Fast and Easy 2018 Part D Breakdown

Is Medicare Part D confusing? Want a fast and easy 2018 Part D breakdown … Well look no further, we can help.

2018 Medicare Part D Breakdown

All Part D Medicare drug plans work the same as far as their coverage levels, they just offer different copayments and/or deductibles.

Deductible

If your plan has a deductible, you pay the total cost of your drugs until you reach your deductible set by your plan … then you move on to the initial coverage level.

Initial Coverage Level – $3,750

During the initial coverage level you pay your copay amounts set by your plan until your total drug cost reaches $3,750. The total drug costs is the amount “you and the insurance company” pay. Then you move to the coverage gap level, or “donut hole”

Coverage Gap Level / “Donut Hole” – $5,000

During the coverage gap level, you pay either a higher copay amount, or discounts until you pay a total in out of pocket expenses of 5,000. Out of pocket expenses is just the amount “you” pay. Then you move to the catastrophic coverage level.

Catastophic Coverage Level – Unlimited

The catastrophic coverage level is where you will pay generally the least copay amount until the end of the year at which time the plan will renew.

This fast and easy 2018 Part D breakdown is not company specific. If you need a specific quote for your Medicare 2018 drug plan click here.

Only some drugs are covered under part B of Medicare, but most drugs are not. You want to make sure that you get a separate drug plan when you become “eligible” for Medicare Part D, in order to avoid the future penalty.

New Medicare Card

New Medicare Cards are soon to be in the mail! The Centers for Medicare & Medicaid Services (CMS) will begin mailing new cards to people with Medicare benefits beginning in April 2018. This comes as an effort to meet the statutory deadline for replacing all existing Medicare cards by April 2019. The new Medicare card will no longer display your social security number (SSN) as your Medicare ID, rather each Medicare beneficiary will be issued a random alphanumeric-based number.

When will I get my new Medicare Card?

Medicare beneficiaries should use the new card once they get it, but either the SSN-based or the new Medicare card with the random alphanumeric-based number can be used through December 2019. Beginning January 1, 2020, only the new card will be usable.

I’m New to Medicare

New and existing Medicare enrollees will get the new Medicare card. New enrollees will get the new card starting in April 2018. Current enrollees will begin receiving a replacement card sometime between April 2018 and April 2019, state by state.

To Prepare for Your New Medicare Card:

This change does not impact your Medicare benefits in any way, nor does it impact your Medicare Supplement, Medicare Advantage, or Medicare Part D benefits.

Make sure your address is up to date so you get your new Medicare card. If your address needs to be corrected, Social Security is the organization who keeps all of the current contact records, even though the new Medicare card is from Medicare. If you haven’t done so already, you can create an online account at ssa.gov and update your address. If online access isn’t your thing, or you would rather talk to someone directly, you can call Social Security at 800-772-1213 and take care of it all over the phone.

Your new Medicare card may arrive any time between April 2018 and April 2019. You may get your card at different times from your friends and neighbors.

Please be on the ALERT to possible scams: Medicare will never contact you and ask for personal and private information in order to issue a new Medicare card or number.

If you are new to Medicare and need help call us 877-740-8683, we can point you in the right direction.

You want to enroll in Medicare 3 month prior to turning 65, and you can enroll by calling Social Security at 800-772-1213, or by going online at www.ssa.gov.

If you have Medicare and would like to compare rates on your Medicare Supplement Plan click here

Retiring Baby Boomers Healthcare

Retiring Baby Boomers healthcare costs are a big concern and need to be planned for … starting now!

When you think of retirement, you think of white sand beaches, or sipping coffee on the porch, or riding your Harley till you find that quaint little town and stop and the night … basically you leave the bump and grind and being your stress-free life, right?  Retiring baby boomers are not thinking of having to deal with the complicated world of Medicare or your retirement health insurance. Yuck!

So for those of you who like to look through the “rose-colored glasses”, we have listed a few key things about healthcare costs that retiring baby boomers should be aware of so you can prepare now as retirement nears.

Medicare isn’t FREE.

