Tag: #estateplanningroslyn

Reset Reset font size. Increase Font Size Increase font size.

New York State Changes the Laws for Transfer on Death Deeds for Real Property

Posted on

New York State laws about transferring property have changed. Previously, if you wanted to bequeath property to a beneficiary upon your death, you could make the beneficiary a co-owner, make a bequest of the property to the beneficiary in your will, or create a trust, then transfer the title of ownership to the trust and name the intended recipient the beneficiary of the trust. However, these options may restrict your ability to sell the property and cause the forfeiture of real estate tax exemptions, among other issues.

There may still be reasons to place real estate property into a trust, but the option now exists to convey property through a Transfer on Death deed. This lets the property pass directly to the new owner upon the original owner’s death, and the property is not subject to probate.

Is a Transfer on Death Deed Right for Your Estate?

A Transfer on Death (TOD) deed lets you designate one or more beneficiaries to receive the property upon your death. It doesn’t impact your ownership rights while you live, and you can revoke it.

Specific requirements make the TOD legally binding. The language of the deed must conform to New York State Law, which requires that the transfer to the beneficiary occur at the transferor’s death. The law requires the deed to be signed like a will; it requires a notary and two witnesses. Here are the details we are concerned about people neglecting to do if they decide to take this on as a DIY project: to be valid, the deed must be recorded with the county clerk before the owner dies. If the deed is not recorded correctly, the TOD is invalid if this step is missed.

How Does a Transfer on Death Impact Applying for Medicaid?

The TOD does not affect Medicaid eligibility because property ownership is not transferred until the owner’s death. However, if the owner of a property is eligible for Medicaid, then Medicaid may pursue the cost of care by going after the decedent’s estate. If there is a TOD in place, it can stop Medicaid from going after the home, as Medicaid can only recoup the amounts paid from the probate estate of the Medicaid recipient.

The primary home is an excludable resource for a Community Medicaid applicant if a spouse or minor child is living there or if there is no spouse or minor child if the equity interest does not exceed $1,071,000. On Long Island, it is common for seniors who bought their homes decades ago to have substantial home equity.

How is a TOD different than a life estate?

A Life estate deed gives the life tenant immediate possession and all rights. This means the prior owner no longer controls the home. If the preceding owner wants to take possession of their home, they will need the approval and signatures of the people who have received the property.

Are there downsides to a TOD?

A TOD is not right for every family. For example, if there are multiple beneficiaries and the TOD names two or more of them, if one dies, that person’s share is transferred automatically to the other beneficiaries. The children of the deceased beneficiary don’t inherit their parent’s share.

If there are joint owners, things will get complicated. A deed of joint owners can only be revoked if the joint owners agree to the revocation. It takes only one person to make the revocation stall. The deed isn’t executed until the original joint owners die, so the joint owners can make all the changes they want, including revoking the TOD.

The TOD cannot pass property to a minor, as minor children may not own real property. If the family includes minor children, a trust is a better option.

A TOD Offers Many Benefits.

It removes the property from the probate estate, which transfers directly to the beneficiary upon the owner’s death. It also gives the owner complete control of the property while they are alive. They have full control and can manage or dispose of the property without needing the approval of the beneficiaries. If you are living, you can revoke the TOD, change the beneficiaries, or make any other changes you want.

Conclusion

TODs for real property are new to New York State but have been in use in other states for many years. Significant case law exists about TODs and the complications that can follow settling an estate. Before going ahead with a TOD, call us to discuss your situation. There are other options for transferring property, and the TOD might be the solution you are looking for.

Reset Reset font size. Increase Font Size Increase font size.

Medicare Guide – What You Need to Know for This Year

Posted on

Every September, the CMS mails out a hard copy handbook, Medicare & You. Around the same time, the annual avalanche of ads about Medicare Advantage plans arrives in your mailbox, on television, and on your social media feeds. These sales pitches escalate during the Open Enrollment season (October 15 – December 7).

Every year, we prepare our Medicare Guide to empower and inform our clients and community members through what can become a confusing process. Our guide, distinct from the Medicare Handbook, is a valuable resource designed to give you an overview of Medicare programs, clarify the differences from one year to the next, and help you make informed decisions about your coverage.

