IBM Medicare Via Benefits Medicare costs in 2022

 I wrote a post earlier this year about the estimates for Medicare costs in 2022.  About a month ago, Medicare announced the 2022 cost and it was a shock how much the part B fee will increase. It will be $170.10 (an increase of $21.60).  They provided some rational about why it was a huge jump. It wasn't a particularly satisfying list of reasons and focused on the cost of the new Alzheimer's drug that was just approved even though there have been reports that doctors are unimpressed and not prescribing it.  

However, maybe there is another reason.  There is also a substantial cola increase for your SSA benefit in 2022 as compared with prior years and it is 5.9%. The SSA cola increase in the past 5 years has been very small by comparison.  It's just a guess, but the coincidence of a hefty part B fee increase coinciding with a hefty SSA cola increase is ironic, don't you think?

There are other Medicare cost increases that are worth noting.  Reminder, as these costs go up, so will the cost of your Medicare supplement premium increase.  If you use Medicare Advantage, your perceived cost might not "go up" but your access to networks, part B drugs, prosthetics and other benefits might "go down".  The MOOP for Medicare Advantage plans did not change and remains at $7,550 for in-network and $11,300 for combined in-network and out-of-network.

• Part B fee - $170.10 (up $21.60)
• Part B deductible - $233 (up $30)
• Part A deductible - $1,556 (up $72)
• Part A hospital day copay after 60 days - $389 (up $16)

IBM Medicare Via Benefits part D alert for 2022

 If you got a letter from your 2021 part D (aka Rx) insurance plan about your plan being consolidated into another plan OR your part D plan is being terminated you must pay attention to that letter for two reasons.

First, if your part D plan is being terminated, you MUST buy a new part D plan before the end of FEBRUARY 2022.  If you wait until January to buy that new plan, you will not have part D insurance during January. Your coverage will begin February 1, 2022.  If you wait until February to buy the new plan, you will not have part D insurance until March 1, 2022.  As important to consider, if you get your HRA benefit based on having bought the part D from Via Benefits (and bought your medigap another way), you will lose access to your HRA funding until you buy the new part D plan, which must be purchased through Via Benefits.

A more subtle problem with part D plans is plan consolidation.  Again, you should have received a letter from your 2021 plan about this if it affects your plan.  Again, this problem only applies to people who did not buy their medigaps from Via Benefit. If your part D plan is being folded into, aka consolidated into another plan, you still have to "buy" that plan through Via Benefit even though the move to the new plan is automatic.  Also, if the plan you are automatically being moved to is not in Via Benefit's inventory, then you must change to a part D plan Via sells. 

You HAVE to read the ANOC notice you receive every year from your part D and Medicare Advantage plans to make sure the change the insurance company makes does not affect your access to your HRA. Reminder, Via Benefits is an insurance broker.  If you don't buy at least one medical plan through them, you will lose access to your HRA for the year.  That's a costly mistake.

IBM Medicare Via Benefits website for 2022 plan changes experience

Last week I think I changed to a new part D plan for 2022. I write "I think" because the Via Benefits website is the least intuitive website I have ever used. 

The sign on to Via makes me feel like I am trying to hack into Fort Knox. But I did manage to sign on. Then I clicked the "shop" icon and bumbled through the menus to get to part D plans and select the plan I wanted to buy.  One would think once one selects a plan and puts it into the cart then it would be easy to "check out".  Fat chance.

I fumbled and bumbled around until I landed back on the Via main page and, as a guess, clicked on the link to go to the description of my policies. Maybe there are instructions somewhere on the site to do that.  It sure wasn't obvious to me.  It is in that menu the  user "purchase process" is completed.  

I sort of  completed the "buying" process and provided an electronic signature.  It's "sort of" because the last time I looked on the site,  the part D policy I want for 2022, it is "pending approval".  What they have to approve is beyond my comprehension.  Medicare, on the www.medicare.gov website, allows me to change my part D policy during Medicare Open Enrollment by just clicking an enroll button.  In fact, I can change it as many times as I want between Oct 15 and Dec 7th. 

I already buy a medigap from Via Benefits which fills the requirement of buying one policy from them,  so I really don't need to jump through the hoops of the Via Benefits website or call them to spend 30 minutes on the phone to make this plan change.  One would therefore think they would make it as easy as possible because they get commission for the sale if I buy it through them.  

What I also realized, is that I don't even need to ask for reimbursement of the part D premiums for the new plan.  I typically use up my HRA account money by about September of the year. The premium for the new plan is about $7/mo or $84/year. Not exactly a barn burner in terms of chewing through the HRA funds.  Bottom line, if Via doesn't "approve" the plan change by mid November, I will cancel the purchase and enroll through Medicare.

10/26/21 Update:

The new plan was "approved" by Via Benefits.  When I get the enrollment materials from the new plan, that will be when I trust the process!

  

 

IBM Medicare Via Benefits "Medicare and You" Book Fall Enrollment for 2022

 A couple of days ago I received my 2022 copy of the "Medicare and You" book and is excellent!  It explains the options for Medicare coverage more clearly than any previous edition and is a great way to reexamine your Medicare choices.  Reminder, for many states if you switch from Original Medicare with a medigap to a Medicare Advantage plan it is a permanent switch because you won't be able to buy a medigap policy if you switch back.  Original Medicare without a medigap is not a wise choice.
   

The estimates for the cost of Medicare coverage are starting to surface.
    
