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What Are The Benefits Of Medicare

Higher Cash Wages And Salaries

Medicare and Your CalPERS Health Benefits

Medicare for All could increase wages and salaries for U.S. workers by reducing employers costs for health insurancefreeing up fiscal space to invest in wages instead. The share of total annual compensation paid to American employees in the form of health insurance premiums rather than wages and salaries rose from 1.1% in 1960 to 4.2% in 1979 to 8.4% in 2018.5 If this post-1960 increase had been only half as largeand employers had spent the health cost savings on wages and salariesthe take-home wages of American workers would have been almost $400 billion higher in 2018.6 Given that the share of total compensation spoken for by health insurance premiums is starting from a high base today, any reform that managed to slow the excess growth of health spending going forward would go a long way in making space for faster growth of cash compensation.7

Lessons Learned From Medicare Annual Enrollment Period 2023

Robert W. Bache is founder and chief of sales for Senior Healthcare Direct, an AmeriLife company.


Each year, Medicare makes changes to its health and drug plans that can alter the cost, benefits, coverage and network of providers. When this happens, beneficiaries often have a lot of questions. They want to know if their current plan is still the best one for them.

Medicares Annual Enrollment Period takes place at the same time every year: October 15 to December 7. Beneficiaries have the opportunity to switch their coverage, with changes going into effect the following January 1.

After years of guiding our agency through the AEP, Ive developed a solid understanding of the process. But every year, something surprises me or changes so vastly that it causes us as an industry to take a pause and discuss what weve learned that well carry into the next AEP. Here are just a few lessons learned and some things I know for sure when it comes to the Medicare AEP.

Medicare Advantage Plans May Cost You Less

If you enroll in a Medicare Advantage plan, you must continue to pay your Medicare Part B premiums and you may pay an additional premium. The insurer determines the Medicare Advantage planâs premium, which can vary from one Medicare Advantage plan to another. Some Medicare Advantage plans may offer enrollees monthly premiums as low as $0.

Your cost sharing may also be less under Medicare Advantage. For, example, if an enrollee visits a primary care physician under Medicare Advantage, they may have a copayment of $10. However, if the enrollee visits a primary care physician under Original Medicare, they may have a coinsurance of 20%, which could be more than $10.

Also, a Medicare Advantage plan limits your maximum out-of-pocket expense. Once you have spent that maximum, you typically pay nothing for covered medical services for the remainder of the year. Original Medicare does not provide a maximum out-of-pocket cap, so potential expenses are limitless.

Often a Medicare Advantage plan can be less expensive than comparable coverage with Original Medicare. To get the most out of a Medicare Advantage plan with Original Medicare, you may also need to enroll in a stand-alone Medicare Part D Prescription Drug Plan as well as a Medicare Supplement Insurance plan.

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How To Apply Online For Just Medicare

Are you within three months of turning age 65 or older and not ready to start your monthly Social Security benefits yet? You can use our online retirement application to sign up just for Medicare and wait to apply for your retirement or spouses benefits later. It takes less than 10 minutes, and there are no forms to sign and usually no documentation is required.

To find out what documents and information you need to apply, go to the .

Social Security Cola Increase: Here’s When You’ll Get Your 87% Hike

2021 Nascentia Skilled Nursing Facility (I

Social Security recipients will soon receive their biggest benefit hike since 1981, with the pension program set to deliver an 8.7% cost-of-living increase in 2023.

The annual cost-of-living adjustment, or COLA, takes effect with the December benefits, but those payments will reach most recipients in January 2023, according to the Social Security Administration. With the increase, the average benefit check will rise more than $140 to $1,827 a month, compared with the typical benefit of $1,681 in 2022.

The Social Security Administration adjusts payments annually based on the inflation rate, which this year has spiked to its highest levels in four decades. Seniors lost purchasing power during this year since the 5.9% they received in 2022 is well below this year’s rise in prices overall, the average Social Security benefit fell short of inflation by more than $500 this year, according to a calculation by the advocacy group the Senior Citizens League.

As a result, 4 in 10 seniors said they drained their emergency savings to stay afloat this year, the group said.

She added, “We have just been through a period where retirees are trying to cope and manage, and they have never been through anything like this before.”

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Should I Sign Up For Medical Insurance

With our online application, you can sign up for Medicare Part A and Part B. Because you must pay a premium for Part B coverage, you can turn it down.

If youre eligible at age 65, your Initial Enrollment Period begins three months before your 65th birthday, includes the month you turn age 65, and ends three months after that birthday.

Note: Important Upcoming Change Rules for 2023 and later: If you accept the automatic enrollment in Medicare Part B or if you sign up during the first three months of your IEP, your coverage will start the month youre first eligible. Beginning January 1, 2023, if you sign up during the month you turn 65 or during the last three months of your IEP, your coverage starts the first day of the month after you sign up.

