Monday, October 28, 2019
Medicare changes for 2020
Q:What are the changes to Medicare benefits for 2020?
A:There are several changes for Medicare enrollees in 2020:
The Social Security cost of living adjustment (COLA) is expected to be about 1.6 percent for 2020, which will increase the average retiree’s total benefit by about $23/month. That’s more than enough to cover the roughly $9 increase in premiums for Part B, which means that the premium increase is likely to apply to nearly all Part B enrollees.
[If a Social Security recipient’s COLA isn’t enough to cover the full premium increase for Part B, that person’s Part B premium can only increase by the amount of the COLA, as Part B premiums are withheld from Social Security checks, and the net check can’t decline from one year to the next.]
Some enrollees have supplemental coverage that pays their Part B deductible. This includes Medicaid, employer-sponsored plans, and Medigapplans C and F. Medigap plans that cover the Part B deductible can only be sold to newly-eligible enrollees through 2019 — after that, people can keep Plans C and F if they already have them, newly-eligible Medicare beneficiaries will no longer be able to buy Medigap plans that cover the Part B deductible. (The impending ban on the sale of Medigap plans that cover the Part B deductible was part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), in an effort to curb utilization by ensuring that enrollees would incur some out-of-pocket costs during the year.)
Many Medicare Advantageplans have low copays and deductibles that don’t necessarily increase in lockstep with the Part B deductible, so their benefits designs have had different fluctuations over the last few years. (Medicare Advantage enrollees pay the Part B premium, but their Medicare Advantage plan wraps Part A, Part B, and various supplemental coverage together into one plan, with out-of-pocket costs that are different from Original Medicare).
Those premiums have trended upwards over time, although they’re lower in 2019 than they were in 2010. They’re projected to increase in 2020, however: The premium for people with 30+ (but less than 40) quarters of work history is projected to be $253/monthin 2020, up from $240/month in 2019. And for people with fewer than 30 quarters of work history, the premium for Part A is projected to be $460/month in 2020, up from $437/month in 2019 (these numbers are from the Medicare Trustees’ 2019 report, the exact amounts will be published by CMS in the fall of 2019).
Part A has a deductible that applies to each benefit period(rather than a calendar year deductible like Part B or private insurance plans), and it generally increases each year. In 2019 it is $1,364, but it’s projected to increase to $1,420 in 2020. The increase in the Part A deductible will apply to all enrollees, although many enrollees have supplemental coverage that pays all or part of the Part A deductible.
The Part A deductible covers the enrollee’s first 60 inpatient days during a benefit period. If the enrollee needs additional inpatient coverage during that same benefit period, there’s a daily coinsurance charge. In 2019, it’s $341 per dayfor the 61st through 90th day of inpatient care, and that’s projected to increase to $355 in 2020. The coinsurance for lifetime reserve daysis $682 per day in 2019, and that’s projected to increase to $710 in 2020.
For care received in skilled nursing facilities, the first 20 days are covered with the Part A deductible that was paid for the inpatient hospital stay that preceded the stay in the skilled nursing facility (Medicare only covers skilled nursing facility care if the patient had an inpatient hospital stayof at least three days before being transferred to a skilled nursing facility). But there’s a coinsurance that applies to days 21 through 100 in a skilled nursing facility. In 2019, it’s $170.50 per day, and that’s projected to increase to $177.50 per day in 2020.
[All of these projections are on page 188 of the 2019 Medicare Trustees’ Report; CMS will confirm the official amounts in the fall of 2019.]
Medigap Plans C and F cover the Part B deductible ($185 in 2019; projected to be $197 in 2020) in full, whereas other Medigap plans require enrollees to pay the Part B deductible themselves. The idea behind the change is to discourage overutilization of services by ensuring that enrollees have to pay at least something when they receive outpatient care, as opposed to having all costs covered by a combination of Medicare Part B and a Medigap plan.
Because the high-deductible Plan F is being discontinued for newly-eligible enrollees, there will be a new high-deductible Plan Gavailable instead.
