tag:blogger.com,1999:blog-72562831602620890312024-02-18T22:14:00.873-05:00AH Insurance ServicesAH Insurance Services, Inc. is an independently owned Life & Health Insurance Agency based in the Tampa Bay area. Our mission is to provide reliable advice and superior service at all times. Consult us when you have questions about insurance, or if you are shopping for new coverage. Our products include Medicare Health & Drug Plans, Health Plans for < Age 65, Long Term Care Insurance, Life Insurance and Fixed Annuities.Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.comBlogger81125tag:blogger.com,1999:blog-7256283160262089031.post-35025951988841805302023-09-13T23:30:00.001-04:002023-09-13T23:30:50.213-04:00Medicare Part D Enrollees to Benefit from Program Changes in 2024 and 2025<p>With nearly two decades having passed since Medicare Part D became
operational, notable program improvements are on the horizon for 2024 and 2025.</p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal">For background, Medicare Part D is prescription drug
coverage available to Medicare Beneficiaries enrolled in Part A and/or Part B. <span style="mso-spacerun: yes;"> </span>Beneficiaries access this voluntary program
through private insurance carriers and can obtain coverage through a standalone
Prescription Drug Plan (PDP) or a Medicare Advantage Prescription Drug (MA-PD)
plan (must have both Medicare Parts A and B to enroll in MA-PD).<br />
<br />
<b>Medicare Part D plans run on a calendar year basis (subject to change each
year) in distinct stages:<o:p></o:p></b></p>
<p class="MsoNormal">• Deductible – enrollees are responsible for a plan
deductible up to a maximum ($505 in calendar year 2023).<span style="mso-spacerun: yes;"> </span>Some PDPs do not have any deductible (this feature
may come with a higher plan premium).<o:p></o:p></p>
<p class="MsoNormal">• Initial Coverage – after the Deductible is reached, enrollees
have a copay ($) or coinsurance (%) based on each drug’s “Tier Level” as shown in
the plan formulary.<span style="mso-spacerun: yes;"> </span>The standard Part D
design allows plans to charge up to 25% coinsurance, but actual costs will vary
and often are lower.<span style="mso-spacerun: yes;"> </span>Medicines must be
on the plan formulary, or they will not be covered at all (unless an exception
applies).<span style="mso-spacerun: yes;"> </span>This stage continues until the
consumer’s out-of-pocket costs PLUS the amount the plan pays reaches $4,660 (in
2023).<o:p></o:p></p>
<p class="MsoNormal">• Coverage Gap (“Donut Hole”) – in this stage, under the original
standard design of the Part D program, enrollees bore the full cost of their medicines.<span style="mso-spacerun: yes;"> </span>Prior to 2023, the program was gradually liberalized
so that in this stage, enrollees pay only 25% of drug costs (with the remainder
covered by manufacturer discounts).<span style="mso-spacerun: yes;"> </span>During
each year, enrollees exit the Donut Hole once their True Out-of-Pocket (TrOOP)
costs reach a threshold level ($7,400 in 2023).<span style="mso-spacerun: yes;">
</span>It should be noted that TrOOP includes what the manufacturers pay, in
addition to costs paid by the enrollee (it does not include what the plan pays
during Initial Coverage).<o:p></o:p></p>
<p class="MsoNormal">• Catastrophic Coverage – the final stage in a calendar year
once an enrollee has hit the Part D TrOOP.<span style="mso-spacerun: yes;">
</span>In this stage, in calendar year 2023, enrollees pay the <i>greater</i>
of 5% of drug costs, or $4.15 for generics and $10.35 for brand names.<span style="mso-spacerun: yes;"> </span>For very costly medicines, the 5% enrollee portion
can add up quickly.<o:p></o:p></p>
<p class="MsoNormal">To illustrate actual 2023 out-of-pocket drug costs on a
standalone PDP, let's review a hypothetical example for a Medicare beneficiary living in
Tampa, Florida and taking one costly medicine -- <b>Pomalyst 3mg capsule.</b><span style="mso-spacerun: yes;"> </span>Then, we will see how much the enrollee's out-of-pocket costs will be reduced in 2024 and 2025.<o:p></o:p></p>
<p class="MsoNormal">The monthly premium is ignored, but it should be noted that
the Plan Sponsor selected in this example provides the lowest standalone Part D 2023 calendar
year costs including premiums and drug copays.<o:p></o:p></p>
<p class="MsoNormal">According to the Medicare plan finder, this consumer travels
through both Initial Coverage and the Coverage Gap in January.<span style="mso-spacerun: yes;"> </span>The $7,400 TrOOP is reached, with the enrollee’s
out-of-pocket drug cost equal to $3,080.<span style="mso-spacerun: yes;"> </span>For the rest of the year, the enrollee is in Catastrophic
Coverage paying $1,188 monthly (5% of $23,762 pharmacy retail cost).<span style="mso-spacerun: yes;"> </span>Over the whole calendar year, the enrollee’s
out-of-pocket drug costs exceed $16,000 (based on the specific 2023 PDP and retail pharmacy).<o:p></o:p></p>
<p class="MsoNormal"><b>So, what will change in 2024 and how will this enrollee
be impacted?<o:p></o:p></b></p>
<p class="MsoNormal">In 2024, costs in the Catastrophic stage change so that <b>the
5% coinsurance requirement is eliminated</b> (Part D plans will pay 20% of
total drug costs in this phase instead of 15%).<span style="mso-spacerun: yes;">
</span>Once Part D enrollees (without low-income subsidies, called LIS), have
drug spending high enough to qualify for Catastrophic Coverage, they are no
longer required to pay 5% of their drug costs, which in effect caps their
expenses.</p>
<p class="MsoNormal">In 2024, the Catastrophic stage threshold will be set at
$8,000.<span style="mso-spacerun: yes;"> </span>As noted above, this amount
includes what Part D enrollees spend out of pocket plus the value of manufacturer
discounts in the Coverage Gap.<span style="mso-spacerun: yes;"> </span>Under
this construct, Part D enrollees who take only brand-name drugs in 2024 will spend
approximately $3,300 out of pocket and then have no further cost for covered medicines.<span style="mso-spacerun: yes;"> </span>So, in the example cited, the enrollee reduces
out-of-pocket medicine costs from over $16,000 in 2023 to about $3,300 in
2024.<o:p></o:p></p>
<p class="MsoNormal"><b>So, what is changing in 2025 and how will this enrollee
be further impacted?<o:p></o:p></b></p>
<p class="MsoNormal"><b>Out-of-pocket drug spending will be capped at $2,000.<o:p></o:p></b></p>
<p class="MsoNormal">Beginning in 2025, Part D enrollees’ out-of-pocket drug
costs will be capped at $2,000.<span style="mso-spacerun: yes;"> </span>This
amount will be indexed to rise each year after 2025 at the rate of growth in
per capita Part D costs. <span style="mso-spacerun: yes;"> </span>(This cap does
not apply to out-of-pocket spending on prescription drugs covered under Medicare
Part B.)<o:p></o:p></p>
<p class="MsoNormal">For Part D enrollees who take only brand name drugs, annual
out-of-pocket costs at the Catastrophic threshold will fall from around $3,300
in 2024 to $2,000 in 2025. <span style="mso-spacerun: yes;"> </span>In other
words, Part D enrollees who take only brand name drugs with costs high enough
to reach the Catastrophic stage should expect to realize savings of about
$1,300 in 2025 as compared to 2024 spending.<o:p></o:p></p>
<p class="MsoNormal"><b>The Coverage Gap will be completely eliminated.<o:p></o:p></b></p>
<p class="MsoNormal">The Coverage Gap stage, where Part D enrollees had faced
100% of total drug costs under the original Part D design and currently face 25%
of costs, will be eliminated in 2025. <span style="mso-spacerun: yes;"> </span>This
means that Part D enrollees will no longer face an increase in cost sharing at the end of the Initial Coverage stage, which is the case in most Part D plans, since today's plans usually vary the cost-sharing amounts instead of charging the standard 25% coinsurance during Initial Coverage.<o:p></o:p></p>
<p class="MsoNormal"><b>Part D plans and drug manufacturers will pay a larger
share of costs for Catastrophic Coverage, and Medicare will pay a smaller share.<o:p></o:p></b></p>
<p class="MsoNormal">Medicare’s share of total costs in the Catastrophic stage
(reinsurance) will decrease from 80% to 20% for brand-name drugs and from 80%
to 40% for generic drugs beginning in 2025. <span style="mso-spacerun: yes;"> </span>This reduction will help address concerns
about the substantial increase in Medicare’s reinsurance payments to Part D
plans over time, which accounted for close to half (48%) of total Part D
spending in 2022, up from 14% in 2006, based on data from the Medicare Trustees
2023 annual report.<span style="mso-spacerun: yes;"> </span>Medicare Part D
plans’ share of costs will increase from 15% to 60% for both brands and
generics above the cap, and drug manufacturers will be required to provide a
20% price discount on brand-name drugs.<o:p></o:p></p>
<p class="MsoNormal"><b>Part D plans and manufacturers will face changes to their
share of total drug costs paid in the Initial Coverage stage.<o:p></o:p></b></p>
<p class="MsoNormal">Drug manufacturers will be required to provide a 10%
discount on brand-name drugs in the Initial Coverage state beginning in 2025,
replacing the 70% price discount in the Coverage Gap stage under the current design.