Shocker?  Most retiring baby boomers assume that all of a sudden once they stop working and get on Medicare, magically all of their medical bills will be paid.  It’s probably because we all paid so much in for so many years, it would seem justified, however it isn’t the case.  How it really works is Medicare Part A covers things in hospital and that part is FREE for most enrollees.  Then Medicare Part B, which covers outpatient services and Medicare Part D, which is the prescription part, isn’t FREE.  To add to it, all of the parts of Medicare come with varying deductibles and other out of pocket costs that can add up, not to mention it doesn’t have an annual out-of-pocket limit like most of us are used to with our health plans.

A typical retiring baby boomers healthcare costs will look something like this once enrolled in Medicare:

  • Part B premium, which for most people is $104.90 as of 2016, but those with higher incomes are subject to higher premiums.
  • Medicare Part A Deductible- $1,288 per benefit period (for 2016).  Now Medicare says a “benefit period” is the day your’re admitted to a hospital or skilled nursing facility up until you reach the point where you haven’t received inpatient care for 60 days in a row.  So basically, in a year you could pay that $1,288 deductible multiple times … there’s no limit to the number of “benefit periods” under Medicare Part A.  Plus, you are charged for each day you are confined, and there is no limit on that either.
  • Medicare Part B Deductible – $166 per year (for 2016).

So to boil it all down, when you are enrolled in Medicare alone, you will spend thousands of dollars each year out-of-pocket. In fact, in 2010, according to the Kaiser Family Foundation, Medicare beneficiaries spent an average of $4,745 on out-of-pocket healthcare expenses. That doesn’t sound FREE to me!

Retiring baby boomers need supplemental insurance.

Generally, Medicare will cover about 80% of the medical expenses, which is why most people use supplement insurance plans to cover the other 20%.   There are a lot of different Supplement Plans or Medigap plans available.  They are sold by individual carriers and vary by price and benefits.  Some do really good at picking up what Medicare doesn’t pay, and others have more out-of-pocket costs to you.  A Medigap plan with very little out-of-pocket cost will probably average you around $180 per month.

Now as we said, Medicare doesn’t cover everything, and may not meet all your retirement needs.  Just as Medicare doesn’t cover funeral expenses, it also doesn’t cover the cost of nursing home care or assisted living facilities, therefore you have long-term care insurance.  Key is, the best time to buy is when you are young and healthy, just like your life insurance.  The average 60-year-old couple pays about $3,400 per year in premium costs, but having a plan could save you and your loved ones thousands upon thousands in the long run. The American Association for Long-Term Care Insurance reports that more than 50% of applicants aged 50 to 59 qualify for long-term discounts based on their health, but that figure drops to 42% among 60- to 69-year-olds and 24% for 70- to 79-year-olds.  The facts show the older we get the less likely we are to qualify, so if you are interested in seeing about long-term care insurance, click here for a free quote.

“I’m not going to be 65 when I retire, what do I do for health insurance?”

So let’s say you are one of the “lucky” ones and will stop working before you get Medicare eligible, you will have to get health insurance on your own until you reach 65.  There are a few ways this can happen:

JOB:  If you had health insurance with your employer, you may can continue your coverage under that same plan, that is called COBRA, which allows you to keep the plan for up to 18 months.  If you elect COBRA, you will pay the full cost of your plan, whereas your employer most likely paid some of it.  Most COBRA premiums are high, but before you make the choice, you need to shop around, you generally have 60 days to elect it.

INDIVIDUAL:  If you didn’t have the option of COBRA, or you have exhausted your COBRA already but you still aren’t 65, you have the option of shopping individual plans.  Now days, everyone is talking about Obamacare, and on and off the exchange.  That is a whole other post you need to read … basically know it is available but keep in mind that the (2016) prices have gone up from when you shopped last, and plans have changed.  You may have to take a higher deductible or a plan with fewer copayments, but the main thing to look at is network.  Most carriers are only offering HMOs, so you must stay with a doctor in network – so make sure your doctor is in that network on the plan you choose, or you will have to change doctors.  Keep in mind, if you get a plan that is not ACA qualified, you will be subject to the penalty when you pay your taxes.

Good news!

Typically we see most retiring baby boomers are happier with the healthcare costs once they get on Medicare vs what they are paying on their individual plans.  However, once you retire, you’ll be on a fixed income, so the more you prepare now, either by putting back extra savings, or paying off more of your other liabilities, the better off you’ll be.