If you have questions about your Medicare coverage, we are here to help. We invite you to call the office. We may not be insurance brokers or sell insurance, but we are experienced with Medicare’s complexities and confusion. We are here to help our community members navigate this issue and make informed decisions.

Our Medicare Guide is especially important this year as significant changes have come to Medicare.

Our recent blog post detailed the changes to prescription drug costs for 2025. Once you reach the $2,000 prescription drug cap, there’s no copay or coinsurance for Part D drugs for 2025. We expect many changes to Medicare Advantage prescription plans to be made to protect the insurance companies from this change, which will negatively affect profits. If you depend on expensive prescription medicine, carefully review your plan and prescriptions before renewing.

Another prescription drug issue relates to people still working after age 65. If you have health insurance through an employer, employer plans that qualified in the past because benefits were as good as Part D may no longer be eligible after January 1, 2025. If your private plan doesn’t cap the amount you need to pay at $2,000 a year or less, the policy may no longer qualify as a substitute for Part D, which means it won’t let you delay signing up for Part D without a penalty. Learn more about this change here.

Agents and brokers who sell different Medicare policies earn commissions based on their sales. In 2025, commissions for new MA signups and renewals will be capped so that brokers and agents can make their sales based on giving seniors the right plan for their needs rather than the size of the commission.

Medicare Advantage plans include coverage like dental, vision, hearing, and fitness benefits, but most MA insureds don’t use these benefits. In 2025, MA plans must send a mid-year notice about these additional benefits. The notice must include information about each benefit’s scope and out-of-pocket cost, how to access the benefit and a customer service number for inquiries. Will this encourage the use of the benefits? Hard to say.

Telehealth coverage has changed. Certain at-home telehealth services, including mental and behavioral health, will still be covered by Medicare. However, seniors will need to be in an office or medical facility in a rural area to have most telehealth appointments covered by Medicare.

The annual “Wellness” visit will include a health risk assessment to understand social needs and refer you for services and support. This is a good thing, as we know that part of healthy aging is a robust social network of friends, family, and community. Mental health care is covered by Medicare and recognized for its essential role in a healthy life.

If you work for the US Post Office, your coverage will come from the Postal Service Health Benefits Program instead of the Federal Employees Health Benefits Program. If you’re starting to receive benefits on January 1, 2025, and not currently receiving Medicare Part B, you need not enroll in Medicare Part B to continue coverage. Participation in Medicare Part B is voluntary. If you’re already enrolled in Medicare Part B, you must stay enrolled to keep receiving coverage under PSHB.

If you have any questions or need assistance with Medicare, we encourage you to call our office. We are here to serve our community and are always ready to help. Your call is always welcome.

Reset Reset font size. Increase Font Size Increase font size.

Photo of Medicare Card

Why You Must Read This Year’s Annual Notice of Change for Medicare Plans

Posted on

Every September, Medicare recipients receive an Annual Notice of Change for their Medicare Plans. That’s because every January, coverage and costs change. Whether you are enrolled in a Medicare Part D prescription drug plan or a Medicare Advantage plan, this letter contains the details on premiums, deductibles, and co-pays from 2024 and what’s coming in 2025.

Be prepared for changes. Health insurance companies’ response to the $2,000 out-of-pocket cap on prescription drugs for 2025 is expected to create more costs for seniors, including higher premiums, higher deductions, and significantly higher co-pays. Certain prescriptions may not be covered at all.

Medicare Advantage plans are feeling the pinch of lowered profits already and if your MA plan includes Part D coverage, be prepared for benefits to be trimmed or eliminated as these companies try to keep the $0 premium intact. Features like gym memberships, vision and dental coverage may evaporate in 2025 also. Some plans may be closing.

If you’re on Medicare Advantage, the Notice of Change will tell you if your doctors and hospitals are still in the plan network.

Note you won’t get any similar letter from Medigap plans, as they don’t usually have any big changes from year to year.

The Annual Notice from your Part D plan will tell you whether or not your prescriptions will be covered and what your costs will be.