The following chart shows when your Medicare Part B becomes effective in 2022:

In 2022, if you sign up during this month of your IEP Your Part B Medicare coverage starts
One to three months before you reach age 65 The month you turn age 65.
The month you reach age 65 One month after the month you turn age 65.
One month after you reach age 65 Two months after the month of enrollment.
Two or three months after you reach age 65 Three months after the month of enrollment.

The following chart shows when your Medicare Part B becomes effective in 2023:

Exploring Medicare Benefits In 2023

As a federal health insurance program, Medicare stands out among the examples of successful social programs if for no other reason than the fact that it has survived for the past five decades with few significant modifications. To understand how Medicare affects your life as an American citizen, you need to appreciate that that the program was an unprecedented measure in its day. Today, it continues to fulfill a vital need for senior citizens and those with certain disabilities or illnesses. In the following sections, well discuss the history of Medicare, its impact as a social program on the country and what it means to you as an individual.

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All Citizens Would Automatically Receive Health Insurance And Would Not Be Responsible For Out Of Pocket Expenses

  • 60% of Americans believe that its the federal governments responsibility to make sure all American have health care.

  • Medicare for All would automatically enroll all U.S. citizens in health care at birth, increasing insurance coverage by 28.3 million people.

  • The plan would cover virtually all hospital and physician care, preventive services, prescription drugs, mental-health services, dental and vision care, and medical devices. Meanwhile, individuals would have no out of pocket expenses. Coverage is maintained even if you are fired or switch jobs.

Will Private Insurance Still Be Available

Here Are All the Benefits of Medicare Advantage Plans

Neither Sanders and Jayapal bills, nor proposals like Warrens, would allow private health insurance to operate the way it does now.

In fact, the current Sanders and Jayapal bills would prohibit employers and insurance companies from offering insurance that covers the same benefits that would be provided under the Medicare for All program, Keith said. In other words, insurers couldnt offer coverage that would duplicate the benefits and services of Medicare for All.

Considering that in 2018, the average cost for employer-based family healthcare was up 5 percent to nearly $20,000 per year, maybe thats not a bad thing.

The number of Americans without health insurance also increased in 2018 to 27.5 million people, according to a report issued in September by the U.S. Census Bureau. This is the first increase in uninsured people since the ACA took effect in 2013.

A Medicare for All option could provide coverage for a significant number of those who are currently unable to afford healthcare under the current system.

Through his Medicare for All who want it proposal, Buttigieg says the coexistence of a public option along with private insurers would force big insurance companies to compete on price and bring down costs.

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What Public Program Will Expand

Bottom line: The vast majority of proposals expand Medicare, the plan that covers Americans over 65. But there is one option that would expand Medicaid, the plan that covers low-income Americans and another option that creates a new government program entirely.

The American government already finances two major health coverage plans: Medicare and Medicaid. Taken together, these two programs cover one-third of all Americans: 19 percent of Americans get their coverage from Medicare, and 14 percent from Medicaid.

Whats more, both of these programs are popular. One recent poll found that 77 percent of Americans think Medicare is a very important program. Voters have recently given a boost to Medicaid, too: Voters in Idaho, Nebraska, and Utah all passed ballot initiatives that will expand the program in their states to thousands of low-income Americans.

Given the popularity and size of Medicare and Medicaid, nearly all the Democrats proposals use these programs as a base for universal coverage, changing the rules to make more people eligible. But there are differences in which programs they pick, and one plan that starts a new government program entirely.

Traditionally, Democrats have focused on Medicare as a base for expanding coverage. And five of the six legislative proposals we looked at use the program that covers the elderly as the one that would absorb additional enrollees.

Surprising Benefits To Medicare Advantage Plans

Choosing a Medicare plan may be one of the most important decisions youll make as a mature adult. And it can be a little intimidating. While Original Medicare may seem safe and easy, you may find yourself missing out on some pretty valuable options only available through Medicare Advantage.

Here are just 4 of them.

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Job Losses In The Health Insurance And Billing Administration Sectors

A recent analysis of the economic effects of M4A includes the projection that up to 1.8 million jobs in the health insurance and billing administration sector could be made redundant. These potential 1.8 million lost jobs are frequently presented as if they constitute the net employment effect of M4A.13 This is a deeply flawed misrepresentation of Pollin and his colleagues work. In fact, their estimates are a gross measure of job displacement or churnthe regular process of workers starting and leaving jobs during the course of their work lives. Relative to the scale of other gross measures of job churn, the churn associated with M4A is not large.

If workers in the insurance or billing administration sectors were particularly hard-pressed for reemployment prospects because of geographic isolation or low average levels of educational credentials, their displacement might pose particular concern to policymakers. But employment in the health insurance and billing administration sectors is not particularly geographically concentrated,14 and Pollin et al. show that 56.5% of workers in these sectors have a four-year college degree or more education, a far greater share than the overall labor force .