<span style="mso-spacerun: yes;"> </span>Part D plans will pay 65% of brand-name
drug costs.<o:p></o:p></p>
<p class="MsoNormal">For further information and graphics that illustrate upcoming
Part D changes in greater detail, please refer to this informative article from
the Kaiser Family Foundation:</p><p class="MsoNormal"><span style="color: white;"><i style="background-color: #fcff01;"><a href="https://www.kff.org/medicare/issue-brief/changes-to-medicare-part-d-in-2024-and-2025-under-the-inflation-reduction-act-and-how-enrollees-will-benefit/">https://www.kff.org/medicare/issue-brief/changes-to-medicare-part-d-in-2024-and-2025-under-the-inflation-reduction-act-and-how-enrollees-will-benefit/</a>.</i></span><o:p></o:p></p>
<p class="MsoNormal">Until next time,<o:p></o:p></p>
<p class="MsoNormal">Andrew Herman<o:p></o:p></p>Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-72962706428868148662023-05-31T18:48:00.000-04:002023-05-31T18:48:40.172-04:00Highlights of the 2023 Medicare Trustees Report<p><span style="font-family: helvetica;"><span style="background-color: white; color: #58585a;">The 2023 Medicare</span><span style="background-color: white; color: #58585a;"> </span><a href="https://www.cms.gov/oact/tr/2023" rel="noopener" style="box-sizing: border-box; color: #476fa0; font-weight: bold; text-decoration-line: none; transition: opacity 0.25s ease-in-out 0s;" target="_blank">Trustees Report</a><span style="background-color: white; color: #58585a;"> spelled good news for the program’s short-term viability but should not delay Congress from seeking a long-term solution that protects the health care of older Americans, experts agreed.</span></span></p><p style="background-color: white; box-sizing: border-box; color: #58585a; max-width: 100%;"><span style="font-family: helvetica;">As part of a webinar this month sponsored by the American Academy of Actuaries, the Centers for Medicare & Medicaid Services’ (CMS) Chief Actuary Paul Spitalnik reported on the program’s finances as detailed in the report. Three other panelists shared insights on how Medicare’s Hospital Insurance trust fund might remain solvent beyond the currently projected exhaustion date, and more generally how to make the program more sustainable in the long-term.</span></p><p style="background-color: white; box-sizing: border-box; color: #58585a; max-width: 100%;"><span style="font-family: helvetica;">For background, the Medicare Program consists of multiple parts:</span></p><p style="background-color: white; box-sizing: border-box; color: #58585a; max-width: 100%;"><span style="font-family: helvetica;"><b>Part A</b> - Covers inpatient hospital and skilled nursing care, post-institutional home health care, and hospice care.</span></p><p style="background-color: white; box-sizing: border-box; color: #58585a; max-width: 100%;"><span style="font-family: helvetica;">Part A has about 65 million enrollees and is funded primarily by Medicare payroll taxes (1.45% paid by employees and employers, each; 2.90% paid by self-employed; additional .90% paid by high-income earners; and no cap on annual taxable earnings as is the case with the Social Security payroll tax). Calendar year 2022 expenditures were $342.7 billion.</span></p><p style="background-color: white; box-sizing: border-box; color: #58585a; max-width: 100%;"><span style="font-family: helvetica;"><b>Part B</b> - Covers physician services, outpatient hospital, diagnostic testing, durable medical equipment, ambulance, some additional services such as general home health care, and physician-administered drugs.</span></p><p style="background-color: white; box-sizing: border-box; color: #58585a; max-width: 100%;"><span style="font-family: helvetica;">Part B has about 60 million enrollees and is funded approximately 30% by monthly premiums paid by Medicare beneficiaries ($164.90 standard premium for 2023 plus additional premiums charged to high-income earners) and 70% by government contributions coming from general taxation. A small portion of revenue stems from fees imposed on drug manufacturers. Calendar year 2022 expenditures were $436.7 billion.</span></p><p style="background-color: white; box-sizing: border-box; color: #58585a; max-width: 100%;"><span style="font-family: helvetica;"><b>Part D</b> - Covers prescription drugs.</span></p><p style="background-color: white; box-sizing: border-box; color: #58585a; max-width: 100%;"><span style="font-family: helvetica;">Part D has slightly over 50 million enrollees and is funded by premiums paid by Medicare beneficiaries (average monthly premium is about $32, funding about 15% of total revenues), additional premiums charged to high-income earners, general federal revenues, and state transfers. Calendar year 2022 expenditures were $125.7 billion.</span></p><p style="background-color: white; box-sizing: border-box; color: #58585a; max-width: 100%;"><span style="font-family: helvetica;"><b>Part C</b> - Medicare Advantage program.</span></p><p style="background-color: white; box-sizing: border-box; color: #58585a; max-width: 100%;"><span style="font-family: helvetica;">The Part C (Medicare Advantage) program is an option for Medicare beneficiaries that are enrolled in both Part A and Part B and live in the service area where the private plan of choice is offered. These plans are provided on a calendar-year basis by plan sponsors contracted with Medicare. Medicare Advantage plans, which typically include Part D coverage, now cover close to half of Medicare beneficiaries nationwide.</span></p><p style="background-color: white; box-sizing: border-box; color: #58585a; max-width: 100%;"><span style="font-family: helvetica;">The Medicare program has grown dramatically in both enrollment and paid benefits over the past four decades. In 1982, Medicare benefits totaled $46.6 billion, or 1.4% of the nation’s gross domestic product (GDP). The 2023 report found that had grown to $911.2 billion overall, or 3.6% of GDP.</span></p><p style="background-color: white; box-sizing: border-box; color: #58585a; max-width: 100%;"><b><span style="font-family: helvetica;">Key highlights of the 2023 Medicare Trustees report are as follows:</span></b></p><p style="background-color: white; box-sizing: border-box; color: #58585a; max-width: 100%;"><span style="font-family: helvetica;">The Part A Hospital Insurance trust fund (a long term reserve that has been set aside to cover future costs) is projected to be depleted by the year 2031, three years <i>later</i> than forecast in last year's report. This is great news for the program's short-term viability, yet the eventual financial shortfall will need to be addressed to avoid reduction in program benefits.</span></p><p style="background-color: white; box-sizing: border-box; max-width: 100%;"><span style="color: #58585a; font-family: helvetica;">The Inflation Reduction Act of 2022, intended to tamp down inflation and reduce the federal budget deficit, will impact Medicare in several ways:</span></p><p style="background-color: white; box-sizing: border-box; max-width: 100%;"><span style="color: #58585a; font-family: helvetica;">• Reduces government expenditures for physician and outpatient services covered under Part B</span></p><p style="background-color: white; box-sizing: border-box; max-width: 100%;"><span style="color: #58585a; font-family: helvetica;">• Increases expenditures for Part D through 2030</span></p><p style="background-color: white; box-sizing: border-box; max-width: 100%;"><span style="color: #58585a; font-family: helvetica;">• Decreases Part D expenditures beginning in 2031</span></p><p style="background-color: white; box-sizing: border-box; color: #58585a; max-width: 100%;"><span style="font-family: helvetica;">In the long-term, experts expect the Inflation Reduction Act of 2022 will be beneficial to the financial health of the Medicare program.</span></p><p style="background-color: white; box-sizing: border-box; color: #58585a; max-width: 100%;"><span style="font-family: helvetica;">While the COVID-19 pandemic caused higher costs for acute treatment, those costs have been more than offset by deaths of seriously ill Medicare beneficiaries as well as reduced spending for non-COVID care.</span></p><p style="background-color: white; box-sizing: border-box; max-width: 100%;"><span style="color: #58585a; font-family: helvetica;">The growing number of members portends long-term challenges. </span><span style="background-color: transparent;"><span style="color: #58585a; font-family: helvetica;">James Mathews, executive director of the Medicare Payment Advisory Commission (MedPAC), noted that the number of program beneficiaries is expected to increase from the current 65 million to 80 million in the next decade. At the same time, the number of workers supporting those on Medicare is projected to decrease from 4 per enrollee to 2.5 per enrollee.</span></span></p><p style="background-color: white; box-sizing: border-box; max-width: 100%;"><span style="color: #58585a; font-family: helvetica;">To control costs, MedPAC is advising cuts to post-acute care payments in 2024 as well as reducing Medicare Advantage plan payments in excess of payments made to Original Medicare. MedPAC also continues to advocate for reductions in Part D plans’ reliance on cost-based reinsurance and improved incentives to manage benefits. However, Mathews said a hike in hospital payment rates is necessary to cover rising hospital costs.</span></p><p style="background-color: white; box-sizing: border-box; max-width: 100%;"><span style="color: #58585a; font-family: helvetica;">Marilyn Serafini, executive director of the Bipartisan Policy Center’s Health Program, said it is </span><span style="color: #58585a; font-family: helvetica;">essential that Congress seek out a bipartisan solution that will keep Medicare fully functioning. Her group is currently in the midst of crafting recommendations to improve the program in the long-term.