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Medicare - January 2020

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Volume 3, Number 4

IN THIS ISSUE...

HIT TAX REPEAL: HOW MEDICARE ADVANTAGE PLANS WILL PROFIT

POLL: 1 IN 5 US ADULTS REPORT TROUBLE AFFORDING PRESCRIPTION DRUGS

HOW TO PICK A PART D PLAN

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News & Updates For Medicare Beneficiaries

Legislation to remove three taxes that have been included in the Affordable Care Act has been enacted. Removal of the HIT tax in 2021 could result in improved supplemental benefits (e.g. vision, hearing, dental and other benefits) in Medicare Advantage plans.

You should always check your medications during the Annual Enrollment Period (October 15-December 7 ) and at any other time you have the opportunity to change stand-alone Part D Prescription Drug plans or drug plans that are included in Medicare Advantage (MAPD) plans. We suggest you download and retain the linked article to use as future reference whenever you have the opportunity to change or choose drug plans. Call us at 877-734-3884 or

561-734-3884 for help in reviewing your medications to determine how they will be covered under your present or proposed plan.

HIT TAX REPEAL: HOW MEDICARE ADVANTAGE PLANS WILL PROFIT

Both chambers of Congress have passed two year-end spending agreements to fund the federal government until September 30, 2020 (H.R. 1158 and H.R. 1865) and. President Trump has signed them into law. One of the agreements, H.R. 1865, the Further Consolidated Appropriations Act of 2020, fully repeals the Health Insurance Industry Fee (aka the Health Insurer Tax or “HIT”) and two other taxes: the 40% excise tax on employer-sponsored coverage (a.k.a. “Cadillac Tax”) and the Medical Device Tax. All three taxes were originally imposed to help fund the Affordable Care Act.

The HIT was suspended in both 2017 and 2019 (but was in effect in 2018) after intense industry lobbying. The spending agreement leaves the tax in place for 2020 but totally repeals it beginning in 2021. The Internal Revenue Service estimates the tax will bring in about $15.5 billion in 2020, up from $14.3 billion in 2018.

Commercial health insurers serving employers and individuals have generally passed the HIT along to their members in the form of higher premiums. Medicaid managed-care insurers are reimbursed for the tax by the states they contract with.

But in the fiercely competitive, fast-growing Medicare Advantage market, insurers have historically absorbed at least part of the tax to keep their policies attractive enough to enroll more seniors.

Repealing the HIT for 2021 and beyond could boost Medicare Advantage enrollment as insurers keep premiums flat and reinvest into supplemental benefits. Repeal of the tax could also bolster Medicare Advantage insurers’ bottom lines, as well.

Learn more about the HIT here .

Learn more about the Cadillac Tax and the Medical Device Tax here .

POLL: 1 IN 5 US ADULTS REPORT TROUBLE AFFORDING PRESCRIPTION DRUGS

The following article by George Hill appears in the November 12 edition of The Hill .

About 1 in 5 U.S. adults say that they or someone in their household has been unable to afford drugs that were prescribed to them in the past 12 months, according to a new poll from Gallup and West Health.

The survey found that 22.9 percent of U.S. adults said there had been a time in the past year when their household was unable to pay for drugs they were prescribed, up from 18.9 percent in January.

The poll illustrates the struggles many Americans have paying for medication at a time when lowering drug prices is an intense subject of debate in Washington.

President Trump has railed against high drug prices and has proposed some steps, including linking certain Medicare drug prices to lower ones paid in other countries, but he has not taken any major action that has yet gone into effect.

The Gallup survey finds the public is mostly negative on Trump’s performance on the issue so far, with 66 percent of adults saying he has done “not very much” or “none at all” to fight high drug prices. Twenty percent said he had done a “fair amount” and 7 percent said “a great deal.”

Speaker Nancy Pelosi (D-Calif.) is pushing a sweeping bill to allow the secretary of Health and Human Services to negotiate lower prices on up to 250 drugs per year. Republicans oppose that measure, warning it would hinder the development of new treatments, but some are supporting smaller measures like a bill in the Senate from Senators Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.).

Drug companies say that the problem is insurers and pharmacy benefit managers who are not passing discounts they receive on to consumers.