But some brokers and enrollment assisters have concerns about the new tool and the fact that it’s being rolled out right before open enrollment. In order to have the new system save the medication information you enter (so that you can come back to it later without having to enter it all again), you have to log into your MyMedicare account.
This is causing concerns about privacyin situations where a beneficiary needs assistance with the plan comparison and enrollment process, and will make it more difficultfor people who are approaching Medicare eligibility to accurately compare their plan options before enrolling in Medicare.
Although the new tool has more capabilities than the old one, it will also take time for people to get used to it if they were already accustomed to the old tool. It’s a good idea to carefully compare your plan options during open enrollment, and Medicare’s plan finder tool is an excellent resource. But beneficiaries will want to allow a little extra time this year to acclimate themselves to the new tool in order to take full advantage of all that it has to offer.
Medicare beneficiaries with high incomes pay more for Part B and Part D. But what exactly does “high income” mean? Since the income brackets were introduced (in 2007 for Part B, and in 2011 for Part D), the threshold has been set at $85,000 ($170,000 for a married couple). But starting in 2020, the income brackets will be adjusted for inflation. A high-income premium surcharge will apply to Medicare beneficiaries who earn at least $87,000/year as of 2020 ($174,000 for a married couple).
For high-income Part B enrollees (income over $85,000 for a single individual, or $170,000 for a married couple), premiums in 2019 range from $189.60/month to $460.50/month, depending on income. For 2020, these amounts are projected to range from $202/month to $490.50/month, and will apply to people earning at least $87,000 for an individual, or $174,000 for a married couple.
As part of the Medicare payment solution that Congress enacted in 2015 to solve the “doc fix” problem, new income brackets were created to determine Part B premiums for high-income Medicare enrollees, and they took effect in 2018, bumping some high-income enrollees into higher premium brackets.
And for 2019, a new income bracket was added on the high end, further increasing Part B premiums for enrollees with very high incomes. Rather than lumping everyone with income above $160,000 ($320,000 for a married couple) into one bracket at the top of the scale, there’s now a new bracket for enrollees with income of $500,000 or more ($750,000 or more for a married couple). People in this category pay $460.50/month for Part B in 2019, and their estimated premium will be $490.50/month in 2020. That top bracket — income of $500,000+ for a single individual or $750,000 for a couple — will remain unchanged in 2020, but the thresholds for each of the other brackets will increase slightly (starting with the lowest bracket increasing from $85,000 to $87,000, and so on; a similar adjustment applies at each level except the highest one).
For perspective, a Kaiser Family Foundation analysisfound that across Medicare Advantage plans with integrated Part D prescription coverage (MA-PDs), the average premium in 2019 is about $29/month, but that includes the fact that more than half of Medicare Advantage enrollees are in plans that have no premium at all. Among people who do pay a premium for their Advantage plan in 2019, the average monthly premium is $65.
About 22 million people have Medicare Advantage plans in 2019; enrollment in these plans has been steadily growingfor the last 15 years. The total number of Medicare beneficiaries has been steadily growing as well, but the growth in Medicare Advantage enrollment has far outpaced overall Medicare enrollment growth. In 2004, just 13 percent of Medicare beneficiaries had Medicare Advantage plans. That had grown to 34 percent by 2019, and the new Medicare Plan Finder tool is designed in a way that could accelerate the growth in Advantage enrollment.
Source: https://www.medicareresources.org/faqs/what-kind-of-medicare-benefit-changes-can-i-expect-this-year/
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A:There are several changes for Medicare enrollees in 2020:
Part B premiums
The standard premium for Medicare Part B is $135.50/month for 2019, but it’s projected to increase to $144.30/month in 2020(this won’t be finalized until the fall of 2020, and as discussed below, higher premiums apply to enrollees with high incomes).The Social Security cost of living adjustment (COLA) is expected to be about 1.6 percent for 2020, which will increase the average retiree’s total benefit by about $23/month. That’s more than enough to cover the roughly $9 increase in premiums for Part B, which means that the premium increase is likely to apply to nearly all Part B enrollees.
