Climate Change Bill Brings a Bright Spot of Good News for Americans

We welcome any good news in a dismal news cycle, but the healthcare provisions built into the “Inflation Reduction Act” are worth a special mention.

The New York Times calls it “the most substantial changes to health policy since the passage of Obamacare in 2010.”

Passed by the U.S. Senate on August 8 and expected to pass in the House of Representatives on August 12, President Biden says he is looking forward to signing the bill into law. Here’s what we are looking forward to:

What seniors have needed for decades: giving Medicare the power to negotiate directly with pharmaceutical companies to reduce the astronomical costs charged for many drugs seniors need to stay alive and healthy.

The bill, beginning in 2025, sets a cap of $2,000 yearly for how much seniors pay for drugs. After reaching the cap, funds will come from the federal government, private insurers, and drug companies.

Federal subsidies for people who buy private health insurance through the Obama exchanges will be extended for three additional years, as they were during the coronavirus pandemic. For example, someone who pays about $80 in premiums will continue to pay that amount. These costs would double in 2023 without the bill.

Adult vaccines will be free starting in 2023 for seniors and people on Medicaid.

The bill uses federal subsidies to reduce the cost of health insurance and prescription drugs, insidious economic difficulties suffered by middle class and senior Americans.

Many benefits of this bill may not be evident to the people they help, as they are not visible directly. For instance, people won’t see large medical bills and may not be fully aware of free vaccines. But for the millions of Americans, particularly seniors, who struggle to pay for their prescription medications, the bill will be life-changing.

By design, the legislation will pay for itself and reduce the federal deficit over time while cutting prescription drug costs for the elderly and tightening enforcement on taxes for corporations and the wealthy.

It sounds like good news to us.

Medicare Open Enrollment

Medicare Open Enrollment Season and Our Free Medicare Consultations

Open enrollment for Medicare Advantage plans and Part D prescription coverage begins on October 15 and ends on December 7, 2020. When it’s over, whatever decisions you may have made will be set in stone for a full calendar year.

Mistakes are costly, especially for people who require multiple prescriptions. Also, if you do not enroll in Medicare when you are eligible, there is a 10% increase in premiums for every year you failed to enroll (i.e., if you enroll in Part B or D three years late, your annual premium is increased by 30%) for the rest of your life.

Among changes you can make include switching from original Medicare, Part A for hospital insurance and Part B for medical coverage to a private Medicare Advantage plan. You can also change from one Medicare Advantage plan to a different one. And you can join a prescription drug plan under Medicare Part D.

It’s very tempting to shrug your shoulders and go with the same plan you had last year. Don’t. Plan changes, networks change, doctor’s participation in networks change. The plan you had last year might not work this year.

Medicare is challenging to navigate. Over the years, we have made a point of speaking with clients about their Medicare plan when we meet during the enrollment season. In recent years, we’ve noted that it has become even more complicated. This especially true of Medicare Part D. Currently, there are over thirty different Part D plans available on Long Island.

The Center for Medicare and Medicaid Service, the federal agency which runs the programs, introduced the Medicare Plan Finder to assist seniors in August 2019. Unfortunately, the Finder had numerous technical glitches and incorrect information; many seniors could not access the Finder. It proved a hardship to seniors. There were reports of Inflated costs and higher premiums. Complaints came from Medicare enrollees, consumer advocates, U.S. Senators, state insurance commissioners, and even the insurance brokers who sell these plans.

As a public service to assist Seniors in making an informed decision about their Medicare coverage, our office is offering complimentary consultations by phone, video conference, or in office.

We are attorneys. We are not an insurance agency or broker and sell no product. Our review is impartial. We want to help seniors avoid mistakes. Medicare is confusing. We are pleased to help.

A few steps to take, as described by CNBC in the article “Medicare open enrollment is coming up. Three steps to save money this fall.”

1 – Know your plan. Look for a piece of mail from Medicare, “Annual Notice of Change.” This letter will have information about changes to coverage and costs, including premiums, deductibles, and co-pays. If you do not participate in Medicare, you will not receive the letter.

2 – Gather up all of your medical expenses from the last year and a list of the doctors you see regularly and the medications you take. If you use a single pharmacy, they will gladly give you a printed list. You’ll need that to figure out which one will be best for you in 2021.

3 – Your modified adjusted gross income (“MAGI”) from two years ago determines your premiums for Medicare Part B. MAGI includes capital gains, Social Security, and required minimum distributions from retirement funds and 401(k) plans. Your 2019 income determines the premium you’ll pay in 2021. It’s too late to do much about that now, but if you can curtail income in 2020, you may reduce Medicare costs.

We invite you to call our office and request a free consultation to discuss your Medicare coverage. Call our office at 516-307-1236.

 

Medicare requires a specific form or it won't provide information

Power of Attorney is Not Enough for Medicare

A power of attorney is usually enough to take charge of a loved one’s financial and medical matters when they become incapacitated. But with Medicare, you need more than a POA.  Many people learn this the hard way. It is a problem that can be easily solved and will save you and your loved ones a great deal of trouble.

A refresher:

  • A Financial Power of Attorney (POA) allows you to name a person handle your financial and legal affairs if you are incapacitated.
  • The Medical POA allows the named person to make critical medical decisions on your behalf.
  • You must sign both of these documents while you are of sound mind and able to decide on your own.

Medicare does not care about your POAs. Medicare requires you to use its form to give a family member permission to discuss your condition, treatments, coverage issues, manage claims, and file appeals. Without it, Medicare will not speak to a family member – even a spouse. You need to do this at once if you or your loved one has enrolled in Medicare. The form is available online (https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS10106.pdf.

And there’s more.  You will need separate authorizations for any other Medicare benefits, including Medicare Advantage, Part D prescription drugs, and Medicare supplement plans. It is further complicated since they all have separate authorization forms. Although they do the same thing, they often have different names. The forms are needed to authorize a personal representative to speak with plan administrators about claims and coverage.

These are challenging times when we don’t know what’s coming next. We can’t stop everything, but we can prepare.