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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

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 2021 Part A and Part B: Premium and Deductible Amounts

The Centers for Medicare & Medicaid Services (CMS) has set the premium, deductible and coinsurance amounts for Medicare Part A and Part B for the calendar year 2021. 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 beneficiaries […]

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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 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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Case Studies Part D Prescription Drug

“Having this EPIC plan was a miracle; an absolute miracle.”

Only a fraction of the nearly 3 million New York State residents aged 65 and older are enrolled in the state’s pharmaceutical assistance program known as New York EPIC. When I meet with New York Medicare Part D clients, I ask if their individual income is below the $75,000 threshold, $100,000 if married. If so, […]

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Case Studies Part D Prescription Drug

“You Made it Easy.”

The Medicare Annual Enrollment Period, which runs from October 15 through December 7, is upon us. So Sybil, from New York’s Capital Region area, asked me to review whether her Medicare Part D prescription drug plan was the best fit for her three generic and one brand name medications.  After doing some research, I met […]

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Case Studies Medicare supplement Part C Medicare Advantage

Medicare Portability or, Am I Covered While Traveling?

Medicare while traveling Retirement remains a few years away for me.  Still, I am looking forward to when the schedule may be a little less hectic and there’s more free time to travel and explore. And I will be wondering how my Medicare will work while traveling outside of New York or the US. So […]