It is estimated that the part B fee will increase to $158.50 (up from $148.50). Everyone above a annual income of about $18,000 gets to pay that every month regardless of the structure of their insurance. People with high incomes pay even more depending on their annual income from 2 years ago (it's called IRMAA).

The estimate for the part B deductible is $217 (up from $203). 

The estimate for the part D maximum before obtaining catastrophic coverage is $7,050. That number include your cost + discount amount from pharmaceutical companies that was negotiated by your insurance policy so your out of pocket is in the range of $5000 before you get your drugs for 5% of the negotiated price.  Even so, it is a lot of money!  The part D deductible estimate is $485 (up from $445). Ugh.
    
It looks like the maximum out of pocket (MOOP) for Medicare Advantage plans will remain the same ($7,550) and can be as much as $11,300 for PPO plans.  Reminder, that does not include the cost for part D, only out of pocket health costs.  The way the Medicare Advantage plans pass along the cost increases describes is through premiums, higher copays or reduced networks.  

Look at your ANOC.  Make sure your drugs are covered in 2022. Make sure your doctors will still take your plan if you use Medicare Advantage. Pick a plan that gives you the right coverage. You have between October 15th and December 7th to do it!

IBM Medicare Via Benefits Medicare Brochures and Fall Enrollment for 2022

 In the last post I provided a link to a specific Medicare brochure about Medicare coverage of "Home Care".  There are 97 more brochures available on www.medicare.gov describing Medicare coverage in great detail that range from the coverage for diabetic equipment to the structure of Medicare prescription drug insurance. Some of them are excellent! I suggest you go to the site and look through the whole list: https://www.medicare.gov/publications  

     

This is the time of year to refresh your Medicare knowledge and get ready for Fall Open Enrollment.  FOE runs from October 15 thru December 7 and during that time you can change your Medicare coverage for 2022.  In September, you will get an "Annual Notice of Change" from your Medicare insurance providers.  Look at it!  Make sure the plan you currently have is still the right plan for you in 2022. 

     

 For those on Original Medicare, that means it's the time to make sure your part D drug insurance will continue to cover your prescriptions and do it at "best price" in 2022.  If not, enroll in a new plan!  If the part D insurance is how you "get" IBM HRA funding because it is the only insurance you buy through them, then work with Via Benefit to find a better plan.  If not, call 1-800-MEDICARE (633-4227) to get help and enroll or do it online at www.medicare.gov (find a plan) before December 8, 2021.  The FOE is NOT for your Medicare Supplement (aka medigap). The rules on when, or if, you can change your medigap depend on your state.  Call your State Health Insurance Assistance Program to find out the rules if you want to make a change as sometimes Via Benefits has inaccurate answers (you can find the state organization phone number at https://www.shiphelp.org/)

   

For those on Medicare Advantage plans, call Via Benefits or go to the website to find out what plans they sell.  You must buy your MA plan through Via to get your HRA money because you must buy a "Medicare plan" to get the money (dental and vision insurance do not count). Make sure the doctors you want to use will take a plan you want to use, the drugs you take are on their formulary, AND what the "Maximum Out Of Pocket" is in 2022 (in 2021 it can be as high as $7,550). Investigate these things, whether for your current plan or for a plan you might want to buy in 2022. 

IBM Medicare Via Benefits Medicare Home Care Coverage

There is a great deal of confusion about Medicare home care coverage. It's one of the top reasons why people ask for help with Medicare. It is compounded by Medicare Advantage plans sometimes offering benefits not available to Original (Traditional) Medicare policy holders.  It makes no sense to not have benefits be exactly the same. Unfortunately, that's a political problem that is difficult to solve. Just realize, when you "get" coverage (such as bathroom equipment) in a Medicare Advantage plan, you "lose" coverage (such as access to doctors nationwide) in Original Medicare. However, no matter what type of Medicare insurance you have, the fundamental principles of home care coverage are the same. 

   

It's simple. Medicare does not cover long term custodial care.  That means: Medicare does not cover the cost of hiring someone to come into your home to feed you, dress you, clean for you or do other chores, such as food shopping.  There is insurance available to cover those services but it is very expensive if your income is above the federal poverty limit.  Long term care insurance might provide some custodial care coverage. If you don't have LTC insurance, you have to pay out of pocket for that kind of help. On the other end of the spectrum, for federal poverty level income people without assets, Medicaid provides custodial care. Qualifying for Medicaid differs from state to state as do the services provided by Medicaid. 

     

Medicare does cover short term care which primarily revolves around a home bound patient needing medical assistance to recover from a medical problem.  The following brochure is provided by Medicare and details home care coverage for both Original Medical and Medicare Advantage.  It is very comprehensive: 

https://www.medicare.gov/Pubs/pdf/10969-medicare-and-home-health-care.pdf

      

All too often, people don't pre-plan actions should they need custodial care. Typically, the need arises as a "surprise" and is the worse time to figure it out. At a minimum, be informed about what is or is not covered by Medicare, Medicaid and long term care insurance and educate your family too.  Identify organizations available in your state that can help your family if you do need such care. On the other side of the spectrum, don't be pushed into unwarranted long term custodial care when the medical problem is temporary and can be remedied with Medicare home care coverage. 

Also, tell your family about home care benefits available from IBM I described in February 2020:   https://ibmmedicare.blogspot.com/2020/02/ibm-medicare-via-benefits-ibm.html