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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?

Plan F, you would pay the 20% share until your total deductible and co-payments reach the limit, $2,340 in 2020. What is the Medigap High F Plan? This plan provides the same benefits as standard Plan F after a $2,340 (2020) deductible has been met. The standard Plan F is a Medigap policy that pays […]

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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 […]

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Part D Prescription Drug

Phase 2: Medicare Part D Initial Coverage Period

In my previous post, Phase I: The Prescription Drug Deductible, I covered how Medicare Part D drug plan benefits reset each January 1. The post also described how a plan deductible amount may apply to any or only a specified group of medications. For many, depending on whether your January refills were affected by the […]

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Part D Prescription Drug

Phase 1: The Prescription Drug Deductible

It’s early January which means Medicare Prescription Drug payment phases have just reset. And I hear this question: “Dan, I just went to refill my medication and the pharmacist quoted me a co-pay almost double what I paid in December.” Medicare Part D Prescription Drug plans reset each year on January 1. What that means […]

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Part D Prescription Drug Uncategorized

Part D Late Enrollment Penalty

Q: “Dan, I just received a letter stating I will have to pay a Part D late enrollment penalty next year for not having a drug plan during the months of February through December, 2017. What’s this all about?” A: “Sam, after you turned 65 in October 2016 you had individual coverage with prescription drug […]

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Medicare A & B

Medicare 2018: Part A and Part B Changes

On November 17, 2017, the Centers for Medicare & Medicaid Services (CMS) released the 2018 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs. [Link to press release.] Medicare Part B Premiums The standard monthly premium for Medicare Part B enrollees will be $134 for 2018, the same amount as […]