What to Do When the Annual Notice Arrives

If you’ve never read these letters in the past because they aren’t written in clear English, you’re not alone. Most recipients find the Annual Notice challenging to understand. But this year, you’ll need to take the time to read the letter and give it the attention it requires. You’ll want to find out if you will need to change your coverage options.

You have an eight-week open enrollment period (October 15 – December 7) when you can make changes with no penalties.

A few tips:

If the premium increase is modest but overall, you’re happy with the plan and it covers your prescriptions, you may not want to rush to make a change.

If your doctors and/or hospital isn’t in the network, you’ll definitely need to make a change. The MA plan has a legal duty to identify other doctors or hospitals to people, but it may take some work on your part to get this done.

In an effort to prevent drastic Part D premium increases, the Centers for Medicare and Medicaid Services decided to provide a special subsidy – a “premium stabilization plan” in an attempt to moderate the possibility of over-the-top premium increases.

Change is always unsettling, and the prospect of increasing healthcare costs is always challenging for retirees. We’re here to help if you have questions.

Reference: Fortune (August 26, 2024) “Why this year’s Medicare Annual Notice of Change will be vital reading for beneficiaries”

Reset Reset font size. Increase Font Size Increase font size.

Law Office Of Stephen J. Silverberg, PC

Stephen J. Silverberg, Esq., and Scott B. Silverberg  Named To 2025 Edition of Best Lawyers® In Elder Law

Posted on

For the eleventh consecutive year, Stephen J. Silverberg, based on extensive peer review, is listed in the 2025 Edition of The Best Lawyers in America® in the practice area of Elder Law.

Scott B. Silverberg is listed in the 2025 edition of The Best Lawyers in America in the practice areas of Elder Law and Trusts and Estates for the first time.

Over 23 million votes were analyzed for the 2025 edition of The Best Lawyers in America®, which resulted in more than 80,000 leading lawyers included in the milestone 31st edition.

Stephen holds the AV® Preeminent (5 out of 5) rating, the highest possible designation from Martindale-Hubbell, and has been on the Super Lawyer New York metro list since 2007.

Stephen J. Silverberg is a nationally recognized leader in estate and tax planning, estate and trust administration, asset preservation planning, and Elder Law. He has served as the President of the National Academy of Elder Law Attorneys (NAELA). In 2003 he was honored as a NAELA Fellow, the highest honor given by NAELA to attorneys who focus on Elder Law, who have made exceptional contributions to meeting the needs of older Americans and who have demonstrated commitment to the Academy. Silverberg has also served as a founder, president and member of the New York State chapter of NAELA. 

He has been designated as a Certified Elder Law Attorney (CELA) by the National Elder Law Foundation, authorized by the American Bar Association. To receive this designation, applicants must pass a stringent written examination and substantial independent peer review. Since its inception in 1993, fewer than 520 attorneys have earned the CELA designation. Silverberg is a Hartwick College and Brooklyn Law School graduate and has been a member of the New York and Florida Bars for over forty years.

Scott B. Silverberg is the Immediate Past President of the New York Chapter of the National Academy of Elder Law Attorneys (NAELA) and a member of the National Board of Directors of NAELA. He also serves as a member of the Board of Directors of the Elder Law Practicum of national NAELA. As a New York State Bar Association member, Scott serves as Vice-Chair of the Practice Management Committee of the Elder Law and Special Needs Section Executive Committee. Previously, he chaired the Technology Committee.

In 2022, Scott became a member of The Estate Planning Council of Nassau County, a member chapter of the National Association of Estate Planners and Councils (NAEPC).

Scott earned an LLM (Master of Laws) in Elder Law from the Stetson University School of Law, a leader in special needs planning. He is the only attorney in New York who holds this degree. He graduated from Fordham Law School (JD, 2013) and holds a Bachelor of Science from the internationally renowned Cornell University School of Industrial and Labor Relations.

The Law Office of Stephen J. Silverberg, PC, represents clients in estate planning, tax, estate administration, asset preservation planning, Elder Law, and related issues. The Law Office of Stephen J. Silverberg, PC is at 185 Roslyn Road, Roslyn Heights, NY 11577, 516-307-1236 and www.sjslawpc.com.