[If a Social Security recipient’s COLA isn’t enough to cover the full premium increase for Part B, that person’s Part B premium can only increase by the amount of the COLA, as Part B premiums are withheld from Social Security checks, and the net check can’t decline from one year to the next.]
Part B deductible
The Part B deductible was $183 in 2017 and it remained at that level in 2018. For 2019, however, it increased to $185. And for 2020, it’s projected to increase to $197, although the exact amount won’t be finalized until the fall of 2019.Some enrollees have supplemental coverage that pays their Part B deductible. This includes Medicaid, employer-sponsored plans, and Medigapplans C and F. Medigap plans that cover the Part B deductible can only be sold to newly-eligible enrollees through 2019 — after that, people can keep Plans C and F if they already have them, newly-eligible Medicare beneficiaries will no longer be able to buy Medigap plans that cover the Part B deductible. (The impending ban on the sale of Medigap plans that cover the Part B deductible was part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), in an effort to curb utilization by ensuring that enrollees would incur some out-of-pocket costs during the year.)
Many Medicare Advantageplans have low copays and deductibles that don’t necessarily increase in lockstep with the Part B deductible, so their benefits designs have had different fluctuations over the last few years. (Medicare Advantage enrollees pay the Part B premium, but their Medicare Advantage plan wraps Part A, Part B, and various supplemental coverage together into one plan, with out-of-pocket costs that are different from Original Medicare).
Part A premiums, deductible, and coinsurance
Medicare Part Acovers hospitalization costs. For most enrollees, there’s no premium for Part A. But people who don’t have 40 quarters of work history (or a spouse with 40 quarters of work history) must pay premiums for Part A coverage.Those premiums have trended upwards over time, although they’re lower in 2019 than they were in 2010. They’re projected to increase in 2020, however: The premium for people with 30+ (but less than 40) quarters of work history is projected to be $253/monthin 2020, up from $240/month in 2019. And for people with fewer than 30 quarters of work history, the premium for Part A is projected to be $460/month in 2020, up from $437/month in 2019 (these numbers are from the Medicare Trustees’ 2019 report, the exact amounts will be published by CMS in the fall of 2019).
Part A has a deductible that applies to each benefit period(rather than a calendar year deductible like Part B or private insurance plans), and it generally increases each year. In 2019 it is $1,364, but it’s projected to increase to $1,420 in 2020. The increase in the Part A deductible will apply to all enrollees, although many enrollees have supplemental coverage that pays all or part of the Part A deductible.
The Part A deductible covers the enrollee’s first 60 inpatient days during a benefit period. If the enrollee needs additional inpatient coverage during that same benefit period, there’s a daily coinsurance charge. In 2019, it’s $341 per dayfor the 61st through 90th day of inpatient care, and that’s projected to increase to $355 in 2020. The coinsurance for lifetime reserve daysis $682 per day in 2019, and that’s projected to increase to $710 in 2020.
For care received in skilled nursing facilities, the first 20 days are covered with the Part A deductible that was paid for the inpatient hospital stay that preceded the stay in the skilled nursing facility (Medicare only covers skilled nursing facility care if the patient had an inpatient hospital stayof at least three days before being transferred to a skilled nursing facility). But there’s a coinsurance that applies to days 21 through 100 in a skilled nursing facility. In 2019, it’s $170.50 per day, and that’s projected to increase to $177.50 per day in 2020.
[All of these projections are on page 188 of the 2019 Medicare Trustees’ Report; CMS will confirm the official amounts in the fall of 2019.]
Medigap Plans C and F will not be available to newly-eligible enrollees
As a result of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Medigapplans C and F (including the high-deductible Plan F) will no longer be available for purchase by people who become newly-eligible for Medicare on or after January 1, 2020. People who become Medicare-eligible prior to 2020 can keep Plan C or F if they already have it, or apply for those plans at a later date (medical underwritingapplies in most statesif you’re switching from one Medigap plan to another after your initial enrollment window ends).Medigap Plans C and F cover the Part B deductible ($185 in 2019; projected to be $197 in 2020) in full, whereas other Medigap plans require enrollees to pay the Part B deductible themselves. The idea behind the change is to discourage overutilization of services by ensuring that enrollees have to pay at least something when they receive outpatient care, as opposed to having all costs covered by a combination of Medicare Part B and a Medigap plan.
