By Roy Whited
New Medicare Premium, Deductible and Co-Pay, 2011.
The basic premium for Medicare Part B will be $115.40 a month in 2011, up from $110.50 in 2010 (a 4.4% increase). But, because there will be not cost of living benefit increase for Social Security recipients for 2011, most beneficiaries will be exempted from paying the increase and will instead pay the same $96.40 premium amount they have paid since 2008.
A “Hold Harmless” provision in the Medicare law prohibits Part B premium from rising more than that year’s cost of living increase in Social Security benefits. Since there is no Social increase, most beneficiaries, about 73%, will not have to pay any increased Part B
premiums because of the Hold Harmless provision. Those currently covered by the provision will continue to pay the Part B premium of $96.40 per month in 2011.
But, the hold harmless protection does not apply to the other 27% of beneficiaries- about 12 million in all- who either:
- Do not have their Part B Premiums withheld from their Social Security checks, or
- Pay a higher Part B premium surcharge based on high income or
- Are newly enrolled in Part B
For more information about these New Medicare Premiums, Deductibles and co-pay for 2011 check on www.elderlawanswers.com or call our office at 800-798-5297.
by: Megail Gaumer
In 2011 the basic monthly premium for Medicare Part B will be $115.40, up 4.4% from 2010. But most beneficiaries will be exempted from paying this increase because there will be no cost of living increase in Social Security Benefits for 2011 and these recipients will pay the same $96.40 monthly premium they have paid since 2008.
A provision call “hold-harmless” in the Medicare law restricts premiums for Part B from exceeding more than the cost of living increase in any given year. Since there is no Social Security increase, approximately 73% of Medicare beneficiaries will not have to pay the increase.
For the other 27% that; A) do not have their Part B premiums withheld from their Social Security checks B) pay a higher Part B premium surcharge based on high income (see below), or C) are newly enrolled in Part B. They will be subject to the higher premiums.
Everyone receiving Medicare benefits will however be responsible for the new deductibles and co-payments, such as, Part B deductible of $162, Part A deductible of $1,132, Co-payment for hospital stay days 61-90 of $283/day, Co-payment for hospital stay days 91 and beyond of $566/day and Skilled nursing facility co-payment, days 21-100 of $141.50/day.
And since 2003, higher-income beneficiaries will fall into a different category of payments as follows:
- $161.50 for individuals with annual incomes between $85,000 and $107,000 and married couples with annual incomes between $170,000 and $214,000
- $230.70 for individuals with annual incomes between $107,000 and $160,000 and married couples with annual incomes between $214,000 and $320,000
- $299.90 for individuals with annual incomes between $160,000 and $214,000 and married couples with annual incomes between $320,000 and $428,000
- $369.10 for individuals with annual incomes of $214,000 or more and married couples with annual incomes of $428,000 or more.
Rates differ for beneficiaries who are married but file a separate tax return from their spouse. Those with incomes between $85,000 and $129,000 will pay a monthly premium of $299.90 and Those with incomes greater than $129,000 will pay a monthly premium of $369.10.
By Megail Gaumer
Afraid to retiree before you are eligible for Medicare? You may not have to fear any longer. The Affordable Care Act has allowed for the Early Retiree Reinsurance Program (ERRP) through January 1, 2014. Many organizations can apply, private companies, State and local governments, non-profits, union operated benefit plans and religious organizations. Retirees over the age of 55 and not yet eligible for Medicare, their eligible spouses and dependents could benefit, but will not cover any benefits Medicare would not. There is still time, ask your employer if they have applied.
If you are close to retirement, it’s time to come in for an Estate Plan Review. Call our office to arrange a meeting.
It is not uncommon for our clients to confuse Medicare with Medicaid or to misspeak when discussing Medicaid and use the term Medicare instead, thinking they are interchangeable. Well, they are not. There is quite a difference. Medicare is a federal insurance program that pays for certain services for those that are 65 and older, or may be disabled, and have paid into the Social Security program. Medicare is financed by you to a small extent through your Part “B” premium, with the remainder paid by the federal government. It is designed to look like insurance, so there are several options and plans. There are Parts A, B, C, and D. Each provides different aspects of health care. For example, Part A is for hospital coverage, Part D is for your prescriptions.
Medicaid, on the other hand, is a public health program that is funded by both the state and the federal government. A person in Ohio is entitled to Medicaid once they meet income and eligibility requirements. It provides necessary health care coverage to individuals that meet these requirements.
Medicaid for older adults and people with disabilities covers several services. It covers home care, prescription drugs, doctor visits, dental care, vision services, hospital care, laboratory work, x-rays and several other services. If eligible, these are services that you are entitled to. The state cannot limit the number eligible nor can they deny access to medically necessary services.
Both programs are very helpful to our seniors. Just remember when calling into the office, there is a difference.
Over half of all Americans say they worry about taking care of their aging parents. Katie Couric says both parties should sit down and have an honest talk about the future.
Navigating Medicare and Medicaid options are mind-numbing and helping our parents live out their lives can be completely overwhelming. Don’t bare the financial burden of your parents medical expenses. A consultation with an Elder Law attorney can help you and your parents plan for the future.
by Roy Whited
As the attorney in fact, also known as the Power of Attorney, for my 86 year old mother, most of her mail is sent to my home address. Over the weekend, we received a four-page informational worksheet from CMS, Centers for Medicare & Medicaid Services. This was a message from Kathleen Sebelius, Secretary of Health and Human Service. While much of the information is general, it did talk about improvements in Medicare you will see right away.