Reset Reset font size. Increase Font Size Increase font size.

What is the Purpose of a Promissory Note in Medicaid Planning?

Posted on

Medicaid planning is often a complex process aimed at preserving a person’s assets while qualifying for Medicaid benefits. Finding a way to pay for long-term care costs without depleting all your hard-earned assets is a key part of Medicaid planning.

One strategy for protecting assets and qualifying for Medicaid that has gained attention in recent years is the use of promissory notes. This article will provide an explanation of promissory notes in the context of Medicaid planning, including their purpose, legality, implications, and considerations. Note that not all states allow promissory notes.

What Are Promissory Notes?

A promissory note is a legally binding document that outlines the terms of a loan agreement between two parties: the lender (creditor) and the borrower (debtor). It includes details such as the loan amount, interest rate, repayment schedule, and any other relevant terms and conditions. Promissory notes are commonly used in various financial transactions, including loans between individuals, businesses, and financial institutions.

Promissory Notes in Medicaid Planning

Medicaid is a public assistance program that assists individuals with limited income and resources in obtaining health insurance. It also serves as the primary way for millions of seniors in the United States to pay for long-term care services.

To qualify for Medicaid in most states, you must have no more than $2,000 in so-called “countable” assets to your name. Typically, five years before you apply, you may “spend down” your excess assets to bring them under this $2,000 threshold. Transferring assets within this five-year window of applying for Medicaid can otherwise result in a penalty period during which you may not be able to receive benefits.

Of course, not everyone plans this far ahead, as many people do not expect they will need long-term care. A Medicaid applicant may use a promissory note to transfer assets to other individuals, such as their children, while still complying with Medicaid eligibility requirements. By transferring assets through a promissory note, they can effectively reduce their countable assets, thereby helping them meet Medicaid’s asset limit criteria.

How Do Promissory Notes Work in Medicaid Planning?

A person seeking Medicaid benefits might opt to transfer some of their assets to a family member, typically a child, in exchange for a promissory note. Assets can also be transferred to a trust. The beneficiaries of a person’s trust are often their children.

When the assets are transferred, a legally binding promissory note is created. The promissory note lays out the terms of the loan, including the principal amount, interest rate, repayment schedule, and other relevant information.

The borrower agrees to repay the loan according to the terms outlined in the promissory note, usually through regular installment payments over a specified period.

By transferring assets by way of a loan and creating a promissory note for the loan, the person seeking Medicaid benefits effectively reduces their countable assets, potentially qualifying them for Medicaid coverage.

Legal Considerations

Though promissory notes can be a valuable tool in Medicaid planning, it’s important to ensure compliance with state and federal laws and regulations. As mentioned, Medicaid has strict rules regarding asset transfers and eligibility. Improper use of promissory notes could result in penalties or loss of benefits.

Key legal considerations include the following:

  • Fair Market Value: The terms of the promissory note, including the loan amount and interest rate, should reflect fair market value to avoid scrutiny from Medicaid authorities.
  • Payments: Payments on the loan must be made in equal amounts during the term of the loan with no deferral of payments and no balloon payments. (A balloon payment is a large payment made at the end of a loan’s term, after making much smaller payments along the way.)
  • Term of the Loan: The term (length of time) of the loan must not last longer than the anticipated life of the lender.
  • Debt Cancellation: The debt cannot be cancelled upon the lender’s death.
  • Arm’s Length Transaction: The transaction should be conducted as an “arm’s length” transaction, meaning it should be carried out as if the parties were unrelated and dealing with each other at arm’s length.
  • Look-Back Period: As stated above, Medicaid has a look-back period during which asset transfers are subject to scrutiny. In most states, the look-back period is five years. Any transfers made within this period may affect Medicaid eligibility, so it’s essential to plan accordingly.
  • State-Specific Regulations: Medicaid rules vary from state to state, so it’s crucial to consult with an experienced attorney familiar with Medicaid regulations in your state to ensure compliance.