Because the high-deductible Plan F is being discontinued for newly-eligible enrollees, there will be a new high-deductible Plan Gavailable instead.
Upgraded Medicare plan finder tool
CMS announcedin August 2019 that the Medicare Plan Finder toolhad been upgraded for the first time in a decade. Both the old and new plan finder tool were available through the end of September 2019. Since then, only the new tool is available. The new tool includes a wide range of improvements and automation, and keeps up with the increasing tech-savviness of new Medicare enrollees.But some brokers and enrollment assisters have concerns about the new tool and the fact that it’s being rolled out right before open enrollment. In order to have the new system save the medication information you enter (so that you can come back to it later without having to enter it all again), you have to log into your MyMedicare account.
This is causing concerns about privacyin situations where a beneficiary needs assistance with the plan comparison and enrollment process, and will make it more difficultfor people who are approaching Medicare eligibility to accurately compare their plan options before enrolling in Medicare.
Although the new tool has more capabilities than the old one, it will also take time for people to get used to it if they were already accustomed to the old tool. It’s a good idea to carefully compare your plan options during open enrollment, and Medicare’s plan finder tool is an excellent resource. But beneficiaries will want to allow a little extra time this year to acclimate themselves to the new tool in order to take full advantage of all that it has to offer.
Inflation adjustments for the high-income brackets
Medicare beneficiaries with high incomes pay more for Part B and Part D. But what exactly does “high income” mean? Since the income brackets were introduced (in 2007 for Part B, and in 2011 for Part D), the threshold has been set at $85,000 ($170,000 for a married couple). But starting in 2020, the income brackets will be adjusted for inflation. A high-income premium surcharge will apply to Medicare beneficiaries who earn at least $87,000/year as of 2020 ($174,000 for a married couple).For high-income Part B enrollees (income over $85,000 for a single individual, or $170,000 for a married couple), premiums in 2019 range from $189.60/month to $460.50/month, depending on income. For 2020, these amounts are projected to range from $202/month to $490.50/month, and will apply to people earning at least $87,000 for an individual, or $174,000 for a married couple.
As part of the Medicare payment solution that Congress enacted in 2015 to solve the “doc fix” problem, new income brackets were created to determine Part B premiums for high-income Medicare enrollees, and they took effect in 2018, bumping some high-income enrollees into higher premium brackets.
And for 2019, a new income bracket was added on the high end, further increasing Part B premiums for enrollees with very high incomes. Rather than lumping everyone with income above $160,000 ($320,000 for a married couple) into one bracket at the top of the scale, there’s now a new bracket for enrollees with income of $500,000 or more ($750,000 or more for a married couple). People in this category pay $460.50/month for Part B in 2019, and their estimated premium will be $490.50/month in 2020. That top bracket — income of $500,000+ for a single individual or $750,000 for a couple — will remain unchanged in 2020, but the thresholds for each of the other brackets will increase slightly (starting with the lowest bracket increasing from $85,000 to $87,000, and so on; a similar adjustment applies at each level except the highest one).
Medicare Advantage enrollment expected to continue to increase
CMS has not yet announced average Medicare Advantage(Medicare Part C) premiums for 2020, although average premiums have been declining for the last several years. (Note that Medicare Advantage premiums are in addition to Part B premiums; people who enroll in Medicare Advantage pay their Part B premium and whatever the premium is for their Medicare Advantage plan, and the private insurer wraps all of the coverage into one plan.)For perspective, a Kaiser Family Foundation analysisfound that across Medicare Advantage plans with integrated Part D prescription coverage (MA-PDs), the average premium in 2019 is about $29/month, but that includes the fact that more than half of Medicare Advantage enrollees are in plans that have no premium at all. Among people who do pay a premium for their Advantage plan in 2019, the average monthly premium is $65.
