Thank You Examiner/Sun HCN Newspapers:
About a month ago, Joe a confused Memorial Examiner reader contacted me about losing his Medicare Part D with a complete bogus claim from CMS (Medicare) about being reinstated, which was denied. The Regional VI Office located in Dallas said his request did not meet “the” criteria for reinstatement. I told Joe to contact his Congressman’s office because this is a Federal problem and this is what our tax dollars pays them to do…represent us!!
I am glad to report that it took about 3 weeks for his Congressman’s office to solve the problem and get Joe’s Part D and his Kelsey Care Medicare Advantage plan reinstated with no penalty. The problem was a computer glitch because Joe’s IRMAA Parts B and D premiums were not applied properly and he was kicked out of the system. It was a “human” error and someone had to take the time to find the problem. Lucky for Joe, he read my column on Medicare and got the answer he needed. This problem was not an average Medicare problem, but even easy Medicare/Social Security problems can overwhelm people with master degrees…Once again, thanks to the Examiner/Sun newspaper for making this column available to the public….Toni
Hello Toni:
I hear so many rumors about how Obamacare is going to affect Medicare. Mainly, that Part B premium is going to be over $200 in a few years and that Medicare Advantage is going away. Can you please tell me what is true and what is myth or rumor…Thanks, Abbey…Sugar Land, TX
Good Day Abbey:
I get this question all the time, especially from those who watch TV and do not know the difference between Obamacare (which is mainly for those under 65) and Medicare. Medicare beneficiaries need not to worry at this time because Medicare is already a national health insurance program. Obamacare rules apply mostly to individual and group health insurance policies for Americans under 65 and who are not yet eligible for Medicare.
Let’s explore some of the common questions that I am receiving:
- Is the Medicare Part B premium going up to $247/month in 2014? This is a myth that has been emailed for the past 2 years. PPACA (Patient Protection and Affordable Care Act) otherwise known as Obamacare does not determine Medicare Part B premiums. CMS (Centers for Medicare and Medicaid Services) uses a formula that has been in place for years to determine the new Part B premium for the coming year. This is determined on claims loss by Medicare in the prior year. You could see an increase in Part B premiums if the Medicare spending is higher from one year to the next. Or your income goes up and you might pay more.
- The Part D “Donut Hole” is going away? This is true… but the Patient Protection and Affordable Care Act or Obamacare is slowly closing the “Donut Hole” between now and the year 2020. Don’t know why it is taking so long!! What is an unknown is if Part D premiums will go up when the “Donut Hole” is eliminated. We will have to wait to see!
- I may lose some benefits in my Medicare Advantage Plan- Is this true? Over time this could be true, but for right now many plans are keeping benefits about the same. In 2014, you may see some Medicare Advantage plans reduce benefits because Congress made changes to how Medicare Advantage plans are paid from CMS and must reduce what were considered “overpayments” to private Medicare insurance companies who offer Medicare Advantage plans.
Don’t worry, much depends on the election in November, so make your Medicare decisions based on today’s laws and worry about 2014 when it gets here. Medicare open enrollment for this year is October 15-December 7th.
Toni King is an advocate/consultant for those “Confused about Medicare”. Email questions to asktoni@medicaretruths.com or call 281/830-3896. Visit her website www.medicaretruths.com. Seeking questions about how Healthcare Reform has affected your Medicare.