Medicare Part A And Part B Dont Vary With Age Or Location

Medicare Advantage vs Medicare Supplement

Employer health insurance premiums change depending on age and location. You are likely to pay three times more for employer insurance than a younger person. But this isnt the case with Part A and Part B Medicare. While you dont have to pay premiums for Part A Medicare, the amount you pay for Part B doesnt fluctuate depending on your age.

Your place of residence largely affects the premiums you pay for employer insurance. However, the premiums you pay for Medicare Part A and Part B are the same regardless of where you live in the USA.

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Additional Costs For Coverage

Original Medicare charges a premium, deductible, and coinsurance for both parts A and B, plus any Part D or Medigap costs.

Medicare Advantage plans often consolidate these costs, but you may notice additional fees. For example, many Medicare Advantage plans include drug deductibles and specialist visit copays.

What Is Medicare Part B Medical Insurance

Medicare Part B provides outpatient/medical coverage. The list below provides a summary of Part B-covered services and coverage rules:

This list includes commonly covered services and items, but it is not a complete list. Keep in mind that Medicare does not usually pay the full cost of your care, and you will likely be responsible for some portion of the cost-sharing for Medicare-covered services.

The 2022 Part-B premium is $170.10 per month

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Medicare Advantage Plans May Limit Your Freedom Of Choice In Health Care Providers

With the federally administered Medicare program, enrollees can generally go to any doctor or facility that accepts Medicare and receive the same level of Medicare benefits for covered services. In contrast, Medicare Advantage plans may be more restricted in terms of their provider networks. If you go out of network, your plan may not cover the medical costs, or your costs may not apply to your out-of-pocket maximum.

What Were Doing About Medicare

Take Advantage of Your Medicare Advantage Plans Benefits

We advise the Australian Government on Medicare policy and manage things like:

  • which health services to include on the MBS
  • the benefit amount for each MBS service
  • the threshold for the MBS Safety Net.

Our Medical Treatment Overseas Program provides financial help for people who need life-saving medical treatment thats only available overseas.

We also help health professionals comply with Medicare requirements by providing information, guidelines and training.

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Medicare Vs Medicaid: What Is The Difference

Deductibles vary according to a persons specific plan. There are many plans with no deductible
Out-of-Pocket Costs’ Part A: Coinsurance varies depending on the length of a hospital stay per benefit period. There is a $0 coinsurance for the first 60 daysPart B: There is a 20% coinsurance after youve met your deductible for Medicare-covered services Coinsurance and copayments vary according to plan
Out-of-Pocket Maximum There is no limit to your out-of-pocket costs Out-of pocket costs’ are capped. In 2021, the out-of-pocket maximum is $7,550, though some plans set lower limits. If youre in a plan that allows out-of-network coverage, theres a separate out-of-pocket limit for combined in- and out-of-network coverage of $11,300

Cobra Coverage From An Employer Plan

Federal and state law allows people who leave their jobs to continue their employer-sponsored health coverage for a period of time. Be aware of the following:

  • You have an eight-month period after your employment ends to enroll in Medicare. If you dont enroll during that eight-month window, you might have to pay a penalty when you enroll.
  • If youre in your Medicare initial enrollment period, you must enroll in Medicare during that time to avoid a possible penalty.
  • If you dont buy a Medicare supplement policy during your open enrollment period, youll be able to buy some Medicare supplement plans within 63 days of losing your COBRA coverage.

Talk to your employer about COBRA and Medicare eligibility.

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Benefits Of Medicare Vs Employer Insurance

If youre looking for health insurance, you can opt for Medicare or employer insurance, depending on your personal needs and finances. However, if youre 65-plus and still working, you might find Medicare your best medical coverage option. We at The Medicare Family dont want to decide for you we take you through all the confusing details of Medicare until you understand them before enrolling.

This article compares Medicare vs. employer health insurance to help you make a more informed decision.

All Medicare Advantage Plans Feature Out

Medicare Supplement Plans  Medigap Guide

With Original Medicare, there is no annual limit to how much out-of-pocket health care spending you may have to pay. That means you could potentially face an infinite amount of medical expenses in any given year.

Medicare Advantage plans, however, are required to include an annual out-of-pocket spending limit that caps the amount of money you will be forced to spend in a calendar year. Once you reach that limit, the plan will pay 100% of your expenses for the remainder of the year.

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Will Be The Year When Democracy Fights Back And We See An Autocratic Recession

This is one of the most significant gaps in our industry: the ability to help current customers fully understand their benefits. When clients receive their Annual Notice of Change in September, we can save them time and money by conducting a thorough review of their plan.

All coverage details will be included in a beneficiarys ANOC. Its an opportunity for the agent to reach out and ensure their client knows the coverage they have and whats changing. This type of retention practice can preserve your book of business without making huge adjustments during the AEP.

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