Benefits of Using Promissory Notes in Medicaid Planning

Promissory notes offer several potential benefits in Medicaid planning, including the following:

  • Asset Preservation: By transferring assets through a promissory note, individuals can preserve their wealth while still qualifying for Medicaid benefits to cover long-term care expenses.
  • Control: The lender retains control over the repayment schedule and can customize the terms of the promissory note to suit their needs.
  • Family Involvement: Promissory notes provide an opportunity for family members to participate in Medicaid planning and contribute to the financial well-being of their loved ones.

Risks of Using Promissory Notes in Medicaid Planning

When considering the benefits of using promissory notes in Medicaid planning you should also consider the risks, which could include the following:

  • Regulatory Scrutiny: Improperly structured promissory notes may attract scrutiny from Medicaid authorities, potentially resulting in penalties or disqualification from benefits.
  • Complexity: Medicaid planning involving promissory notes can be complex and requires careful consideration of legal and financial implications.
  • Tax Implications: Transferring assets through promissory notes may have tax implications for the lender and the borrower, so it’s essential to seek professional tax advice.

Will a Promissory Note Work for Your Medicaid Planning?

Promissory notes can be a valuable tool in your Medicaid planning process. They could allow you to transfer assets while maintaining Medicaid eligibility. However, it’s crucial to navigate this strategy carefully, ensuring compliance with applicable laws and regulations.

Call our office to talk further about gaining acceptance into the Medicaid program. We can help you determine whether including a promissory note in your planning will work for your situation. We can also walk you through other benefits that may be available to you and help you understand how you can qualify for coverage.

Reset Reset font size. Increase Font Size Increase font size.

MEDICARE DRUG PLAN ADVISORY: Upgrades May Require Action for 65+ Wage Earners with Employee Prescription Plans

Posted on

If you’ve delayed signing up for Medicare prescription drug coverage (Part D) because you’re still working and have health insurance through your employer, you must know about some changes that may affect your budget in 2025.

Working people who qualify for Medicare sometimes delay applying, which is fine if you meet the requirements. Your employer’s prescription plan must pay as much on average as the standard Medicare plan for prescription drugs. Simple enough, right?

However, changes are coming because of upgrades that are part of the Inflation Reduction Act, which takes effect on January 1, 2025. Some employer plans that qualified because benefits were as good as Part D before this change may no longer be eligible. One example: the out-of-pocket maximum under Part D will be $2,000 yearly, starting on January 1.

If your private plan doesn’t cap the amount you need to pay at $2,000 a year or less, the policy may no longer qualify as a substitute for Part D, which means it won’t let you delay signing up for Part D without a penalty.

If you are working and eligible for Medicare and your job prescription plan is deemed not credible, you must immediately apply for Part D coverage. If you are not enrolled in Medicare, you must apply for Part A regardless of your employer’s health plan. If the plan does not provide credible coverage, you must also apply for Part D. If you delay enrolling, you may face a substantial penalty.

The penalty will hit your Medicare bill if, after your initial enrollment period, you have 63 or more sequential days without Medicare drug coverage or another creditable prescription drug plan.

What will the penalty be? Multiply 1% of the “national base beneficiary premium” — $34.70 – by the number of whole months you didn’t have Part D or creditable coverage rounded to the nearest 10 cents. Your monthly Part D premium is increased by this amount for life.

Take a breath – Medicare-eligible policyholders must be notified by law whether their prescription drug coverage meets the standard for being “creditable.” But if you are 65+, working and getting health benefits through your employer, and haven’t heard from your employer or the insurance company, now would be an excellent time to determine whether you need to make any coverage decisions when the Part D rules change.

Reset Reset font size. Increase Font Size Increase font size.

When Decoration Day Became Memorial Day, and Why It Still Matters  

Posted on

Memorial Day is a topic I return to every May because it is important to honor the Americans who gave their lives in service to our great nation. It’s a national holiday with a somber and respectful history, and we need, especially now, to keep that in mind.

Our activities on Memorial Day should include remembering and honoring the lives and sacrifices of our veterans—and their families.

For me, this last weekend of May will always be Decoration Day.