</span></p><p style="background-color: white; box-sizing: border-box; max-width: 100%;"><span style="color: #58585a; font-family: helvetica;">It is developing a set of principles to guide policymakers, including improving the enrollment process, simplifying and improving the traditional Medicare benefit, promoting price competition in both Original Medicare and Medicare Advantage, and re-evaluating the trust fund structure and accountability mechanisms.</span></p><p style="background-color: white; box-sizing: border-box; max-width: 100%;"><span style="color: #58585a; font-family: helvetica;">It is extremely likely additional funds will be needed to support growing Medicare enrollment. Bowen Garrett, senior health fellow at the Urban Institute, noted that Congress in the past has always acted when the program neared fund exhaustion—as is happening now. That’s for good reason, as doing nothing “would be a significant stressor on providers.”</span></p><p style="background-color: white; box-sizing: border-box; max-width: 100%;"><span style="color: #58585a; font-family: helvetica;">The Urban Institute has examined 12 different options to raise revenues, ranging from an across-the-board increase in payroll or income taxes, to taxing health care benefits, or targeting solutions that would only impact more wealthy Americans or businesses.</span></p><p style="background-color: white; box-sizing: border-box; max-width: 100%;"><span style="color: #58585a; font-family: helvetica;">Regardless of the path taken, there was broad agreement for congressional action in the near future to save Medicare for future generations. “Demographics are pretty clear,” CMS Chief Actuary Spitalnic said. “It is a question of when it will be depleted.”</span></p><p style="background-color: white; box-sizing: border-box; max-width: 100%;"><span style="color: #58585a; font-family: helvetica;">Until next time,</span></p><div style="background-color: white; box-sizing: border-box; max-width: 100%; text-align: left;"><span style="color: #58585a; font-family: helvetica;">Andrew Herman, President</span></div><div style="background-color: white; box-sizing: border-box; max-width: 100%; text-align: left;"><span style="color: #58585a; font-family: helvetica;">AH Insurance Services, Inc.</span></div><p style="background-color: white; box-sizing: border-box; color: #58585a; max-width: 100%;"><br /></p>Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-72691234686933587172023-01-16T18:21:00.001-05:002023-01-16T18:22:53.058-05:002023 Medicare – New Expanded Enrollment Access, Update to Premiums and Deductibles, and New Immunosuppressive Drug Benefit<p><b><span style="color: #7030a0; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">CMS Updates Medicare Enrollment
and Eligibility Rules</span></b></p>
<p class="MsoNormal" style="background: white; line-height: 15pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #444444; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">On
October 28, 2022, the Centers for Medicare & Medicaid Services (CMS) issued
a final rule effective on January 1, 2023, updating Medicare enrollment and
eligibility rules to expand coverage for people with Medicare and advance
health equity.<span style="mso-spacerun: yes;"> </span>Among the changes,
Medicare coverage now becomes effective the month after enrollment for
individuals signing up in the last three months of their Initial Election
Period, or in the General Election Period, thereby reducing potential gaps in
coverage.<o:p></o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: 15pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #444444; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">The
rule also expands access through Medicare special enrollment periods (SEPs) and
allows eligible beneficiaries to receive Medicare Part B coverage without a
late enrollment penalty.<span style="mso-spacerun: yes;"> </span>Examples of new
SEPs created by this rule are SEPs for eligible individuals who miss an
enrollment opportunity because:<o:p></o:p></span></p>
<ol start="1" type="1">
<li class="MsoNormal" style="background: white; color: #444444; line-height: 15pt; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">They were
impacted by a disaster or government-declared emergency;<o:p></o:p></span></li>
<li class="MsoNormal" style="background: white; color: #444444; line-height: 15pt; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Their
employer or health plan materially misrepresented information related to
timely enrollment in Medicare Part B;<o:p></o:p></span></li>
<li class="MsoNormal" style="background: white; color: #444444; line-height: 15pt; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">They were
incarcerated; and<o:p></o:p></span></li>
<li class="MsoNormal" style="background: white; color: #444444; line-height: 15pt; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Their
Medicaid coverage was terminated after the COVID-19 Public Health
Emergency (PHE)s ends or on or after January 1, 2023 (whichever is
earlier).<o:p></o:p></span></li>
</ol>
<p class="MsoNormal" style="background: white; line-height: 15pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><b><span style="color: #444444; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">These changes are related to Original Medicare A/B eligibility
only. <span style="mso-spacerun: yes;"> </span>They do not apply to Medicare
Advantage. <span style="mso-spacerun: yes;"> </span>The effective dates and SEPs
for Medicare Advantage remain unchanged.</span></b><span style="color: #444444; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: 15pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #444444; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">The
final rule also establishes a new immunosuppressive drug benefit that extends
vital Medicare immunosuppressive drug coverage to individuals who have had a
kidney transplant and otherwise would lose Medicare coverage.<o:p></o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: 15pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #444444; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">To
view the final rule, refer to this link:</span></p><p class="MsoNormal" style="background: white; line-height: 15pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #444444; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><i><b><u><a href="https://www.federalregister.gov/documents/2022/11/03/2022-23407/medicare-program-implementing-certain-provisions-of-the-consolidated-appropriations-act-2021-and" target="_blank">https://www.federalregister.gov/documents/2022/11/03/2022-23407/medicare-program-implementing-certain-provisions-of-the-consolidated-appropriations-act-2021-and</a></u>.</b></i><o:p></o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: 15pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><b><span style="color: #7030a0; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">2023 Medicare Part A Premium, Deductible, and Coinsurance Amounts<o:p></o:p></span></b></p>
<p class="MsoNormal"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Medicare Part A covers inpatient hospital, skilled nursing
facility, and some home health care services.<span style="mso-spacerun: yes;">
</span>About 99 percent of Medicare beneficiaries qualify for premium-free Part
A due to having at least 40 quarters of their own Medicare-covered employment
(or the work history of a spouse), or two years having passed from initial eligibility
for Social Security Disability benefits.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Enrollees aged 65 and over who have fewer than 40 quarters of
coverage and certain persons with disabilities must pay premium for Medicare
Part A.<span style="mso-spacerun: yes;"> </span>Individuals who had at least 30
quarters of coverage or were married to someone with at least 30 quarters of
coverage may buy into Part A at a reduced monthly premium rate of $278 in 2023
(increase of $4 from 2022).<span style="mso-spacerun: yes;"> </span>Certain
uninsured aged individuals who have less than 30 quarters of coverage and
certain individuals with disabilities who have exhausted other entitlement will
pay the full premium of $506 a month in 2023 (up $7 from 2022).</span></p>
<p class="MsoNormal"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">The Medicare Part A inpatient hospital deductible that
beneficiaries pay if admitted to the hospital is $1,600 in 2023 (increase of
$44 from 2022).<span style="mso-spacerun: yes;"> </span>The Part A inpatient
hospital deductible covers beneficiaries’ share of costs for the first 60 days
of Medicare-covered inpatient hospital care in a benefit period.<span style="mso-spacerun: yes;"> </span>In 2023, beneficiaries must pay a coinsurance
amount of $400 per day for the 61<sup>st</sup> through 90<sup>th</sup> day
of a hospitalization (increase of $11 from 2022) in a benefit period and $800
per day for lifetime reserve days (increase of $22 from 2022).<span style="mso-spacerun: yes;"> </span>For skilled nursing facilities, the daily
coinsurance for days 21 through 100 of extended care services in a benefit
period is $200.00 in 2023 (up $5.50 from 2022).<o:p></o:p></span></p>
<p class="MsoNormal"><b><span style="color: #7030a0; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">2023 Medicare Part B Premium and Deductible Amounts<o:p></o:p></span></b></p>
<p class="MsoNormal"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Medicare Part B covers physician services, outpatient hospital
services, certain home health services, durable medical equipment, and certain
other medical and health services not covered by Medicare Part A.<span style="mso-spacerun: yes;"> </span>General tax revenues, along with premiums
paid by Medicare beneficiaries, fund the Part B program.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">There is a special rule for Social Security recipients, called the
“hold harmless rule,” that ensures that Social Security benefits will not
decline from one year to the next because of an increase in the Medicare Part B
premium.<span style="mso-spacerun: yes;"> </span>Whether this rule comes into
play in any year depends on the amount of Cost of Living Adjustment (COLA) and
the Medicare Part B premium increase.<span style="mso-spacerun: yes;">
</span>The hold harmless rule applies in 2023 for those people who had been
paying the standard Part B premium, and their Medicare Part B premium increased
but the Social Security COLA amount was not large enough to cover the
increase.<span style="mso-spacerun: yes;"> </span>Those who are subject to the
2023 hold harmless rule pay less than the $164.90 standard Part B premium.<span style="mso-spacerun: yes;"> </span>All others pay the 2023 not held harmless
premium, which is determined based on the Modified Adjusted Gross Income (MAGI)
as reported on the individual’s 2021 tax return.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">The standard monthly premium for Medicare Part B enrollees is
$164.90 for 2023, a decrease of $5.20 from $170.10 in 2022.<span style="mso-spacerun: yes;"> </span>In most years (unlike 2023), the Medicare
Part B premium rises. <span style="mso-spacerun: yes;"> </span>Medicare Part B
enrollees will pay the standard $164.90 Part B premium amount in 2023 unless:<o:p></o:p></span></p>
<ul style="margin-top: 0in;" type="disc">
<li class="MsoNormal" style="mso-list: l1 level1 lfo2; tab-stops: list .5in;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">You
have Medicare and Medicaid, and Medicaid pays your premiums. <span style="mso-spacerun: yes;"> </span>(Your state will pay the standard premium
amount.)<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l1 level1 lfo2; tab-stops: list .5in;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Your
modified adjusted gross income as reported on your IRS tax return from 2
years ago is above a certain amount. <span style="mso-spacerun: yes;"> </span>If so, you’ll pay the standard premium
amount and an Income Related Monthly Adjustment Amount (IRMAA). <span style="mso-spacerun: yes;"> </span>IRMAA is an extra charge added to your
premium.<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l1 level1 lfo2; tab-stops: list .5in;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">You
are protected by the "hold harmless" rule discussed above.<o:p></o:p></span></li>
</ul>
<p class="MsoNormal"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Since 2007, a beneficiary’s Part B monthly premium is based on his
or her income.<span style="mso-spacerun: yes;"> </span>These income-related
monthly adjustment amounts affect less than 10 percent of people with Medicare
Part B. <b>The 2023 Part B premiums based on MAGI from the 2021 tax
return are shown in the following table:</b></span></p>
<span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><span style="mso-bookmark: _Hlk124773467;"></span><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="background: rgb(1, 69, 108); mso-cellspacing: 0in; mso-padding-alt: 0in 0in 0in 0in; mso-yfti-tbllook: 1184;">
<tbody><tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="border: 1pt solid white; mso-border-alt: solid white .75pt; padding: 3pt 6.75pt;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><b><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Beneficiaries who file individual tax
returns with income:</span></b></span><span style="mso-bookmark: _Hlk124773467;"><b><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></b></span></p>
</td>
<td style="border: 1pt solid white; mso-border-alt: solid white .75pt; padding: 3pt 6.75pt;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><b><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Beneficiaries who file joint tax
returns with income:</span></b></span><span style="mso-bookmark: _Hlk124773467;"><b><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></b></span></p>
</td>
<td style="border: 1pt solid white; mso-border-alt: solid white .75pt; padding: 3pt 6.75pt;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><b><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">2023 Part B premium not held harmless</span></b></span><span style="mso-bookmark: _Hlk124773467;"><b><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></b></span></p>
</td>
<td style="border: 1pt solid white; mso-border-alt: solid white .75pt; padding: 3pt 6.75pt;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><b><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Premium level</span></b></span><span style="mso-bookmark: _Hlk124773467;"><b><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></b></span></p>
</td>
</tr>
<tr style="mso-yfti-irow: 1;">
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Less than or equal to $97,000</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Less than or equal to $194,000</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">$164.90</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Standard</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
</tr>
<tr style="mso-yfti-irow: 2;">
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than $97,000 and less than or
equal to $123,000</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than $194,000 and less than or
equal to $246,000</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">$230.80</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">1.4 x standard</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
</tr>
<tr style="mso-yfti-irow: 3;">
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than $123,000 and less than or
equal to $153,000</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than $246,000 and less than or
equal to $306,000</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">$329.70</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">2.0 x standard</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
</tr>
<tr style="mso-yfti-irow: 4;">
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than $153,000 and less than or
equal to $183,000</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than $306,000 and less than or
equal to $366,000</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">$428.60</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">2.6 x standard</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
</tr>
<tr style="mso-yfti-irow: 5;">
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than $183,000 and less than
$500,000</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than $366,000 and less than
$750,000</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">$527.50</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">3.2 x standard</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
</tr>
<tr style="mso-yfti-irow: 6; mso-yfti-lastrow: yes;">
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than or equal to $500,000</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than or equal to $750,000</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">$560.50</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">3.4 x standard</span></span><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></span></p>
</td>
</tr>
</tbody></table>
<p class="MsoNormal"><span style="mso-bookmark: _Hlk124773467;"><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><br />
</span></span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Medicare Part B has an annual deductible of $226 in 2023 (down $7
from 2022), then Medicare beneficiaries are responsible for 20% of the
Medicare-approved amount for services.</span></p><p class="MsoNormal"><b><span style="color: #7030a0; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">2023 Medicare Part D Premiums</span></b></p>
<p class="MsoNormal" style="background: rgb(250, 250, 250); line-height: normal; margin-bottom: 0.2in;"><span style="color: #323a45; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Since 2011, Medicare beneficiaries’
Part D premiums have been based on income.<span style="mso-spacerun: yes;">
</span>In addition to any Part D plan premium, there is an income-related
monthly adjustment amount (IRMAA) impacting less than 10% percent of people with
Medicare Part D. <span style="mso-spacerun: yes;"> </span>Part D premiums vary
from plan to plan (note when Part D benefits are included in a Part C Medicare
Advantage plan, there may not be any premium).<span style="mso-spacerun: yes;">
</span>Roughly two-thirds of beneficiaries pay premiums directly to the plan,
while the remaining beneficiaries have their premiums deducted from their
Social Security benefit checks. <span style="mso-spacerun: yes;"> </span>Regardless
of how a beneficiary pays their Part D premium, the Part D income-related
monthly adjustment amounts are deducted from Social Security benefit checks or
paid directly to Medicare. <span style="mso-spacerun: yes;"> </span>The 2023 Part
D income-related monthly adjustment amounts for high-income beneficiaries are
shown in the following table:</span><span style="background-color: transparent;"> </span></p>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="background: rgb(1, 69, 108); mso-cellspacing: 0in; mso-padding-alt: 0in 0in 0in 0in; mso-yfti-tbllook: 1184;">
<tbody><tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="border: 1pt solid white; mso-border-alt: solid white .75pt; padding: 3pt 6.75pt;">
<p class="MsoNormal"><b><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Beneficiaries who file
individual tax returns with income:</span></b><b><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></b></p>
</td>
<td style="border: 1pt solid white; mso-border-alt: solid white .75pt; padding: 3pt 6.75pt;">
<p class="MsoNormal"><b><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Beneficiaries who file
joint tax returns with income:</span></b><b><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></b></p>
</td>
<td style="border: 1pt solid white; mso-border-alt: solid white .75pt; padding: 3pt 6.75pt;">
<p class="MsoNormal"><b><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">2023 Part D base premium*</span></b><b><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></b></p>
</td>
<td style="border: 1pt solid white; mso-border-alt: solid white .75pt; padding: 3pt 6.75pt;">
<p class="MsoNormal"><b><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">IRMAA</span></b><b><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></b></p>
</td>
</tr>
<tr style="mso-yfti-irow: 1;">
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Less than or equal to
$97,000</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Less than or equal to
$194,000</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Plan premium</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">$0</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
</tr>
<tr style="mso-yfti-irow: 2;">
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than $97,000 and
less than or equal to $123,000</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than $194,000 and
less than or equal to $246,000</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Plan premium</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">$12.20</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
</tr>
<tr style="mso-yfti-irow: 3;">
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than $123,000 and
less than or equal to $153,000</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than $246,000 and
less than or equal to $306,000</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Plan premium</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">$31.50</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
</tr>
<tr style="mso-yfti-irow: 4;">
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than $153,000 and
less than or equal to $183,000</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than $306,000 and
less than or equal to $366,000</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Plan premium</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">$50.70</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
</tr>
<tr style="mso-yfti-irow: 5;">
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than $183,000 and
less than $500,000</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than $366,000 and
less than $750,000</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Plan premium</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">$70.00</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
</tr>
<tr style="mso-yfti-irow: 6; mso-yfti-lastrow: yes;">
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than or equal to
$500,000</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Greater than or equal to
$750,000</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">Plan premium</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
<td style="padding: 0in;">
<p class="MsoNormal"><span style="color: white; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext;">$76.40</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>
</td>
</tr>
</tbody></table>
<p class="MsoNormal" style="background: rgb(250, 250, 250); line-height: normal; margin-bottom: 0.2in;"><span style="color: #323a45; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><o:p> </o:p></span><span style="color: #323a45;">* Hold harmless rule
does not apply to Medicare Part D premiums for prescription drugs.</span></p>
<p class="MsoNormal" style="background: rgb(250, 250, 250); line-height: normal; margin-bottom: 0.2in;"><b><span style="color: #7030a0; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">New for 2023 -- Immunosuppressive
drug benefit </span></b><span style="color: #7030a0; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></p>
<p class="MsoNormal" style="background: rgb(250, 250, 250); line-height: normal; margin-bottom: 0.2in;"><span style="color: #323a45; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">If you only have
Medicare because of End Stage Renal Disease (ESRD), your Medicare coverage,
including immunosuppressive drug coverage, ends 36 months after a successful
kidney transplant. Medicare offers a benefit that helps you pay for your
immunosuppressive drugs <b>if you don't have certain types of other health
coverage </b>(like a group health plan, TRICARE, or Medicaid that covers
immunosuppressive drugs). <span style="mso-spacerun: yes;"> </span><b>This new
benefit only covers your immunosuppressive drugs and no other items or
services. <span style="mso-spacerun: yes;"> </span>It isn’t a substitute for full
health coverage. <span style="mso-spacerun: yes;"> </span>You can sign up for
this benefit anytime as long as you had Medicare because of ESRD at the time of
your kidney transplant. <span style="mso-spacerun: yes;"> </span></b>To sign up,
call Social Security at 1-800-772-1213. <span style="mso-spacerun: yes;"> </span>TTY
users can call 1-800-325-0788. <o:p></o:p></span></p>
<p class="MsoNormal" style="background: rgb(250, 250, 250); line-height: normal; margin-bottom: 0.2in;"><b><span style="color: #323a45; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Note: <span style="mso-spacerun: yes;"> </span></span></b><span style="color: #323a45; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">You’ll pay a monthly premium of $97.10 (or higher based on your
income) and $226 deductible for this benefit in 2023. <span style="mso-spacerun: yes;"> </span>Once you've met the deductible, you'll pay 20%
of the Medicare-approved amount for immunosuppressive drugs. If you have limited income and resources, you
may be able to get help from your state to pay for this benefit.</span></p><p class="MsoNormal" style="background: rgb(250, 250, 250); line-height: normal; margin-bottom: 0.2in;"><span style="color: #323a45; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Until next time,</span></p><p class="MsoNormal" style="background: rgb(250, 250, 250); line-height: normal; margin-bottom: 0.2in;"><span style="color: #323a45; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Andrew Herman</span></p>Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-53681704415617191732022-10-15T15:46:00.004-04:002022-10-15T15:46:58.330-04:00Medicare Annual Enrollment Period (AEP) Starts Today With Some Impact From Inflation Reduction Act<p><b>Medicare Annual Enrollment Period explained</b></p><p>The Medicare Annual Enrollment Period – AEP for short – is a set time each year during which Medicare beneficiaries can make new coverage choices. AEP runs from October 15th - December 7th, with new coverage effective on January 1st.</p><p>The actions you can take during AEP depend on your current coverage:</p><p><b>I. If you currently have Original Medicare (Parts A & B), you can:</b></p><p>•<span style="white-space: pre;"> </span>Join a Medicare Advantage plan (Part C) with or without built-in drug coverage. You may be charged a late enrollment penalty if you do not currently have other creditable drug coverage.</p><p>•<span style="white-space: pre;"> </span>Join a stand-alone Medicare prescription drug plan (Part D). A penalty may apply here as well if you do not currently have other creditable drug coverage.</p><p>•<span style="white-space: pre;"> </span>Make no changes and your current coverage will renew as is (unless there is a Plan Termination, which does not occur frequently).</p><p><b>II. If you currently have Original Medicare (Part A and/or Part B) and a stand-alone Medicare prescription drug plan (Part D), you can:</b></p><p>•<span style="white-space: pre;"> </span>Join a Medicare Advantage plan (Part C) with or without built-in drug coverage.</p><p>•<span style="white-space: pre;"> </span>Switch from your current Medicare prescription drug plan to another Medicare prescription drug plan.</p><p>•<span style="white-space: pre;"> </span>Drop Medicare prescription drug coverage completely. You may be charged a penalty if you decide to re-enroll in drug coverage later.</p><p>•<span style="white-space: pre;"> </span>Make no changes and your current coverage will renew as is.</p><p><b>III. If you currently have a Medicare Advantage plan (Part C) with built-in drug coverage, you can:</b></p><p>•<span style="white-space: pre;"> </span>Switch from your current Medicare Advantage plan to another Medicare Advantage plan with or without built-in drug coverage.</p><p>•<span style="white-space: pre;"> </span>Drop your Medicare Advantage plan and go back to Original Medicare.</p><p>•<span style="white-space: pre;"> </span>Join a stand-alone Medicare prescription drug plan if you go back to Original Medicare or if you switch to a Medicare Advantage plan that does not include drug coverage.</p><p>•<span style="white-space: pre;"> </span>Drop Medicare prescription drug coverage completely. You may be charged a penalty if you decide to re-enroll in drug coverage later.</p><p>•<span style="white-space: pre;"> </span>Make no changes and your current coverage will renew as is.</p><p><b>IV. If you currently have a Medicare Advantage plan (Part C) and a stand-alone Medicare prescription drug plan (Part D), you can:</b></p><p>•<span style="white-space: pre;"> </span>Switch from your current Medicare Advantage plan to another Medicare Advantage plan with or without built-in drug coverage.</p><p>•<span style="white-space: pre;"> </span>Switch from your current Medicare prescription drug plan to another Medicare prescription drug plan.</p><p>•<span style="white-space: pre;"> </span>Drop your Medicare Advantage plan and go back to Original Medicare.</p><p>•<span style="white-space: pre;"> </span>Drop Medicare prescription drug coverage completely. You may be charged a penalty if you decide to re-enroll in drug coverage later.</p><p>•<span style="white-space: pre;"> </span>Make no changes and your current coverage will renew as is.</p><p><b>Inflation Reduction Act Impacts - Part D Cost-Sharing Updates and New SEP</b></p><p>Effective January 1, 2023, the Inflation Reduction Act (IRA) will be in effect for all Medicare beneficiaries. The IRA was introduced in October this year and provides cost-share reductions to assist Medicare beneficiaries with their Part D drug expenses. The following updates will be reflected for Plan Year 2023:</p><p></p><ul style="text-align: left;"><li>Covered insulins will be capped at $35 per fill for a 30-day supply.</li><li>Part D vaccines (flu, shingles, pneumonia, COVID-19 etc.) will be $0.</li></ul><p></p><p><b>Cost-Share Reduction Information on the Medicare Plan Finder</b></p><p>Prior to October 1, 2022, the Medicare Plan Finder reflected insulin and vaccine benefits as they were submitted in the 2023 bids made by Plan Sponsors. Since the formulary submissions to CMS prior to the IRA being instated did not reflect the requirements highlighted above, some Part D coverage may not be accurately reflected on the Medicare Plan Finder. CMS is in the process of making updates to include new insulin and vaccine drug footnotes and other help features to explain the benefit changes resulting from the IRA.</p><p><b>New Special Enrollment Period (SEP)</b></p><p>Due to the inaccuracies in the Medicare Plan Finder, CMS is granting a Special Enrollment Period (SEP) for Exceptional Circumstances to allow members to add, drop, or change their Part D coverage if they find a better option after the 2022 Annual Enrollment Period (AEP) through the end of 2023. This SEP will be available for all beneficiaries who use a covered insulin product and begins on December 8, 2022 and ends on December 31, 2023. Beneficiaries may use this SEP one time during this period. To utilize this SEP, beneficiaries must call 1-800-MEDICARE so a customer service representative can process the enrollment change.</p><p>Until next time,</p><p>Andrew Herman</p>Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-9267075989660444332022-10-14T20:03:00.000-04:002022-10-14T20:03:12.168-04:00Affordability of Employer Coverage for Family Members of EmployeesEarlier this week, the Internal Revenue Service released a final rule changing the way health insurance affordability is determined for members of an employee’s family under Affordable Care Act (ACA) regulations.<div><br /></div><div>As discussed in the prior post, need-based calculations to determine eligibility for the federal ACA program and its subsidies consider only the employee, ignoring the spouse and children. In many cases, an employer pays all or a portion of the employee's premium but nothing towards other members of the household. In this case, ACA calculations determine that subsidized insurance is not available since the employer's health insurance is deemed "affordable" for the employee; but in fact, the family premium is prohibitively expensive and would be deemed unaffordable if the ACA need-based calculations included family members.</div><div><br /></div><div>Under the new rules that begin in 2023, if a consumer has an offer of employer-sponsored coverage that extends to the employee’s family, the affordability of that offer of coverage for the family members will be based on the family premium amount, not the amount the employee must pay for self-only coverage.</div><div><br /></div><div>This is a long-awaited solution to the "family glitch", which has been an issue since the ACA program's inception. The change will be reflected in the online application through the HealthCare.gov enrollment platform and Enhanced Direct Enrollment certified partner applications during this year’s Open enrollment period that starts on November 1, 2022. State-based Marketplaces not using the HealthCare.gov enrollment platform are also working to implement this change, but may have different implementation timelines. </div><div><br /></div><div>To view the final rule, please visit:</div><div><br /></div><div><a href="https://www.federalregister.gov/documents/2022/10/13/2022-22184/affordability-of-employer-coverage-for-family-members-of-employees" target="_blank"><span style="color: #a64d79;">"https://www.federalregister.gov/documents/2022/10/13/2022-22184/affordability-of-employer-coverage-for-family-members-of-employees"
</span></a></div>Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-74540292232207643562022-06-04T12:07:00.000-04:002022-06-04T12:07:17.005-04:00A Proposed Solution for the Affordable Care Act (ACA) Family Glitch<span style="font-family: arial;">In April, the Biden administration proposed a
solution to the ACA's "family glitch", a technical issue that has impacted family health premium subsidies since the program's inception.</span><div><span style="font-family: arial;"><br /></span></div><div><div><span style="font-family: arial;">Currently, people who are without access to "affordable" health insurance through a job may
qualify for a premium tax credit to be applied towards a plan on the ACA’s health insurance
marketplaces. However, regulations that determine if employer-based insurance is affordable give consideration only to the employee, without any need-based calculations allowed for spouse or children. </span></div><div><span style="font-family: arial;"><br /></span></div><div><span style="font-family: arial;"><span style="background-color: white; color: #0a2458; font-size: 16px;">In the current situation, family members of the employee may have access to coverage through the employer, but the cost is often prohibitive</span>ly<span style="background-color: white; color: #0a2458; font-size: 16px;"> expensive and out of reach for the househo</span>ld budget. <span style="background-color: white; color: #0a2458; font-size: 16px;">The so-called "family glitch" affects about five million people and has made it impossible for many families to use the premium tax credit to purchase an affordable ACA marketplace plan.</span><br style="background-color: white; box-sizing: border-box; color: #0a2458; font-size: 16px;" /></span></div><div><span style="font-family: arial;"><br /></span></div><div><span style="font-family: arial;">Should the proposed rule be finalized, family
members of workers with affordable self-only
coverage but unaffordable family coverage may
qualify for premium tax credits to buy an ACA plan,
according to a statement from the White House. The proposed rule would extend marketplace tax
credits to only the family members of workers who
are not offered affordable job-based family
coverage.</span></div></div><div><span style="font-family: arial;"><br /></span></div><div><span style="font-family: arial;">"Most people thought it would be up to Congress to
remedy the family glitch. But since getting
modifications through Congress has proved nearly
impossible, advocates have pushed for executive
action,” said Julie Rovner of Kaiser Health News.
“That is not as foolproof as passing a law and is
subject to a challenge through lawsuits."</span></div><div><span style="font-family: arial;"><br /></span></div><div><span style="font-family: arial;">It is not uncommon where employee-only coverage
is affordable but family coverage is not. Most
employers offer family coverage, but many do not
subsidize the cost for family members of the employee. The Kaiser Family Foundation’s 2021 Employer
Health Benefits Survey shows premiums and employee contributions have
increased significantly. In 2021, average premiums
for employee-only coverage were $7,739,
compared to $22,221 for family coverage. That's nearly $2,000/month!</span></div><div><span style="font-family: arial;"><br /></span></div><div><span style="font-family: arial;">The IRS will hold a hearing on the proposed rule on
June 27. Assuming the rule is finalized as
proposed, the family glitch would no longer exist,
and dependents offered unaffordable job-based
family coverage could be eligible for more
affordable marketplace coverage beginning in
2023.</span></div><div><span style="font-family: arial;"><br /></span></div><div><span style="font-family: arial;"><a href="https://www.whitehouse.gov/briefing-room/statements-releases/2022/04/05/fact-sheet-biden-harris-administration-proposes-rule-to-fix-family-glitch-and-lower-health-care-costs/" target="_blank"><b><span style="color: #2b00fe;">Click here</span></b></a> for the Fact Sheet distributed by the Biden Administration.</span></div><div><span style="font-family: arial;"><br /></span></div><div><span style="font-family: arial;">Until next time,</span></div><div><span style="font-family: arial;"><br /></span></div><div><span style="font-family: arial;">Andrew Herman</span></div><div><br /></div>Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-22529107422536777692021-11-15T19:35:00.001-05:002021-11-15T19:35:21.679-05:00CMS Announces 2022 Medicare Parts A & B Premiums and Deductibles<p><span style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px;">On November 12, the Centers for Medicare & Medicaid Services (CMS) released the 2022 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs, as well as the 2022 Medicare Part D income-related monthly adjustment amounts.</span></p><p style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;"><strong style="min-height: 0px; min-width: 0px;">Medicare Part B Deductible Increase</strong></p><p style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;">The annual Medicare Part B deductible increases to $233 in 2022, an increase of $30 from the $203 deductible level applicable in 2021. Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A.</p><p style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;"><strong style="min-height: 0px; min-width: 0px;">Medicare Part B Premium Increase</strong></p><p style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">Each year the Medicare Part B premium is set according to the Social Security Act. The standard monthly premium for most Medicare Part B enrollees will be $170.10 for 2022, an increase of $21.60 from the $148.50 monthly premium applicable in 2021.</span></p><p style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;">According to CMS the nearly 15% increase to the Medicare Part B premium and deductible levels are due to the following factors:</p><ul style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 1em 0px; min-height: 0px; min-width: 0px; padding: 0px 0px 0.25em 15px;"><li style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">Rising prices and utilization across the health care system that drive higher premiums year-over-year alongside anticipated increases in the intensity of care provided.</span></li></ul><ul style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 1em 0px; min-height: 0px; min-width: 0px; padding: 0px 0px 0.25em 15px;"><li style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">Congressional action to significantly lower the increase in the 2021 Medicare Part B premium, which resulted in the $3.00 per beneficiary per month increase in the Medicare Part B premium (that would have ended in 2021) being continued through 2025.</span></li></ul><ul style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 1em 0px; min-height: 0px; min-width: 0px; padding: 0px 0px 0.25em 15px;"><li style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">Additional contingency reserves due to the uncertainty regarding the potential use of the Alzheimer’s drug, Aduhelm™, by people with Medicare. In July 2021, CMS began a </span><span style="min-height: 0px; min-width: 0px;">National Coverage Determination</span><span style="min-height: 0px; min-width: 0px;"> analysis process to determine whether and how Medicare will cover Aduhelm™ and similar drugs used to treat Alzheimer’s disease. As that process is still underway, there is uncertainty regarding the coverage and use of such drugs by Medicare beneficiaries in 2022. While the outcome of the coverage determination is unknown, our projection in no way implies what the coverage determination will be, however, we must plan for the possibility of coverage for this high cost Alzheimer’s drug which could, if covered, result in significantly higher expenditures for the Medicare program.</span></li></ul><p style="background-color: #fafafa; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;"><span style="color: #323a45; font-family: Muli, Helvetica Neue, Arial, sans-serif;">CMS said the rise in Social Security benefits, which most of the 62 million people on Medicare, who are mostly 65 and older, collect will cover the expenses, as there is expected to be a 5.9% bump in 2022 monthly payments due to cost-of-living adjustment the agency said, the largest in 30 years.</span></p><p style="background-color: #fafafa; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;"><span style="color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif;">"This significant COLA increase will more than cover the increase in the Medicare Part B monthly premium," CMS said. "Most people with Medicare will see a significant net increase in Social Security benefits. For example, a retired worker who currently receives $1,565 per month from Social Security can expect to receive a net increase of $70.40 more per month after the Medicare Part B premium is deducted."</span></p><p style="background-color: #fafafa; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;"><span style="color: #323a45; font-family: Muli, Helvetica Neue, Arial, sans-serif;">The cost-of-living adjustment goes into effect in January and is estimated to average $71.40 per recipient.</span></p><p style="background-color: #fafafa; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;"><span style="color: #323a45; font-family: Muli, Helvetica Neue, Arial, sans-serif;"><a href="https://www.cms.gov/newsroom/fact-sheets/2022-medicare-parts-b-premiums-and-deductibles2022-medicare-part-d-income-related-monthly-adjustment" target="_blank">Click here</a> for the November 12th Fact Sheet published by CMS.</span></p><p style="background-color: #fafafa; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;"><span style="color: #323a45; font-family: Muli, Helvetica Neue, Arial, sans-serif;">Until next time,</span></p><p style="background-color: #fafafa; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;"><span style="color: #323a45; font-family: Muli, Helvetica Neue, Arial, sans-serif;">Andrew Herman</span></p>Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-42207304924569267802021-07-14T17:40:00.000-04:002021-07-14T17:40:00.293-04:002021 Guide to choosing a Medigap policy has been published by CMS<p>The official 2021 Guide to choosing a Medigap Policy has been published by the Centers for Medicare and Medicaid Services (CMS). This important guide covers topics such as:</p><ul><li>What is a Medicare Supplement Insurance (Medigap) policy</li><li>What Medigap policies cover</li><li>Your rights to buy a Medigap policy</li><li>How to buy a Medigap policy</li></ul>A Medigap policy is private health insurance that wraps around the Original Medicare Program (Parts A and B) by filling in gaps that otherwise would result in out-of-pocket costs. This means Medigap will pay some of the costs that Original Medicare doesn't cover, such as copayments, coinsurance and deductibles. During the six months that follows a Medicare Beneficiary's enrollment in Medicare Part B, Medigap can be purchased on a guaranteed issue basis regardless of health status. After the six months pass, insurance companies are allowed by law to decline or rate applicants due to health status.<div><br />Medigap plans, or Medicare Supplements, are known by their "plan letter name" such as Plan G or Plan N. Consumers who purchase Medigap typically also buy a Stand-alone Medicare Part D Prescription Drug Plan (PDP), since Medigap policies do not include any drug coverage.<br /><br />Medigap is entirely different from Medicare Advantage (also known as Medicare Part C), which is a program that delivers both Medicare health and drug benefits through a private insurance company on a year-to-year basis. Medicare Advantage plans, such as HMOs and PPOs, utilize insurance company networks and often require additional authorization for care access that is not required under Medigap policies. There is an Annual Election Period (AEP) for Medicare Advantage that runs from October 15th to December 7th; during this period a plan change can be made for the next January 1st. Medicare Beneficiaries also can disenroll from their Medicare Advantage plan during the AEP, and purchase a Medigap policy (as long as they meet the health eligibility requirements to buy a policy).<br /><div><br /></div><div><a href="https://ahinsuranceservices.com/documents/21-medigap.pdf" target="_blank"><span style="background-color: #01ffff;">Click Here To Download the 2021 Choosing a Medigap Policy Guide</span></a><br /><br />Until next time,<br /><br />Andrew Herman<br />AH Insurance Services, Inc.</div></div>Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-79415442295496078012021-07-01T21:15:00.000-04:002021-07-01T21:15:23.612-04:00Federal Long-Term Care WISH Act Introduced in U.S. House of Representatives<p>Earlier this week, U.S. Representative Thomas Suozzi introduced the WISH Act (H.R. 4289) to create a public catastrophic Long-Term Care Insurance program funded by a new payroll tax. The acronym stands for "Well-Being Insurance for Seniors to be at Home Act" (<a href="https://suozzi.house.gov/sites/suozzi.house.gov/files/WISHActBillText.pdf" rel="" target="_blank">click here to read H.R. 4289</a>).</p><p>The program is to be financed by a payroll tax of 0.3 percent for workers and 0.3 percent for employers; and it would pay out a monthly cash benefit of about $3,600 (indexed to inflation). This amount is estimated to pay for about six hours of in-home care daily. Family members would not be eligible to receive payment; and the individual entitled to the benefit must comply with State and Federal laws relating to minimum wage and withholding of payroll taxes and other employment-related taxes.</p><p>The following chart shows how 2021 payroll taxes would be increased by this new program:</p><p><br /></p><p><br /></p><p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEioKXw8hwGXEmt9XUOozKoVXGVeEA4YLXPMyb02dhwaQh4u2ewntYtAz7T1qkK23ZiHKdy9Ltz3rflnN8p0BX3dU2M-p5-PGRE3LeZ1pvkV_M6LJ1R4PX_KuXCdfRPGOfBecDLeDYLJZNFd/" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="451" data-original-width="1036" height="279" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEioKXw8hwGXEmt9XUOozKoVXGVeEA4YLXPMyb02dhwaQh4u2ewntYtAz7T1qkK23ZiHKdy9Ltz3rflnN8p0BX3dU2M-p5-PGRE3LeZ1pvkV_M6LJ1R4PX_KuXCdfRPGOfBecDLeDYLJZNFd/w640-h279/image.png" width="640" /></a></div><br /><p></p><p><br /></p><p>Including the proposed Long-Term Care (LTC) Tax, W-2 employees would pay total payroll taxes of 7.95% with self-employed workers paying 15.9% (employee plus employer portion).</p><p>The WISH Act conditions benefit eligibility on reaching full Social Security retirement age, and having a severe cognitive impairment or needing assistance in at least two activities of daily living (ADLs). Full benefits would be paid to those who contributed to the program for at least 10 years (people would be eligible for partial benefits once they paid into the system for six quarters).</p><p>The program proposes to pay benefits after an enrollee required a high level of care for a varying amount of time based on a beneficiary’s average indexed earnings. Those with the lowest incomes could receive benefits after one year; a median income worker would be eligible after twenty months; and the highest income workers would begin to receive benefits after five years.</p><p>Funding for the WISH Act is not limited to the LTC Tax noted above. In addition, there is appropriated to the Federal Long-Term Care Trust Fund out of moneys in the Treasury: $12,000,000 for program establishment in each of Fiscal Years 2022-2024; and another $50,000,000 for educating the public.</p><p>An immediate question that comes to mind is whether it would be allowed to opt out of the federal program, for instance if a taxpayer already owns private Long-Term Care Insurance. It should be noted that an opt out provision was included in a Washington State program passed into law earlier this year.</p><p>The new Washington State Long-Term Care program mandates public Long-Term Care benefits for Washington residents. The Long-Term Care Act was created to reduce pressure on the Medicaid system and is paid for by 0.58% tax on employee wages. Under current law, residents have one opportunity to opt out of this tax by having private Long-Term Care Insurance in place by November 1st, 2021.</p><p>The WISH Act's sponsor said he is hopeful the program also will have an effect on the private Long-Term Care Insurance market, increasing opportunities for insurance companies and their agents to offer Long-Term Care Insurance to supplement the federal program. That just may be WISH-ful thinking.</p><p>Until next time,</p><p>Andrew Herman, President</p>Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-27251686636934396692021-06-17T18:04:00.014-04:002021-06-17T20:01:44.220-04:00U.S. Supreme Court Upholds Affordable Care Act in 7-2 Ruling<p><span style="font-family: arial;">Once again, the nation's highest court has upheld the Affordable Care Act (ACA) in a 7-2 ruling dismissing a <span style="-webkit-font-smoothing: antialiased; background-color: white; color: black; font-size: small;">challenge made to the ACA in the suit </span><i style="-webkit-font-smoothing: antialiased; background-color: white; color: #201f1e;"><span style="-webkit-font-smoothing: antialiased; color: black; font-size: small;">Texas v. United States</span></i><span style="-webkit-font-smoothing: antialiased; background-color: white; color: black; font-size: small;">. That suit, which had the potential to invalidate the entire law, was turned away by today's majority ruling in <span style="-webkit-font-smoothing: antialiased; color: #201f1e;"><span style="-webkit-font-smoothing: antialiased; color: black; font-size: small;"><i>California v. Texas. </i></span></span></span><span style="background-color: white;">This marks the third time the U.S. Supreme Court has ruled in favor of the ACA.</span></span></p><p><span style="font-family: arial;"><span style="background-color: white;">Today's ruling found that the plaintiffs did not have a </span><span style="-webkit-font-smoothing: antialiased; font-size: small;">legal right to bring
the case before the Court. The opinion held that plaintiffs in the challenge “failed to show a concrete, particularized injury fairly traceable to the defendants’ conduct in enforcing the specific statutory provision they attack as unconstitutional.” The opinion did not speak to the underlying issue of the mandate’s constitutionality.</span></span></p><p><span style="font-family: arial;"><span style="-webkit-font-smoothing: antialiased; font-size: small;">Justice Stephen Breyer delivered the court’s opinion, with Justices Samuel
Alito and Neil Gorsuch dissenting. </span>Writing for the court, Justice Stephen Breyer said the states and people who filed the latest suit lacked legal standing to go to court. Breyer said they could not show they were injured by the now-toothless mandate, as required under the Constitution.</span></p><p><span style="font-family: arial;">The prior mandate, arguably the most controversial aspect of the ACA law, was a federally imposed tax penalty for not being enrolled in health insurance. It was eliminated in 2019 by actions taken under the Trump Administration. The penalty amount for not having health insurance in 2018 was $695 for adults and $347.50 for children, or 2% of yearly income, whichever amount is more.</span></p><p><span style="font-family: arial;">Breyer noted, “To find standing here to attack an unenforceable statutory provision would allow a federal court to issue what would amount to an advisory opinion without the possibility of any judicial relief."</span></p><p><span style="font-family: arial;">Justices Samuel Alito and Neil Gorsuch dissented, indicating they would have let the suit go forward and continue to support dismantling most of the ACA.</span></p><p><span style="font-family: arial;">In his dissent, Alito wrote “No one can fail to be impressed by the lengths to which this court has been willing to go to defend the ACA against all threats." Alito was in dissent in both previous ACA cases.</span></p><p><span style="font-family: arial;">In a concurring opinion, Justice Clarence Thomas said he agreed with Alito’s analysis of the previous cases, but agreed with the majority that the latest challengers lacked the right to sue. “Although this court has erred twice before in cases involving the Affordable Care Act, it does not err today,” Thomas wrote.</span></p><p><span style="-webkit-font-smoothing: antialiased; font-family: arial; font-size: small;">Today’s ruling
leaves the entire ACA intact. The case is <a href="https://www.supremecourt.gov/opinions/20pdf/19-840_6jfm.pdf" rel="nofollow" target="_blank"><i>California v. Texas, 19-840</i>.</a></span></p><p><span style="font-family: arial;">Until next time,</span></p><p><span style="font-family: arial;">Andrew Herman</span></p>Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-22475960238830485812021-06-14T13:24:00.000-04:002021-06-14T13:25:58.372-04:00Investing in Fixed Annuities for Safety, Accumulation, and Tax Advantages<p><i><span style="font-family: Arial, sans-serif; font-size: 13.5pt; letter-spacing: -0.25pt;">While
they are best known for providing guaranteed income during retirement, Fixed Annuities
can be purposed for tax deferred accumulation.
They are designed to protect your principal from downside loss and can
be funded from after-tax money or pre-tax accounts such as IRAs and 401Ks. Additionally, distributions made for Qualified
Long-Term Care expenses are entirely tax-free.</span></i></p><p><b><span style="font-family: Arial, sans-serif; font-size: 14pt; letter-spacing: -0.1pt;"><br /></span></b></p><p><b><span style="font-family: Arial, sans-serif; font-size: 14pt; letter-spacing: -0.1pt;">Are
Annuity products a safe investment?</span></b></p>
<p class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 12.0pt;"><span style="font-family: Arial, sans-serif; letter-spacing: -0.1pt;">Not all Annuities are equal
when it comes to protecting your principal from investment loss.</span></p><p class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 12.0pt;"><b><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";">Variable Annuities are the
least safe</span></b><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";">, as contract funds typically
are invested directly into equities and other assets that can fluctuate widely in
value.<span style="mso-spacerun: yes;"> </span>Variable Annuities offer a potentially
rewarding upside, but their suitability is limited to investors who can
tolerate the risk of losing their invested principal.<o:p></o:p></span></p><p class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 12.0pt;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";"><br /></span></p><p class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 12.0pt;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";"></span></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjw4-OrAWt8kj9f_KDorPcJ2e1lH0NdqqCk_JAVc3VWbpKtSyHYhneBk1D_dOMsLDs7oGGBNKdEJGe60Mjkkw8yx4x-qBCvsxLsFt8QWuuT52O0EgVr8F1XK2_-wmADbJTSdC6AYOH-b-nv/" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="391" data-original-width="748" height="167" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjw4-OrAWt8kj9f_KDorPcJ2e1lH0NdqqCk_JAVc3VWbpKtSyHYhneBk1D_dOMsLDs7oGGBNKdEJGe60Mjkkw8yx4x-qBCvsxLsFt8QWuuT52O0EgVr8F1XK2_-wmADbJTSdC6AYOH-b-nv/" width="320" /></a></div><br /><br /><p></p>
<p class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 12.0pt;"><span style="font-family: Arial, sans-serif; letter-spacing: -0.1pt;">Investors seeking growth
and safety of principal have better options with </span><b style="font-family: Arial, sans-serif; letter-spacing: -0.1pt;">Fixed Deferred Annuities.</b><span style="font-family: Arial, sans-serif; letter-spacing: -0.1pt;"> </span><span style="font-family: Arial, sans-serif; letter-spacing: -0.1pt;">Two popular products are </span><b style="font-family: Arial, sans-serif; letter-spacing: -0.1pt;">Multi-Year
Guaranteed Annuities (MYGAs)</b><span style="font-family: Arial, sans-serif; letter-spacing: -0.1pt;"> and </span><b style="font-family: Arial, sans-serif; letter-spacing: -0.1pt;">Fixed Indexed Annuities (FIAs)</b><span style="font-family: Arial, sans-serif; letter-spacing: -0.1pt;">.</span></p>
<p class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 12.0pt;"><b><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";"><br /></span></b></p><p class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 12.0pt;"><b><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";">MYGAs</span></b><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";"> offer a contractually guaranteed interest
rate for a fixed period, such as three years or five years.<span style="mso-spacerun: yes;"> </span>Interest earnings grow fully tax-deferred when
no distributions are made (when money is withdrawn, gains are taxed first prior
to return of principal).<span style="mso-spacerun: yes;"> </span>“Surrender Charges”,
or fees, generally apply for early termination; however, most MYGAs allow penalty-free
withdrawals during the guarantee period.<span style="mso-spacerun: yes;">
</span>Such withdrawals may be limited to certain thresholds such as: 10% of
account value each year, accumulated interest earned, