The Medicare Catastrophic Coverage Act Of 1988
The Medicare Catastrophic Coverage Act of 1988 began with the 1984 report of the Social Security Advisory Council chaired by Otis Bowen, a physician and former Republican governor of Indiana. The council’s report did not focus on prescription drugs but on the limited hospital coverage provided by Medicare and the out-of-pocket expenses for both hospital and physician services. After Bowen was appointed as secretary of HHS by President Ronald Reagan in November 1985, he urged the White House to support the council’s reform proposals and successfully lobbied for an initial proposal in the 1986 State of the Union address. The combination of Bowen’s interest and changes in the political climatethe Iran/contra scandal in the White House and Democrats regain of control of the Senate after the 1986 election, along with their continuing control of the House of Representativessoon created the opportunity for new Medicare benefits, among them prescription drug coverage .
In the spring of 1988 the chairman of the Senate Finance Committee, Lloyd Bentsen , proved to be the final arbiter when he accepted a drug benefit scaled back to catastrophic coverage and not a routine benefit. Medicare would cover 80 percent of drug costs once the beneficiary met a $600 deductible. The administration, weakened by scandal, did not have the will to fight over prescription drugs, and it ultimately supported the final package .
How Often Do You Have To Enroll In Medicare
In general, once youre enrolled in Medicare, you dont need to take action to renew your coverage every year. This is true whether you are in Original Medicare, a Medicare Advantage plan, or a Medicare prescription drug plan. As long as you continue to pay any necessary premiums, your Medicare coverage should automatically renew every year with a few exceptions as described below.
What Should You Do With Your Medicare Supplement Each Year
The Medicare Annual Open Enrollment Period starts October 15th and ends on December 7th of each year. During this enrollment period, youâre likely getting swamped with advertisements, mailers, and phone calls from people trying to get you to switch or buy a new Medicare plan. But what you need to know is that for Medicare Supplements, there is no annual enrollment required!
Your renewal date for your Medicare Supplement could be any time of the year. Letâs say you turned 65 in April, so your Medicare Supplement became effective that month. That means that your personal renewal date for your Medicare Supplement is in April.
So, what do you need to do when your renewal month comes around, if anything?
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Do I Have To Renew My Health Plan Annually
Does my insurance have to be renegotiated every year? in 2014 I carried a Gold Health Alliance policy in Illinois. Without my knowing Jan 2015 my policy was changed to a much higher deductible policy. I only found out this happened in the middle of January 2015 when I received new insurance cards. I was admitted to the hospital Jan 3rd with Influenza A and pneumonia. After finding out my policy had been switched I called the Illinois marketplace to go back to my Gold Health Alliance policy. I am now having to pay out 4000.00 out of pocket with none of that amount going towards the deductible because I corrected the policy. Health Alliance and the Illinois Marketplace do not take responsibility for the change of policy as of Jan 2015. I feel there is a major flaw in the system . My hope is that you may be able to help me get some answers.
Do I Need To Do Anything With My Medicare Supplement Plan
Whether youâre entirely new to Medicare or youâve been a Medicare participant for a while, you may have questions about your Medicare Supplement plan, such as âWhat do I need to do with my Medicare Supplement plan this year?â
Medicare Supplements are handled very differently from Medicare Advantage plans, and many individuals donât know this!
Remember that our team of licensed agents is always willing to help you, so please feel free to contact us at any time for individualized help.
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Medicare If Youre Disabled And Under 65 How It Works
If youre disabled and received Medicare Part A before age 65 but did not accept Part B at that time, you may be automatically enrolled in Medicare Part B when you reach your 65th birthday. You will receive a new Medicare card showing the Part A entitlement date based on disability and the Part B entitlement date based on aging into the program.
You will receive the card about three months prior to the month you turn age 65. You wont have to pay a late-enrollment fee for Medicare Part B, but you will be responsible for paying the Part B monthly premium if you choose to keep that coverage. The package you receive before your 65th birthday will explain how you can decline Part B if you dont want it.
Keep in mind that you need to be enrolled in Medicare Part B to qualify for certain Medicare plan options, such as Medicare Advantage and Medicare Supplement insurance. If you delay Part B enrollment, you might face a late-enrollment penalty when you enroll later on.
To qualify for Medicare, whether by age or disability, you must be an American citizen or permanent legal resident of at least five years in a row.
There Are Two Types Of Medicare:
- Original Medicare includes Part A and Part B. For drug coverage, you join a Medicare prescription drug plan . To pay additional costs, which can mount up quickly, most people buy a Medicare Supplement plan .
- Medicare Advantage, otherwise known as Medicare Part C, is an all-in Medicare health plan operated by private companies that contract with Medicare to provide Part A and Part B benefits and usually, but not always, prescription drug coverage.
Which plan you choose affects many things going forward, including how your Medicare works, what it pays for, and how easy or hard it is to switch things around.
One of the best places to learn about Medicare is Medicare.gov, the governments information site. In order to get accurate information, you must create an account. Once youve done that, you can tailor your results. The site doesnt give you help making a decision about what is best for you, but it does offer plenty of personalized details to guide your decision making.
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Medicare Part B Late Enrollment Penalty
If youre new to Medicare and dont sign up for Part B when youre first eligible, you may end up having to pay the Part B late enrollment penalty. The late enrollment penalty is imposed on people who do not sign up for Part B when theyre first eligible. If you have to pay a penalty, youll continue paying it every month for as long as you have Part B.
Does Medicare Cover Long
As people live longer and longer, there is an increasing likelihood that theyll need long-term care at some point in their lives. Unfortunately, Medicare does not cover long-term care expenses. Therefore, its important to account for Medicare and long-term care expenses as part of a comprehensive retirement income plan.
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Review Your Finances When Turning 65
If you arent retired already, chances are that you are at least thinking about it. Many people havent saved enough for retirement, so think they have to work for the rest of their lives. This may be true, or it might not.
Now might be the time to schedule an appointment with a financial adviser, or at least use a Robo-advisor.
You can check out organizations such as the Financial Planning Association, and the National Association of Personal Financial Advisors to help you find an adviser that works best for you.
In addition to managing the money that you have saved, some simple changes to your lifestyle may allow you to retire sooner than you think. This might mean moving across the country where its less expensive to live.
It might even mean moving to a foreign country where dollars stretch longer.
One place to research this is the magazine called International Living.
The Retirement Index is still the most comprehensive and in-depth survey of its kind. Its the best way we know of to sift through the wealth of opportunity the world offers, bring some order, and help you pinpoint the best destination for you.2
And according to their 2018 survey, Costa Rica is the best place for Americans to live.
So dont despair if you having saved enough to retire. If you are willing to move then you might still be able to retire. Keep in mind that your Medicare Insurance probably wont work out of the country if you move permanently.
Do You Have To Renew Medicare Advantage
You will be automatically re-enrolled in your Medicare Advantage plan annually unless the company that provides your plan stops offering it. Then youll get a chance to buy a different one during the annual Open Enrollment Period from October 15 to December 7. There is also a Medicare Advantage Open Enrollment Period from January 1 to March 31. During both those periods, youll also be able to switch Medicare Advantage plans even if its just because you dont like the Advantage plan you have, or you are looking for more benefits or lower cost. Once you enroll in a new plan, you will be automatically disenrolled from the old one.4
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Browse Plans Online > >
In the Medicare Advantage Disenrollment Period, you will have until Feb. 14 to pick up a Part D plan for prescription drug coverage. During this time, you cannot switch between Medicare Advantage plans or move from Original Medicare to Medicare Advantage. Your coverage will start on the 1st day of the month after the month in which you switch coverage.
You can leave your Medicare Advantage plan and return to traditional Medicare Part A and Part B at any time. Just give your managed care plan 30 days written notice, and they will notify Medicare.
Do You Need To Renew Medicare Part B Every Year
As long as you pay the Medicare Part B medical insurance premiums, youll continue to have the coverage. The premium is subtracted monthly from most peoples Social Security payments. If you dont get Social Security, youll get a bill. If you fail to pay the bill three months in a row, youll get a cancellation notice. At that point, its not too late to pay up. But if you go a couple of weeks longer without paying, youll be cut off. You can have Part B reinstated during the general enrollment period each January through March, but youll probably be charged a penalty.2
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What Is Medicaid
First, a reminder: Medicaid is a program jointly funded by the federal government and the states to provide health insurance plans to low-income Americans. Medicaid provides free or low-cost medical care and is overseen by the Department of Health and Human Services.
Your Medicaid eligibility is based on your income level. And adults, children, pregnant people, the elderly, and people with disabilities can all become Medicaid recipients. Right now in the U.S., Medicaid covers 25 percent of all children, 21 percent of low-income adults, and 60 percent of all nursing home residents.
If you are one of the 50 million Americans who would be without health care coverage if they did not have Medicaid, its very important that you remember to reapply for this coverage each year.
How To Use Epic:
- Show both your Medicare Part D drug plan and EPIC cards to your pharmacist. Tell your pharmacist that you have prescription coverage through both plans.
- Tell your pharmacist that your Medicare Part D drug plan is your primary prescription coverage, and all claims for prescription medications must be submitted to Medicare Part D first and then to EPIC.
- EPIC will cover Medicare Part D- and EPIC-covered drugs after any Medicare Part D deductible is met. EPIC will also cover approved Part-D excluded drugs once a member is enrolled in a Part D plan.
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How To Avoid The Medicare Part D Late Enrollment Penalty
You are not required to do your Medicare Part D enrollment during your IEP. However, if you go without Medicare Part D or other creditable prescription drug coverage for a continuous period of 63 days or longer after your IEP is over, you could be subject to a Part D late enrollment penalty. Coverage could come from a stand-alone prescription drug plan, a Medicare Advantage plan with prescription drug coverage , or another type of creditable prescription drug coverage.
The amount of the Part D late enrollment penalty depends on how long you went without prescription drug coverage. Medicare calculates the amount by multiplying the number of months you didnt have prescription drug coverage by 1% of the national base beneficiary premium. In 2021, the national base beneficiary premium is $33.06.
The penalty amount is added to your monthly premium and you will continue to pay the penalty as long as you are enrolled in Medicare Part D. You can avoid this penalty by ensuring you dont go without creditable prescription drug coverage for 63 days or longer. Creditable coverage pays at least as much as standard Medicare coverage for prescription drugs.
Medicare Part D enrollment is the first step in getting the coverage you need for your prescription medications. With multiple plans to choose from, it is helpful to compare plans carefully to find the right plan for you. You can start by entering your zip code on this page.
New To Medicare?
When Can You Get A Medicare Supplement
For starters, you need to understand when you can first get a Medicare Supplement. In sum, if youâre eligible for Medicare, youâre eligible for a Medicare Supplement.
The month you turn 65, youâre eligible for the open enrollment period. This lasts for the next six months. For example, if you turn 65 in January and enroll in Medicare Part B, you can purchase a Medicare Supplement from January to June.
Even if youâre 65, though, you can choose to put off signing up for Medicare, which means you can also put off signing up for a Medicare Supplement. This is really common if youâre 65 but are still working. If youâre on a group plan provided by your employer, you donât really need Medicare health coverage just yet.
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Can I Decline Medicare Altogether
Medicare isnt exactly mandatory, but it can be complicated to decline. Late enrollment comes with penalties, and some parts of the program are optional to add, like Medicare parts C and D. Medicare parts A and B are the foundation of Medicare, though, and to decline these comes with consequences.
The Social Security Administration oversees the Medicare program, and recommends signing up for Medicare when you are initially eligible, even if you dont plan to retire or use your benefits right away. The exception is when you are still participating in an employer-based health plan, in which case you can sign up for Medicare late, usually without penalty.
While you can decline Medicare altogether, Part A at the very least is premium-free for most people, and wont cost you anything if you elect not to use it. Declining your Medicare Part A and Part B benefits completely is possible, but you are required to withdraw from all of your monthly benefits to do so. This means you can no longer receive Social Security or RRB benefits, and must repay anything you have already received when you withdraw from the program.
What If I Dont Sign Up For Part B Because I Have Other Health Insurance
If you have health insurance through your employer, your spouses employer, or a union, you can keep your coverage. You wont have to pay a penalty for waiting to sign up for Part B. But, if you lose your coverage or stop working for that employer, the clock begins to tick.
Usually, you will be allowed to sign up for Part B right away, during a Special Enrollment Period. This is an eight-month period beginning when the employment coverage ends. If you do not enroll during this period, youll have to pay a Part B penalty for each full 12 months you wait, beyond the date, the SEP began.
For example, if youre still working when you turn 65, you can keep your employer health insurance instead of signing up for Part B. If you then retire at age 67, you can avoid a penalty by signing up for Part B during your eight-month SEP. If you instead decide to wait until age 70 to enroll, you will pay a 30% penalty every month. 10% for every 12-month period you delayed.
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Do You Need To Renew Medicare Part D Annually
If you have Medicare Part D, one of the smartest things you can do is shop around during the fall open enrollment from October 15 to December 7. In most parts of the country, there are dozens of available Part D plans with different formularies, pricing, and coverage rules. Medicare enrollees in Original and some Advantage plans can check the plans networks of retail and mail-order pharmacies serving their area to find the ones that have the best deals for all the drugs they take. If you arent enrolled in Medicare.govs site for comparing plans, do that first. Then plug in the information about your prescriptions. Youll see an elaborate chart that will allow you to compare prices and availability. Run the comparison at least annually because things change regularly.