About 22 million people have Medicare Advantage plans in 2019; enrollment in these plans has been steadily growingfor the last 15 years. The total number of Medicare beneficiaries has been steadily growing as well, but the growth in Medicare Advantage enrollment has far outpaced overall Medicare enrollment growth. In 2004, just 13 percent of Medicare beneficiaries had Medicare Advantage plans. That had grown to 34 percent by 2019, and the new Medicare Plan Finder tool is designed in a way that could accelerate the growth in Advantage enrollment.
Source: https://www.medicareresources.org/faqs/what-kind-of-medicare-benefit-changes-can-i-expect-this-year/
Follow us: @EyeOnInsurance on Twitter| healthinsurance.org on Facebook
Some facts About Working While on Social Security
Can you work and collect Social Security? The simple answer is yes. The more complicated answer is that you may not want to.
There are two reasons to wait to apply for benefits if you plan to continue to work – penalties and taxes.
Your age and how much you expect to earn will help you decide whether working, while collecting Social Security, makes sense.
What Is Your Full Retirement Age and Why is it Important?
If you have not reached your Full Retirement Age (FRA), you are subject to the earnings test. This means there is a limit to how much you can earn without a penalty.
Your FRA is the age that the Social Security Administration deems you eligible for your full Social Security benefit. It is the center point for determining the amount of your monthly payment.
If you begin collecting benefits before your FRA, your payment amount will be reduced. If you apply after FRA, your payment will be higher.
The Full Retirement Age used to be 65 for everyone, but now it depends on the year you were born.
If you were born between 1943 and 1954 your Full Retirement Age is 66. It increases as follows:
1955 66 and 2 months
1956 66 and 4 months
1957 66 and 6 months
1958 66 and 8 months
1959 66 and 10 months
1960+ 67
If you begin collecting benefits before your FRA, there is an earnings limit of $15,720. You can work, but anything over that amount is subject to a penalty. You will be required to pay $1 for every $2 you earn. That is half of anything you make over the $15,720 limit.
For example, if you bring in $30,720 in a given year, that’s $15,000 over the limit. The penalty will be $1 for every $2 you earn or $7,500. The average monthly Social Security payment is $1,300. It would take nearly six months of payments to satisfy that amount.
This money is not immediately taken out of your paycheck. However, once reported, you will be expected to pay the penalty in full or your entire monthly Social Security payment will be withheld until the fine is fully paid.
You are supposed to report anticipated income to the Social Security Administration so that they can withhold penalty amounts from your Social Security payments as they are acquired. However, should you lose your job or decide to quit, it is difficult to get payments reinstated quickly. So, plan ahead, where possible.
Stopping and starting payments can be confusing for both you and the Social Security Administration. This is where many mistakes occur and, unfortunately, it may be difficult to get them straightened out.
Every year, your income is reported to the Social Security Administration by the IRS. That said, it may be several months before the Social Security Administration notifies you of the over payment and asks for it to be paid back.
This is something you definitely need to plan for. The amount due may be significant and, if you cannot pay it, several months of your benefit may be withheld. If you continue to earn more than the limit, your payments may be suspended for years.
The Year of Your Full Retirement Age
In the year of your FRA, the earnings limit is higher and the penalty is lower than previous years. From the first of the year until the month you reach your FRA, the limit is $41,880. If you exceed this amount, you will incur a penalty of $1 for every $3 you earn.
Once you reach the month of your FRA, there is no limit to how much you can earn. There is no longer an earnings test or penalty. You can keep all the funds you make from this point forward.
You will be reimbursed for payments missed because of the earnings limit. Once you reach FRA, your benefits will be recalculated to include the months your payments were suspended. In addition, your monthly payment amount will be increased accordingly. But it is paid in small increments and may take 15 years to recoup the missed funds.
What About Taxes?
The U.S. Government considers Social Security benefits income. As a result, Social Security benefits may be taxed.
If your combined income – adjusted gross income, tax exempt interest income and half of your Social Security benefit – is over $25,000 for an individual and $34,000 for a couple, up to 85% of your benefit may be subject to Federal tax. Social Security Administration provides a benefit planner to help you determine if you need to pay tax on your payment.
