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Part C Medicare Advantage

Medicare and Veterans

This spring I received calls for help from several veterans who were paying a monthly premium to be enrolled in a MAPD, a Medicare Advantage with Prescription Drug Plan. These veterans are not eligible for CHAMP or TRICARE, are enrolled in Medicare Parts A and B and pay the Part B premium. Since these veterans […]

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Medicare A & B Medicare supplement Part D Prescription Drug

What is the “Medicare Savings Program?”

Individuals enrolled in Medicare Parts A and B may apply for the Medicare Savings Program. If eligible you will receive help paying the Medicare Part B premium, currently $135.50. In some instances, (QMB) the program will pay your Part A and Part B deductible and co-insurance amounts. (And possibly a percentage of your Part C […]

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Part D Prescription Drug

Eli Lilly Will Sell Half-Price Version of Humalog Insulin

This is a step in the right direction. Drug manufacturer Eli Lilly is introducing Insulin Lispro, a generic version of Humalog – an insulin to treat Type 2 diabetes. However don’t expect for this to appear on your health insurance generic drug formulary anytime soon. “…those with drug coverage will either experience no change or […]

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Case Studies Part D Prescription Drug

A Medicare Advantage case study.

If you, a loved one, friend or neighbor has experienced “sticker shock” with your Medicare Part D prescription drug co-payment, the following case study may interest you. Earlier this week, I received this message from an Albany New York County couple: “We were talking with our neighbor Kathy about the sudden and unaffordable cost of […]

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Part D Prescription Drug

The $9 billion in Extra Cash From Medicare

On January 4, 2019 the Wall Street Journal published a powerful article written by Joseph Walker and Christopher Weaver describing how Medicare Part D insurers kept $9.1 billion more in taxpayer funds than they would have had their estimates been accurate from 2006 to 2015. In the WSJ  article, the writers do a deep dive […]

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Part D Prescription Drug

Medicare Prescription Drug Plan Deductible – How Does It Work?

A client called this morning and asked this question: “Dan, I went to refill my prescription and was quoted almost double what I paid in 2018.“ Medicare Part D Prescription Drug plans reset each year on January 1. What that means is the prescription drug benefit levels start over at what is called the Deductible […]

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Medicare A & B Medicare supplement

What is Medigap High F?

What is the Medigap High F Plan? This plan provides the same benefits as standard Plan F after a $2,300 (2019) deductible has been met. The standard Plan F is a Medigap policy that pays the Medicare hospital and medical Parts A and B deductible and co-insurance – the dollars not paid by Original Medicare.  Plan F […]

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Medicare A & B Medicare supplement

Medicare 2019 Part A and Part B: Premium and Deductible Changes

On October 12, 2018, the Centers for Medicare & Medicaid Services (CMS) released the 2019 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs. Medicare Part A Deductible Medicare Part A covers covers inpatient hospital, skilled nursing facility, and some home health care services. The annual inpatient hospital deductible that […]

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Medicare A & B Patient Health

Medicare’s Observation Status Makes Inpatients Into Outpatients (via NPR)

Beware of the “Admitted for Observation” Billing Code A daughter’s story: “An ER doctor examined her, saw that she couldn’t move her leg, couldn’t really even hold her body upright and had trouble with her memory. He said he would admit her to the hospital’s observation unit to figure out what was going on. He […]

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Part D Prescription Drug

Phase 3: Medicare Part D Donut Hole

Previously: In the first two posts in this series, Phase I: The Prescription Drug Deductible, and Phase 2: The Initial Coverage Period, I reviewed how Medicare Part D drug plan benefits reset each January 1, how Medicare Part D prescription drug plans may include a deductible amount to be paid before any medications are covered […]