Sen. Casey pushes to halt premium increases expected under Medicare Part B

Now the rising cost of specialty drugs is putting upward pressure on premiums. If you have employment-related coverage, talk to your benefits administrator, insurer or plan before making any changes. They often offer benefits that are not available from original Medicare.

Those shopping for a Medicare Advantage plan may gravitate toward the option with the lowest premium. Two popular plans from Humana (NYSE:HUM) will also impose cost hikes of between 8% and 17% on their 3.2 million participants, although both plans will see costs remain well below the overall average.

Boomer: What are the costs involved with Medicare coverage? Will you pay a penalty if you join a drug plan later?

Medicare beneficiaries may have noticed their mailboxes are filling with brochures and packets from health insurance companies. Under the law, those who have their Part B premiums deducted from Social Security can not be subject to a premium increase. For most people who have enrolled in Part B this year or in previous years, the monthly premium is $104.90.

But 30 percent are not protected from higher premiums. Medicare Advantage plans (Part C) have traditionally no or low premiums. Fortunately, during the open enrollment period (which is October 15 – December 7), you have the ability to shop and compare plans and choose one that better fits your needs and budget. Medigap is supplemental insurance, provided by private insurance firms, that covers the difference between Medicare coverage and Part D costs.

“Every year Part D plans can change prices, the drugs they cover, even the pharmacies where you get the biggest discount”. It is called the 5-Star Special Enrollment Period.

Joining Medicare is your responsibility!

Travel: Will the plan cover you if you travel to another state? With Medicare Plan D coverage, are your medications still covered?

Sen. Casey said he and nine other sponsors, all Democrats, are trying to rally bipartisan support for the legislation meant to hold Medicare Part B premiums and deductibles level for all enrollees next year. However, for new people enrolling in Part B in 2016 and other groups, the monthly premium could jump up to $153.30.

Boomer: If I am still working past age 65, can I stay on my employer plan instead of electing coverage under Medicare? You can help someone you care about apply for Extra Help with his or her Medicare prescription drug costs.

While it may hard to gauge the quality of unknown physicians, Medicare beneficiaries should at least check a plans network to see if their preferred doctors and facilities participate.

Quinlan: First, review costs and coverage. Sometimes, it makes sense to pay a higher premium for coverage if it saves you more in out-of-pocket costs when you actually buy your prescription drugs. There is, as you mention, the widely discussed Medicare drug “donut hole”. If you’re a beneficiary, your Social Security number is prominently displayed on the front of your Medicare card. For 2016, that cost is expected to rise by more than 6% to $496. Your resources must be limited to $13,640 for an individual or $27,250 for a married couple living together. Your State Health Insurance Assistance Program may also be able to help you navigate your choices. Should you enroll in “traditional” Medicare or a managed-care option? Many people, including me, point to Medicare as an example of a single-payer, government administered health plan that might, someday, be the model for a national health service in the United States. You can also locate an insurance agent/broker that is up to speed on Medicare insurance matters.

For information about Medicare, contact SHIIP at 1-800- 234-7119.