an additional amount. Can that additional amount skyrocket each year and not be affected by the hold-harmless law? Is that a big disadvantage of Medicare Advantage plans?
Does the hold-harmless law have any impact on Medicare Advantage? Some Medicare Advantage plans want the $104.90 plus an additional amount. Can that additional amount skyrocket each year and not be affected by the hold-harmless law? Is that a big disadvantage of Medicare Advantage plans?
It's not the Medicare Advantage Plan that "wants" the $104.90, it's Medicare itself. Medicare collects the Part B premium from everybody, whether they have a Medicare Advantage Plan or not has nothing to do with it.
The hold-harmless provision simply means that our Social Security benefit payment is not supposed to be reduced because of increases in the Part B premium amount. Therefore the hold-harmless provision works in the same way whether we have straight (traditional) Medicare only, or Medicare plus a Medigap (supplement) plan, or a Medicare Advantage Plan.
This wouldn't work because your first check would not be issued until January 2016. You need that Medicare premium deducted from a SS check issued in 2015.
Lenora, I see what you answered to my post and this one post but does this apply when your income for a married couple is NOT anywhere near 170,000? The way I read that pamphlet it would not effect us because our income is not that high.
Lenora, I see what you answered to my post and this one post but does this apply when your income for a married couple is NOT anywhere near 170,000? The way I read that pamphlet it would not effect us because our income is not that high.
If you are not collecting SS before EOY 2015, the new 2016 Part B premium will be - at minimum - $159.30. If your income is higher, it will be more.
The key is - will you receive your first SS check in December 2015?? If not, you pay at minimum $159.30.
Does the hold-harmless law have any impact on Medicare Advantage? Some Medicare Advantage plans want the $104.90 plus an additional amount. Can that additional amount skyrocket each year and not be affected by the hold-harmless law? Is that a big disadvantage of Medicare Advantage plans?
Advantage plans vary within one company. Mine has a number of optional plans to choose from, ranging from more coverage (lower co-pays) to less (higher co-pays). Even within one Advantage plan, the premium for the very same option often varies from one part of a state to another. Sounds like income level is one factor determining the Medicare hike. The Advantage plan essentially "takes over" (manages) your Medicare.
At least that is true in my state, so check it out for yours.
Does the hold-harmless law have any impact on Medicare Advantage? Some Medicare Advantage plans want the $104.90 plus an additional amount. Can that additional amount skyrocket each year and not be affected by the hold-harmless law? Is that a big disadvantage of Medicare Advantage plans?
Quote:
Originally Posted by RiverBird
Advantage plans vary within one company. Mine has a number of optional plans to choose from, ranging from more coverage (lower co-pays) to less (higher co-pays). Even within one Advantage plan, the premium for the very same option often varies from one part of a state to another. Sounds like income level is one factor determining the Medicare hike. The Advantage plan essentially "takes over" (manages) your Medicare.
At least that is true in my state, so check it out for yours.
RiverBird, you statement is correct, but it has nothing to do with eok's question, which you quoted in your answer. Time to re-read, I do believe. When he mentions $104.90 he is referring to the Medicare Part B premium amount. My post explained all that, as did Ariadne's.
I deleted, because I harangue far too much on this issue, but, since my deleted post was mentioned, here it is:
Quote:
Originally Posted by eok
Does the hold-harmless law have any impact on Medicare Advantage? Some Medicare Advantage plans want the $104.90 plus an additional amount. Can that additional amount skyrocket each year and not be affected by the hold-harmless law? Is that a big disadvantage of Medicare Advantage plans?
Medicare Advantage is PRIVATE insurance run by FOR-PROFIT insurance companies.
Medicare Part B premium of $104.90 has NOTHING whatsoever to do with any additional insurance premium charged by the Advantage and/or any or Medicare supplement (Medigap) private insurance plan.
The private insurers' premium decisions are in no way tied, connected to, or determined or limited by the cost (to you) of Medicare Part B coverage.
Your enrollment in Part B is a requirement for you to participate in an Advantage plan. You are no longer enrolled in Original Medicare. Instead, you have turned over all decisions and payments regarding your health care to the private Advantage insurer.
The govt sends the Advantage plan a set fee for your coverage - ranging between $750-$1,200/mo., depending on location. Any medical costs for you are paid by the Advantage plan from that fee. Any money not paid out by the Advantage plan is their profit. But, the Advantage company will not get its money ($750-$1,200/mo.) from the government for you unless you are first enrolled in Medicare Part B.
Whatever the Advantage company does not pay out for you from this monthly stipend, it keeps as PROFIT. If those PROFITS are not high enough, the PRIVATE insurer raises its rates.
So, the answer to your question is - yes - the Advantage premiums can change independently and with no regard whatsoever to what you are paying for Part B - and is determined, instead, by the Advantage company's bottom line/profits.
And, no, the fact that premiums may increase is not the biggest disadvantage of an Advantage plan.
The biggest disadvantage is that you have now turned over all decisions on your health care to a PRIVATE INSURER. Some MA's behave very badly, denying mandated benefits, deny receiving claims, drag their feet on approval for services, strict and onerous oversight on services for chronic conditions, do not pay providers for up to a year. Your MA may be behaving very well and you have not encountered these issues.
Second biggest disadvantage of an MA is the restricted provider network. Instead of the ability to see any Medicare doctor anywhere in the country, unless the plan is a PPO - and most are HMO's - you are stuck with their providers.
Don't worry about the MA premium. Worry more about the oversight, provider network, and whether or not the coverage is hassle-free as far as access to services and approval and payment of benefits.
Last edited by Ariadne22; 08-25-2015 at 08:11 PM..
Lenora, I see what you answered to my post and this one post but does this apply when your income for a married couple is NOT anywhere near 170,000? The way I read that pamphlet it would not effect us because our income is not that high.
The "hold harmless" clause does not apply for several groups. One group consists of the high earners, those singles earning $85 thou and those couples earning $170 thou.
Another group consists of Medicare beneficiaries who did not have a Medicare premium withheld from their Social Security check in 2015. It is unfortunate that your husband reaches FRA in December 2015, because social security checks are issued the month following entitlement.
Of course, he could file to receive his benefit one month before FRA but I doubt it's worth it. As noted by MadManofBethesda, once the COLA is reinstated, it is possible your husband's premium may actually drop while those who have been "held harmless" will see their premiums rise.
As an aside, the "hold harmless" provision only applies to the Part B premium. All * Medicare recipients will be subject to an increased Part B deductible ($223) and an increased Part D deductible ($360). Folks going with Plan F will probably see an increase (of 4%?) because F picks up the (increased) deductible.
That said, the numbers are estimates. I have read the Secretary of Health and Human Services may be able to help, somehow.
Nevertheless, there was essentially no increase in the CPI-W for the first month of the 3rd quarter (July). It looks to me that the Trustees were correct in assuming there will be no COLA for 2016.
*I am not including Medicare Advantage plans.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