More Affordable Prescription Drugs
- If you enter the Part D “donut hole” this yea, you will receive a one time, $250 rebate check if you are not already receiving Medicare Extra Help. These checks will begin mailing in mid-June and will continue monthly through out the year as beneficiaries enter the coverage gap.
- Next year, if you reach the coverage gap, you will receive 50% discount when buying Part D covered brand-name prescription drugs.
- Over the next ten years, you will receive additional savings until the coverage gap is closed in 2020.
Important New Benefits to Help you Stay Healthy
- Next year you can get free preventive care services like colorectal cancer screening and mammograms. You can also get a free annual physical to develop and update your personal prevention plan based on current health needs.
Improvements to Medicare Advantage
- Today, Medicare pays Medicare Advantage insurance companies over $1000.00 more per person on average than Original Medicare. These additional payments are paid for in part by increased premiums by all Medicare beneficiaries – including the 77% of seniors not enrolled in a Medicare Advantage plan.
- The new law levels the playing field by gradually eliminating Medicare Advantage overpayments to insurance companies.
- If you are in a Medicare Advantage plan, you will still receive guaranteed Medicare benefits.
- Beginning 2014, the new law protects Medicare Advantage members by taking strong steps to ensure that at east 85% of every dollar these plans receive is spent on health care, rather than administrative costs and insurance company profits.
For more information about the new health care law and other improvements that you will see soon, visit www.medicare.gov or call 1-800-633-4227. In Ohio you can call OSHIIP 1-800-686-1578, or call our office to discuss your specific situation and concerns as part of your overall estate plan.
by guest author Roy Whited
If you are admitted to a hospital as a Medicare patient, the hospital may try to discharge you before you are ready. As a Medicare beneficiary you may want to fight a hospital discharge. One of the major benefits of Medicare is its coverage of hospitalization. Medicare covers 90 days of hospitalization per illness (plus a 60-day “lifetime reserve”). You may need more time to recover from surgery or your hip fracture may not be fully healed, but the hospital may want the room back. While the hospital can’t force you to leave, it can begin charging you for services Therefore, it is important to know your rights and how to appeal. Even if you don’t win your appeal, appealing can buy you crucial extra days of Medicare coverage.
Remember, Medicare only pays for skilled care in a nursing home and you must have a 3-day stay in the hospital prior to going to the nursing home.
For more information on the procedures you need to follow, you can visit
www.medicare.gov.
There is a great deal of confusion about Medicare and Medicaid. Medicare is the federally funded and state administered health insurance program primarily designed for older individuals (i.e. those over age 65). There are some limited long term care benefits that can be available under Medicare. In general, if you are enrolled in the traditional Medicare plan, and you’ve had a hospital stay of at least three days, and then you are admitted into a skilled nursing facility (often for rehabilitation or skilled nursing care), Medicare may pay for a while. (If you are a Medicare Managed Care Plan beneficiary, a three day hospital stay may not be required to qualify.) Keep in mind, Medicare does not pay for treatment of several diseases and other medical conditions.
If you qualify, traditional Medicare may pay the full cost of the nursing home stay for the first 20 days and can continue to pay the cost of the nursing home stay for the next 80 days, but with a deductible of $133.50 per day. Some Medicare supplement insurance policies will pay the cost of that deductible. For Medicare Managed Care Plan enrollees, there is no deductible for days 21 through 100, as long as the strict qualifying rules continue to be met. So, in the best case scenario, the traditional Medicare or the Medicare Managed Care Plan may pay up to 100 days for each “spell of illness.” In order to qualify for this 100 days of coverage, however, the nursing home resident must be receiving daily “skilled care” and generally must continue to “improve.” (Note: Once the Medicare and Managed Care beneficiary has not received a Medicare covered level of care for 60 consecutive days, the beneficiary may again be eligible for the 100 days of skilled nursing coverage for the next spell of illness.)While it’s never possible to predict at the outset how long Medicare will cover the rehabilitation, from our experience, it usually falls far short of the 100 day maximum. Even if Medicare does cover the 100 day period, what then? What happens after the 100 days of coverage have been used? At that point, in either case you’re back to one of the other alternatives… long term care insurance, paying the bills with your own assets, or qualifying for Medicaid.
One of the things that concerns people most about nursing home care is how to pay for that care. There are basically four ways that you can pay the cost of a nursing home:
1. Long Term Care Insurance – If you are fortunate enough to have this type of coverage, it may go a long way toward paying the cost of the nursing home. Unfortunately, long term care insurance has only started to become popular in the last few years and most people facing a nursing home stay do not have this coverage.
2. Pay with Your Own Funds – This is the method many people are required to use at first. Quite simply, it means paying for the cost of a nursing home out of your own pocket. Unfortunately, with nursing home bills averaging between $5,000 and $6,600 per month in our area, few people can afford a long term stay in a nursing home.
3. Medicare – This is the national health insurance program primarily for people 65 years of age and older, certain younger disabled people, and people with kidney failure. Medicare provides short term assistance with nursing home costs, but only if you meet the strict qualification rules.
4. Medicaid – This is a federal and state funded and state administered medical benefit program which can pay for the cost of the nursing home if certain asset and income tests are met. Since the first two methods of private pay (i.e. using your own funds) and long term care insurance are self-explanatory, our discussion will concentrate on Medicare and Medicaid.
New Medicare Premium, Deductible and Co-Pay, 2011.