Decoration Day began in 1868 when General John A. Logan called for a holiday to honor the soldiers who died in the Civil War. Women placed flowers on the graves of their husbands, sons, and brothers. On the first Decoration Day, 5,000 people helped decorate the graves of the over 20,000 soldiers buried in Arlington National Cemetery – both Union and Confederate soldiers.

Similar ceremonies inspired the event in cities around the country. Soldiers would decorate the graves of fallen comrades with flags, wreaths, and flowers. By 1890, every Union state had a Decoration Day.

After World War I, the purpose of Decoration Day expanded to honor all soldiers who died in all American wars. It was considered a day of civic duty to honor the dead and remember why they gave their lives.

In 1971, Congress declared a national holiday on the last Monday in May.

Some civic groups and veterans’ groups continue to honor our servicemen and women by taking the time to attend ceremonies and decorate the graves of soldiers. Flags should be flown at half-mast until noon on Memorial day and a national moment of silence takes place at 3:00 pm.

Here on Long Island, we have two large military cemeteries – Long Island National Cemetery in Farmingdale and Calverton National Cemetery. We have a large population of veterans and families who know all too well the impact of the ultimate sacrifice their loved ones made for their country.

As the years and wars have come and gone, Decoration Day became Memorial Day. Unlike Veterans Day, which honors all who serve, the traditions of Memorial Day honor those who gave their lives in service to our nation.

I encourage you to find out where your town’s wreath ceremony is taking place and take the time to show your support. On Long Island, ceremonies take place at town halls, fire departments and other civic centers. Your presence will be appreciated.

                                                            #             #             #

Reset Reset font size. Increase Font Size Increase font size.

Hand of a senior woman reaching to place tomatoes on checkout conveyer belt at supermarket

Social Security Administration Releases Final Rule Omitting Food from In-Kind Support and Maintenance Calculation for SSI      

Posted on

The most important takeaway from the Social Security Administration’s rule change is that any purchases of food for Supplemental Security Income recipients from Special Needs Trusts and families will not decrease the SSI payment. The new rule was approved on March 27 and effective September 30, 2024.

This new ruling makes Special Needs Trusts (SNTs) even better for those who depend on SSI benefits.

Food will no longer be considered in the calculation of In-Kind Support and Maintenance (ISM). The definition of income will be changed to align with this, which will make it far less cumbersome to administer and more accessible for the general public to understand. The goal is to improve the equitable treatment of food assistance within the SSI program.

The SSA traditionally included in-kind receipt of food in its ISM calculations because food assistance helps people meet a basic need, but the rule needed to be revised for several reasons. One is to make policies easier to understand, and another is to promote equity by treating food assistance equally, regardless of the source. The goal is not to harm an already vulnerable population when receiving food assistance.

SSI recipients historically have low income and resources, facing barriers across a wide range of social and economic outcomes. Disabled individuals are more likely to be food insecure, and this will remove barriers to receiving informal food assistance from friends, family, and community networks of support.

SSI recipients will still be asked about their food sources to determine specific values about other benefits, including shelter, as part of their maintenance calculations.

For disabled family members who depend on SSI benefits, this makes a Special Needs Trust even more valuable. When trust assets are used to buy food, they will not be countable against the recipient’s SSI benefits.

Please contact the office if you have questions about the impact of the rule change.

Source: Federal Register (March 27, 2024) Social Security Administration Final Rule

Reset Reset font size. Increase Font Size Increase font size.

What are the New IRA and Retirement Saving Rules for 2024?

Posted on

If your New Year’s resolutions included increasing your retirement savings efforts in 2024, there are a few changes to rules about IRAs, 401(k)s, and even 529 College Savings Plans you’ll want to know about.

Contribution limits for 2024 have gone up. Annual contributions for IRAS in 2024 are now $7,000, up from $6,500 in 2023. It applies to the total contributions to all traditional and Roth IRAs. For those 50 and older, the contribution limit is $8,000 because of the $1,000 “catch-up” contribution allowed for older savers.

401(k) annual contributions are now $23,000. It applies to similar employer-sponsored retirement accounts, including 403(b) plans, most 457 plans, and the Thrift Savings Plan for federal government workers. Older savers (50-plus) may contribute up to $30,500 this year to a 401(k), 403(b), and most 427 plans and Thrift Savings Plans.