In addition to federal tax, 13 states tax Social Security benefits – Colorado, Connecticut, Kansas, Minnesota, Missouri, Montana, Nebraska, New Mexico, North Dakota, Rhode Island, Utah, Vermont and West Virginia. Each state has its own tax rate. This may be a factor when deciding where to live later in life.
At the end of the day, you can definitely work while collecting Social Security benefits. That said, you should consider all of the factors and talk with a tax professional before making a final decision.
Do you plan on working in retirement? Did you realize that Social Security benefits may be taxable? Please tell us your thoughts in comments below.
Disclaimer: Everyone’s financial situation is unique, so, please check with your financial professional before making any changes to your tax, retirement or investment strategies. None of the information in this article should be considered financial advice.
Monday, October 7, 2019
The germiest place in your home and the best way to combat those microbes
(CNN)Do you compulsively scrub your toilet for fear of germs? Good for you, but how often do you change your bath and hand towels?
You're well-informed, so you already microwave your germy kitchen sponge. Or should you?
When's the last time you sanitized your refrigerator, scrubbed your microwave handles or bleached your kitchen sink?
Yes, there are microbes everywhere and most are just fine for us, perhaps even beneficial to our microbiomes and immune systems. We don't care about those.
It's the dangerous ones that prompt us to pull out the disinfectants and gloves: gastro and flu viruses, cold bacteria, salmonella, listeria, yeast, mold, staph, fecal matter and E. coli -- to name but a few.
But are you cleaning all the germiest places? Let's take a stroll around your home and find out.
Of course, we start in the bathroom, where we deposit things we'd rather not think about. Surely the toilet is the prime collector of germs, yes?
No, because we obsessively clean it (or use paper coverings at work), said microbiologist Charles Gerba, a professor of public health, environmental science and immunology at the University of Arizona. Click here to continue reading.
How Sikorsky’s first helicopter took flight in CT: Getting There
Have you ever flown in a helicopter? They seem such a glamorous (if expensive) way to travel, bypassing the traffic en route to the airport or sightseeing over rugged terrain.
But do you know the helicopter had its first flight ever right here in Connecticut. It was the creation of Russian immigrant and inventor Igor Sikorsky, 80 years ago.
Sure, Leonardo da Vinci made early drawings of a vertical flying machine, but that was in the 1480s. And kids had been playing with hand-turned, propeller-driven toys for centuries before that.
Sikorsky drew his earliest concept drawings of a helicopter years before the Wright brothers ever flew at Kitty Hawk. But when he fled Russia with his family, it was a fixed-wing aircraft that gave Sikorsky his start in aviation.
At the age of 21, he designed his first airplane, the S-1, a single-engine pusher biplane. Twenty-three designs later, he built the S-42 flying boat, made famous by Pan American as “The Flying Clipper.” The four-engined craft had a range of 1,200 miles carrying 37 passengers by day or 14 by night in berths, cruising at 170 mph.
Even as Pan Am was opening overseas markets, Sikorsky was still working on his dreams of a helicopter. At his plant in Stratford, his VS-300 made its first flight, albeit tied to the ground, in September of 1939.
A 1942 version, the Sikorsky R-4, became the first mass-produced helicopter, quickly adopted by the armed forces of the U.S. and UK. It had only one crew member, could only carry 500 pounds, but had a range of 130 miles flying 65 mph at up to 8,000 feet.
Flash forward to the present and Sikorsky’s old company, now part of Lockheed Martin, still produces helicopters. Sikorsky’s successor companies, then part of United Aircraft Corp, even designed the short-lived (1968 -1976) Turbotrain, powered by a Pratt & Whitney turbine “jet engine.” The train could make the 230-mile New York-to-Boston run in 3 hours, 39 minutes. Today’s Acela can do the same run in no less than 3 hours, 55 minutes.
In a competition with the electric-powered Metroliner in 1967, the Turbotrain hit 170 mph, a land speed record for a gas turbine-powered rail vehicle. Acela does no better than 145 mph. Click to keep reading in The Middletown Press
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