Reader Alert: 8 weeks to October 15th…Medicare’s Open Enrollment Countdown…
Dear Toni:
I am 68 and have been on Medicare for 3 years with the same $0 premium Medicare Advantage HMO that has Medicare Prescription Drug plan included but recently I received a letter from Social Security stating that I will now have an additional $29.90 deduction from my Social Security check because I have a Medicare Advantage Part D prescription drug plan. I enrolled on time and have no late penalties. What is going on? Sam…Sugar Land
Well Sam:
There is now an income related monthly adjustment amount in addition to your monthly premium. The different income levels, also called IRMAA, are included in Toni’s Medicare Survival Guide. The 2013 Medicare costs and deductibles for Parts A and B are included.
If your income is above a certain limit, then you will have to pay more. Since your additional amount is $29.90, it tells me that your modified adjusted gross income as reported on your IRS tax return from 2 years ago was $107,001-$160,000. The bottom line is if your income is over $85,000 as an individual or $170,000 for a couple, and you have your Medicare prescription drug plan from a Medicare Advantage (Part C) or Stand alone Medicare Prescription Drug plan (Part D), you will have more premiums deducted from your Social Security check.
I would go to the local Social Security office and appeal the decision if your income has changed. Remember, this is one of your “Rights” as someone who is receiving Medicare!!
Toni:
My mother was admitted to a skilled nursing facility after being in the hospital with pneumonia? She is supposed to have 100 days of skilled nursing care but after only 3 weeks they are sending her home. What can I do… Susan from Cypress, TX
Dear Susan:
Your mother has up to 100 days of skilled nursing care. When the doctors and/or therapist report that she has reached her maximum level of improvement or no longer requires skilled nursing care, she will have to be discharged.
You can have her moved to a private pay room in a nursing facility or you can have her discharged home (her home or your home) with home health care. Medicare will only give you 20 days at no cost, but days 21-100 are $148.00 per day. As long as your mother is still improving most Medicare Supplements will pick up days 21-100, but if your mother has a Medicare Advantage Plan, then her days of care will be limited to what is in the summary of benefits.
One thing that you must know is that if your mother needs more than 100 days of Long Term Care or she might need additional help with cooking, cleaning or other type of personal care then either you or your mother will have to pay for it out of pocket. It might be left up to you to make sure the care is paid for if your mother does not qualify for Medicaid. I would seek the advice of Eldercare professionals
In Chapter 9 of Toni’s Medicare Survival Guide, it discusses Long Term Care and the different types of LTC policies. In regards to Veterans assistance, there are aid and attendance benefits that help pay nursing homes, assisted living facilities, and extra care at home which Medicare does not cover. There are 20 billion dollars of pension benefits available for Vets who need help!!
Toni’s at The Abbey again presenting her “Confused about Medicare” workshop on Wednesday, August 28th 5:30 PM at The Abbey at Westminster Plaza, 2865 Westminster Plaza Dr., Houston, TX 77082. The workshop is free and the public is invited. Toni’s new “Confused About Medicare” workshop DVD (video) is now released and available for those who cannot attend a workshop. RSVP as seating is limited 832/800-4674.
Toni King, Medicare advocate, consultant and author of Medicare Survival Guide) available only at www.tonisays.com. For any Medicare questions, contact Toni at www.tonisays.com/ask-toni or call 832/519-TONI (8664).