Funds in a 529 college savings account may now be rolled over into a Roth IRA for the beneficiary with no penalty. This tax-free rollover rule is part of SECURE 2.0. Individuals may roll over as much as $35,000 from 529 savings accounts, subject to annual Roth IRA limits. There are rules to follow: the account must be owned for at least 15 years before you can roll over the funds, and you may only roll over money that’s been in the account for at least five years. The account holder, typically a child’s parent or grandparent, may roll no money into their own Roth IRA – it can only go into an account established for the beneficiary of the 529 plan.

Rules about emergency withdrawals have changed. Previously, if you had an immediate financial emergency, you could get an early distribution from 401(k)s and IRAs. You’d have to pay income tax on the withdrawal, and if you were younger than 59 ½, you’d also get hit with a 10% penalty.

In 2024, you may make one withdrawal of $1,000 per year to pay for an emergency expense without owing the 10% penalty, as long as you “self-certify” that you need the money for an emergency.

There is another penalty-free withdrawal allowed to victims of domestic abuse under age 59 1/2, who may withdraw up to $10,000 from IRAs and 401(k)s.

“Starter 401(k)s” were introduced in 2024. These leaner plans have lower costs, fewer administrative burdens, and are designed specifically for small business employers. Employees may contribute up to $6,000 yearly, and small businesses have until tax time to set up the plans. The goal is to expand access to workplace retirement plans for people who work in small businesses.

Reset Reset font size. Increase Font Size Increase font size.

2024 Bringing Big Savings for Medicare Patients Relying on Expensive Drugs

Posted on

There is good news for Medicare recipients in 2024 who count on costly prescriptions. The Inflation Reduction Act passed in 2022 puts an annual ceiling of $3,300 in 2024 for Part D drugs. The number could shift slightly depending on whether they take brand-name or generic medications.

In 2025, the news is even better: the cap changes to a flat $2,000.

Here’s how it worked: people who pay for their medications through Medicare Plan D, the government insurance plan covering most prescription drugs, paid thousands for medications until they reach what’s known as the “catastrophic zone of spending.” After that, they pay a 5% deductible for the rest of the year, often in the thousands.

In 2024, the IRA eliminates the 5% coinsurance. And once patients spend roughly $3,300, they have met the “catastrophic zone.” And they won’t have to pay any more out of pocket for Part D drugs.

Here’s an example of the new rules. Let’s say a 69-year-old man has a plan with a $505 deductible. He takes a blood cancer drug that costs $200,000 per year—roughly $16,600 monthly. In 2023, he pays his full deductible, plus 25% coinsurance, until he hits the $3,100 catastrophic limit for 2023, plus 5% coinsurance after. On his next refill, as he has remained in the catastrophic zone, he paid only the 5% deductible–roughly $830. He’ll pay about $830 every time he fills his prescription, spending more than $12,000 out of pocket for the year.

In 2024, the same man taking the same drug will save a few hundred dollars the first time he fills the prescription, topping out at around $3,300. Subsequent refills will cost nothing. He will not pay for the blood cancer drug, or any other drug, for the year. In 2025, his first trip to the pharmacy will cost him $2,000, the cap for the year, unless he wants to participate in a “cost-smoothing” program and spread the $2,000 over 12 months.

The Inflation Reduction Act lets Medicare officials negotiate the price of drugs. By doing away with the 5% coinsurance, the law forces insurers and drugmakers to pick up part of the tab. Part D covers most outpatient prescription drugs, although some medications, including physician-administered infusions, are covered under Part B.

The downside is that premiums may go up, and Part D paperwork may become more complex. Premiums for stand-alone Part D plans were up an average of 20% in 2023. Because Part D plans are paying for more medications, they may be motivated to use techniques pushing patients to less expensive drugs or requiring them to get insurers’ approval before filling prescriptions. They may also change the list of drugs covered.

It’s always important for Medicare recipients to check their plans and medications, but these changes make it even more important.

Reference: The Wall Street Journal, January 15, 2024, “Medicare Patients on Pricey Drugs Are Saving Big This Year”