Monthly Archives: November 2023

A brief note on choosing a Medicare plan.

Obvious first step? Go to Medicare.gov if you are just beginning your investigation:
https://www.medicare.gov/basics/get-started-with-medicare/using-medicare/helpful-tools
Want to talk to someone who is not a “salesman”? Call 1-800-MEDICARE (1-800-633-4227)

Traditional Medicare or Medicare Advantage? Rule of Thumb

If you are a “young” healthy Medicare beneficiary, you likely would choose a Medicare Advantage plan with all the “free” extras. Here you will consider what doctors and hospitals are “in network” and what are out of network. If you are a “snow bird” then this question must be answered for both your summer home and your winter home coverage. You only get one plan.

If you have serious chronic medical conditions, consider traditional Medicare with Medigap coverage. Medigap plans run A through K and are standardized.

Can You switch from Medicare Advantage to a traditional Medicare plan? Yes, but.

What if you develop a serious medical condition and the need for “prior authorization” by the insurance plan denies the treatment your doctor orders? And what if your co-pays and deductibles are getting seriously expensive? You want to consider traditional Medicare Medigap plan, but get ready for “attained age” and denial of coverage.

The most serious limit on your choice is denial of coverage. Some plans may deny you coverage, others will impose a six month period of non-coverage for your pre-existing medical condition. For a sample list of disqualifying conditions and more information see: https://www.kff.org/medicare/issue-brief/medigap-enrollment-and-consumer-protections-vary-across-states/.

For attained age cost information simply go to https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan
Go to choose a policy and you’re off and running. For example in Southeast Michigan where I am a Blue Cross Medigap Plan D for a person age 65 will cost $159 + plus the annual monthly Part B premium of $164.90 in 2024. For age 75 the cost is $264 + the annual Part B premium.

Prescription Plans, “Part D”

Choosing a prescription plan is simpler. There is no traditional Medicare plan, so simply enter your prescriptions, follow the instructions and make your choice. Whatever plan you may have you might lower your prescription costs with an add on  such as GoodRx: https://www.goodrx.com/

Let us know if you found this article helpful.  Call and leave a message at (248) 356-3500,

All the best,
Jim

Fall Update

What’s been going on? National advocacy. I am on the National Academy of Elder Law Attorneys Advocacy Committee. I’ve been watching for the reintroduction of the repeal of Medicaid Estate Recovery – I wrote about the Jan Schakowsky bill before. But, in spite of all the interest by advocacy groups, she did not reintroduce the bill, this session of Congress.
However another bill introduced by Ohio Senator Sherrod Brown the ” SSI Savings Penalty Elimination Act” has a chance at getting passed, even during this era of wars – Culture War, Middle East War, Ukraine Russia War. However as slow as Congress is, so are the “ships” of national advocacy associations, including NAELA. I’m hoping to get something going on the bill by NAELA. In other words, what we think of as very important does not get the light of day! Nonetheless, I will continue to work in these very important national issues that will benefit all my clients, and all persons who have an interest in our elders and elder law.

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