News

  • Ask The Advisor September 2013

    Prices like these are not only unaffordable for most Medicare recipients, these costs also place pressure on Medicare's finances, since Medicare pays 80% of Part D costs during the catastrophic phase of coverage. Although drug plans vary significantly, the 2019 "standard Part D benefit" has a 5 deductible and a 25% co-insurance up to an initial coverage limit of ,820 in total drug costs. That includes both what consumers and their drug plans pay. Once total costs exceed that amount, beneficiaries hit the Part D "doughnut hole" or coverage gap. Under that stage of coverage, beneficiaries pay 25% coinsurance on the discounted price of brand name drugs, and 37% co-insurance for generics until they have spent a total out-of-pocket of ,100. At that point beneficiaries enter the catastrophic phase of coverage, but are still on the hook for 5% of the cost of their prescriptions. .At a seven-hour Senate Judiciary Committee hearing this week, Homeland Security Secretary Janet Napolitano praised the Gang of Eight for their comprehensive plan, while members of the committee picked it apart and discussed potential amendments. Secretary Napolitano called the plan "realistic" and "achievable" and she said the department would be ready to implement border security provisions within the outlined timeframe. However, committee members seemed wary, and Ranking Member Charles Grassley (IA) said: "This bill would put no pressure on this secretary or any future secretary to secure the borders." . Basing a decision on amenities and features. Just because the facility markets itself like a five - star hotel or is located near a great golf course does not equate to five - star standards of care. Look around and get a feel for the number of staff to residents. Try to meet a few residents. Are they happy? Does the staff look like they get satisfaction from their work? The office of your local Long Term Care Ombudsman can tell you about documented issues and problems that facilities have had in the past. … Continued

  • Legislative Update For Week Ending September 7 2012

    If the COLA were calculated using the methodology used in 1990, this year's COLA would not be 1.7 percent – it would be 5.2 percent. And if the COLA were calculated using the 1980 methodology, this year's COLA would be 9.4 percent. As a result of the CPI's manipulation over the past three decades, Social Security beneficiaries have lost over 20 percent of their purchasing power, according to our research. Next year's projected zero COLA will put them even further behind. .Higher-income beneficiaries. People with modified gross incomes of ,000 (individuals) or 0,000 (couples) in 2017 are required to pay higher Part B premiums, depending on income. .One-out-of-five people who participated in TSCL Senior Survey spend more than 0.00 per month out-of-pocket on prescription drugs. That's an enormous amount, considering the average Social Security benefit is just ,460.00 per month. But even if you only take generics, or your Medicare drug or health plan premium goes down, this does not mean that your 2020 Medicare plan's drug coverage costs will also decrease. Your Medicare drug plan's prescription coverage – including which drugs are covered by your plan, and the cost, usually changes every year. … Continued

He said the out-of-pocket costs that patients are paying need to be fixed and that pharmaceutical company executives would be willing to help cover the cost of such reform. However, he said they want to ensure their contributions would go directly toward lowering patient costs and not into the federal budget to be used for other things. .To make the COLA more fair and accurate, TSCL believes that Congress must fully implement the CPI-E, and use it to provide a more realistic annual benefit boost. We support a number of bills before Congress that would do just that, including the CPI-E Act (H.R. 1030), the Guaranteed 3% COLA Act (H.R. 1585), the CPI for Seniors Act (H.R. 2154), and the Social Security Guarantee Act (H.R. 1275). Each of them would go a long way in ensuring that seniors receive the retirement security they deserve. .The Chairman of the House Armed Services Committee, Adam Smith (D-Wash.) has announced that if the bill is vetoed the House will come back into session over the holidays and vote to override. .Alexandria, V An overwhelming majority of seniors oppose two Medicare changes that are among the most widely - discussed reforms in Congress, according to a new survey by The Senior Citizens League (TSCL). Eighty-one percent of seniors strongly oppose a proposal that would impose a significantly higher annual deductible while restricting supplemental Medigap plans from covering the cost. Only 1 percent of those responding favored the idea. Seventy - four percent also strongly oppose replacing Medicare with a premium support system of private health plans, and giving beneficiaries a premium subsidy or voucher to shop for a new health plan. Just 5 percent said they favored this idea. "Both plans shift costs to seniors, something the vast majority can ill afford," says TSCL Chairman Ed Cates. .Medicare has three Parts: A (hospital), B (doctors and hospital outpatient) and D (prescription drugs). Each has a deductible and each increases every year. In 2007 the Medicare deductibles (annually) are: .Alzheimers and some Potentially Good News .Medicare's therapy cap on rehabilitation services, such as physical, occupational and speech therapy, has a long and sordid history in Washington D.C. The therapy cap sought to keep the Medicare budget under control but often hurt patients who need care after traumatic medical events. In practice, this cap limits access to Medicare - covered rehabilitation services. Patients are faced with either footing the bill for additional expensive care out of their own pocket or purchasing additional supplementary coverage if they can afford it. .A new online survey by The Senior Citizens League (TSCL) finds that older Americans overwhelmingly want Congress to take action to lower the cost of prescription drugs by reducing Medicare Part D's out-of-pocket spending requirements. Fifty-six percent of participants in the survey indicate that they spend more than 2 a year on prescription drugs. About one-out-of-five retirees spends more than 0 per month on prescription medications. .Check to see if your drug plan has a deductible, and how much the deductible should be. The number of drug plans that are charging a deductible increased in 2020, and a larger percentage of the plans is charging the full standard deductible of 5 in 2020. A deductible is the amount you pay before your coverage kicks in. Deductibles can vary in how they are applied. You may get coverage for generics from day one, but you are probably going to be required to satisfy a deductible for your Eliquis. Of particular note, enrollees in the SilverScript Choice plan paid no deductible in many regions of the U.S. last year, but they will pay as much as 5 in 2020. A similar situation affects enrollees of the Humana Enhanced plan, who paid no deductible in 201For those who chose to remain in the plan — which is now called Humana Premier Rx, they will pay a 5 deductible.