Medicare’s annual open enrollment period ended last month, but certain beneficiaries who regret their selection can get a do-over from now through mid-February. The Medicare Advantage disenrollment period runs from Jan. 1 through Feb. 14. During this time, beneficiaries in private Medicare Advantage plans can switch to Original Medicare and, if desired, select a Part D drug plan. This is the only move permitted: Those in Original Medicare can’t switch to Medicare Advantage and those already in Medicare Advantage can’t switch to a different Medicare Advantage plan. Unless those beneficiaries qualify for a special enrollment period, they will have to wait until the fall to make any changes to their coverage that will be effective at the start of 2018. The winter disenrollment period for Medicare Advantage may be easy to miss. It’s not accompanied by the same advertising blitz that characterizes the annual fall open enrollment, when the airwaves fill with commercials for Medicare Advantage and Part D drug plans. For those unhappy with their Medicare Advantage coverage, it’s an important chance to leave your plan, regardless of whether you enrolled years ago or during the recent open enrollment. (For tips on navigating Medicare in general, check out Money’s comprehensive guide.) Beneficiaries aren’t limited in the number of times they can take advantage of the Medicare Advantage disenrollment period during their lifetimes.
Below are the most important figures seniors and their families will confront in 2017:
Medicare Part A deductible: $1316 for each benefit period
Medicare Part A hospital stay day 1-60: $0 co-insurance for each benefit period
Medicare Part A hospital stay day 61-90: $329/day co-insurance for each benefit period
Medicare Part A hospital stay beyond 91 days: $658/day co-insurance for each benefit period
Medicare Part B Premium: $134/month.
Medicare Part B Deductible: $183/year
Medicare Skilled nursing home co-payment day 21-100: $164.50/day
Medicaid Individual Resource Allowance: $2000.00
Resource Allowance for a Couple who both reside in a facility: $3,000.00
Medicaid Community Spouse Resource Allowance: Minimum $24,180.00; Maximum $120,900.00
Medicaid Monthly Maintenance Needs Allowance: Minimum $2,002.50; Maximum $3,022.50
Medicaid Monthly Personal Needs Allowance: $35.00/month
Medicaid Divestment Penalty Divisor: $332.50/day
Medicaid Income Cap Limit: When is a Miller Trust required? $2205/month
Principal Residence Equity Exclusion: $840,000.00
Community Spouse Monthly Housing Allowance: $600.75
Standard Heating & Utility Allowance: $501.00
Federal Estate Tax Threshold: $5,490,000
Federal Gift Tax Exclusion: $14,000.00
NJ Estate Tax Threshold: $2,000,000.00
NJ Inheritance Tax: Class A & E exempt
This settlement addresses delays that Medicare beneficiaries have been experiencing at the Administrative Law Judge (ALJ) level of review.
For the article from the Center for Medicare Advocacy, click here.
Health Savings Accounts are surging in popularity — and that can lead to some complications for older workers who enroll in Medicare. Health Savings Accounts (HSAs) are offered to workers enrolled in high-deductible health insurance plans. The accounts are used primarily to meet deductible costs; employers often contribute and workers can make pretax contributions up to $3,350 for individuals, and $6,750 for families; the dollars can be invested and later spent tax-free to meet healthcare expenses. But as more employees work past traditional retirement age, some sticky issues arise for HSA account holders tied to enrollment in Medicare. The key issue: HSAs can only be used alongside qualified high-deductible health insurance plans. The minimum deductible allowed for HSA-qualified accounts this year is $1,300 for individual coverage ($2,600 for family coverage). Medicare is not considered a high-deductible plan, although the Part A deductible this year is $1,288 (for Part B, it is $166). That means that if a worker – or a spouse covered on the employer’s plan – signs up for Medicare coverage, the worker must stop contributing to the HSA, although withdrawals can continue. Failing to do that can lead to a tax penalty.
For the article from the Reuters, click here.
No one knows how big the problem of hospice fraud is — all types of improper Medicare payments are estimated at $65 billion for 2010 — but federal investigators prosecuted more than 60 cases in the last year alone, involving hundred of millions of dollars nationwide. The system that was built to help dying patients live out their remaining days with dignity and comfort has few quality metrics to meet, no minimum requirements for how often care is provided, and low barriers to getting into the business. Critics say that can make end-of-life care seem ripe for abuse. “There’s a built-in incentive to get patients in the door,” said Claire Sylvia, a lawyer representing whistleblowers in health care fraud cases at the San Francisco offices of Phillips & Cohen LLP. For example, former Horizons Hospice chief operating officer Mary Ann Stewart, is under indictment in federal court in Pittsburgh on charges of inflating enrollment at her company’s Monroeville facility by recruiting patients who often weren’t really dying. A long-awaited reform in how Medicare pays hospice providers that went into effect in January will do little to curb such abuse, experts say. Medicare began staggering payments to better reflect the cost of care — the first reimbursement change since the benefit began in 1983.
For the article from the Pittsburgh Post-Gazette, click here.