News

  • Benefit Bulletin July 2016

    Planning healthcare costs is extremely important, but not an easy task. According to the Kaiser Family Foundation, healthcare expenses, on average, accounted for nearly 15 percent of Medicare household budgets in 200But even if you're in good health today, you're not out of the woods. The amount you spend on healthcare not only grows every year, but your need for more healthcare services increases with age. .The Drug Plan Finder can help you get very specific information because you can input the prescriptions you currently use and then find the lowest cost plan that covers your drugs. However, the lowest cost plan may not always be your wisest choice, especially since your doctor may change your prescriptions in the future or you may be close to the doughnut hole coverage gap. You may benefit by spending a little more and getting a plan that covers 95% of all drugs and covers at least generics in the gap. .Should seniors with Medigap supplements that provide "first dollar coverage" be required to pay more up-front? Should Medicare continue to pay for services based on medical necessity, or should the government change to a system "based on evidence of the value of services?" Congress may be debating these questions this month when the Medicare Payment Advisory Commission (MedPAC) issues its June report to Congress. The idea is to make Medicare beneficiaries "think twice" before scheduling doctor, outpatient services, or hospital stays in order to reduce government spending on Medicare. … Continued

  • Legislative Update For Week Ending December 4 2015

    For more information see the Medicare publication, "Are You a Hospital Inpatient or Outpatient?" CMS Product No. 1143Get a copy online at www.Medicare.gov or call 1-800-MEDICARE ( 7). .You should still delay domestic and international travel. If you do travel, you'll still need to follow CDC requirements and recommendations. ."This year is particularly difficult to forecast with certainty," Johnson says. "The inflation patterns, caused in large part due to the COVID-19 pandemic, were unprecedented in my experience," she says. … Continued

As you have learned, there's a long lag time between the year you earned the money and when you get the notice from Social Security. Social Security makes the adjustments based on your W2s and tax returns. Making matters worse, the earnings limit is adjusted annually and was even lower in prior years. In 2018 the limit was ,040 and in 2017, ,920. In addition, the notice you received would likely only pertain to one year of earnings, and you possibly could receive a similar notice next year and go through the process of withheld benefits all over again. .By Jessie Gibbons, Legislative Director .Which is right for you? Medigap policies tend to have have higher premiums, but pay most of your out-of-pocket costs, so your costs stay more consistent and predictable. You are also free to use any healthcare provider that accepts Medicare. If you choose Medigap you will also need to enroll in a separate Part D prescription drug plan. Medicare Advantage plans tend to have lower premiums and include drug coverage, but you will have deductibles, as well as co-pays and cost sharing for most services. Hospitalizations could be costly. Many Medicare Advantage plans are managed care and require that you use participating providers to receive reimbursement for your care. .TSCL's Board of Trustees Meets with Members of Congress .For the last few weeks we have reported on President Trump's executive order to allow employers to defer payroll taxes owed by workers, which funds Social Security and Medicare. TSCL is opposed to payroll tax cuts of any kind because they seriously jeopardize the financial viability of both programs. .If signed into law, H.R. 242 would require the federal government to negotiate lower drug prices on behalf of Medicare Part D beneficiaries. Currently, Medicare is prohibited from doing so despite the fact that other federal health programs are required to. If adopted, H.R. 242 would go a long way in reducing the costs of lifesaving medications for millions of Part D beneficiaries, and it would result in lower spending on prescription drugs for the Medicare program. . Find out which drug store has the lowest cost-sharing before you fill. Your cost sharing can be dramatically higher depending on where and how you fill your prescription (retail versus mail order). Make sure you are using a preferred vs. standard network pharmacy and compare the prices of retail pharmacies with getting a 90-day supply from your drug plan's mail order pharmacy. For example, if you are enrolled in the Wellcare Wellness Rx plan and get your Eliquis from a standard in-network pharmacy, your copay for Eliquis after the 5 deductible would be during the initial coverage phase, and 7.38 in the Part D coverage gap. However, if you get your Eliquis from a preferred in-network pharmacy the co-pay is .00 during the initial coverage phase and 3.36 in the coverage gap. Depending on where you live, and your drug plan's mail order pharmacy, sometimes you may save a little more using mail order. .This week, Members of Congress remained in their home states and districts for the week-long holiday recess. Meanwhile, The Senior Citizens League (TSCL) saw support grow for two critical bills that would strengthen the Social Security program. .You must follow Medicare guidelines for receiving the services to ensure coverage. Find out how often you should receive a service. Some preventive services are covered only once every few years, others are covered only if you meet specific criteria. To learn more read "Your Guide to Medicare's Preventive Services," CMS Product No. 101Download a copy at www.Medicare.gov or call 1-800- Medicare ( 7).