HOW TO PICK A PART D PLAN

This article was published on November 25, and I came across it too late to be published in the December newsletter. However, we suggest you make a copy of this article, retain it, and follow the recommendations when you next become eligible (due to aging-in, the October 15-December 7 annual enrollment period, or a special enrollment period) for a Part D drug plan (either on a stand-alone basis or as part of a Medicare Advantage plan). The article contains an outline of some of the major things we recommend to beneficiaries when we speak to them about drug plans.

Retirees should create a checklist of their medications and compare costs for each using the Medicare Plan Finder tool at www.medicare.gov (or call us at 877-734-3884 or 561-734-3884 ) before signing up for Medicare Part D or Medicare Advantage Prescription Drug (MAPD)coverage. Plans with lower monthly premiums may not be better choices because of higher out-of-pocket costs, the tier in which drugs are placed on the plan's formulary or might not include the drug in their formulary at all. Individuals considering drug coverage should always consider the plan’s premium (if any) AND the cost of the medications.

Beneficiaries should also consider any utilization management techniques (quantity limits, prior authorization, or step therapy) that apply to their medications under their proposed plan.

Finally, individuals who are not on any drugs or who are on a limited number of inexpensive drugs should also consider enrolling in a low-premium drug plan. (An individual who has not had creditable coverage within 63 days of enrolling in a drug plan will have a MONTHLY penalty of 1% of each year’s national average drug premium times the number of months s/he has not had creditable coverage EACH month that individual is enrolled in a stand-alone Part D plan or a Medicare Advantage Prescription Drug Plan).

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HEALTH

DENTAL

MEDICARE

DISABILITY

LIFE

2020 Schedule
Affordable Care Act Open Enrollment

Open Enrollment began November 1, 2019 and ended December 15, 2019
on the federal facilitated marketplace for plans to start January 1, 2020.

Before the next open enrollment period starts you can only enroll
for an Affordable Care Act plan if you have a qualifying life event.

You may be eligible to enroll for another type of plan.
Call us at 561-734-3884 or 877-734-3884 for details.

2020 Schedule
Medicare Annual Enrollment Period

Annual Enrollment began October 15, 2019
and ended December 7, 2019 for a January 1, 2020 enrollment.

You’re eligible to enroll now if you’re first becoming eligible for
Medicare or are eligible for another type of enrollment period.
Enrollment rules differ between Medicare Supplement plans and
Medicare Advantage, Medicare Advantage Prescription Drug,
and stand-alone Prescription Drug Plans.

Call us at 561-734-3884 or 877-734-3884 for details.

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We offer a comprehensive set of Affordable Care Act (“Obamacare”) plans

to individuals and families qualified to buy health (tax- and non-tax subsidized) insurance and dental/vision and/or hearing plans through the Federal marketplace (this is called buying “on-exchange” or “on-marketplace”) or directly from insurance carriers (this is referred to as buying “off-exchange or -marketplace”). Our Affordable Care Act policies comply with the Affordable Care Act and contain all of the “essential health benefits” required by that law.

The dental/vision and/or hearing insurance

products are available both on an insured or discount basis

We offer short-term health insurance policies

for those who are looking for more inexpensive coverage and shorter term alternatives.

We offer Medicare Supplement, Medicare Advantage, and Part D Drug plans

to Medicare beneficiaries. Our site is compliant with federal, state, and carrier guidelines in selling these policies. See the Medicare section of this site for details.

We represent many carriers that offer supplemental benefits

to both individuals and families and Medicare beneficiaries, and the site contains information about hospital indemnity, cancer, critical illness, gap, accident, and international medical insurance offered by many different carriers. This section of the site also contains valuable information and tools about lowering the cost of prescription medications. Call us if you want more information about or would like to enroll in one of these products.

We also offer Short- and Long-Term Disability products

and can also help you meet the costs of long-term care, nursing home, or short-term (recovery) care needs.

Finally, we have a complete array of Life, Final Expense, and Annuity products

and offer pre-need services in Florida, as we have both life insurance and pre-need licenses in that state.

You pay nothing for our services:

we’re paid directly from the carriers we represent, Premiums are NEVER EVER marked up to include paying us for our services: you pay the same whether you order directly from the carrier or the marketplace on your own or directly through us or from our site.

We ONLY offer alternatives that are suitable for you and for which we feel meet YOUR needs.
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In short, we’re experts in all aspects of health and life insurance and also have relationships with professionals who can help you with very specialized situations.

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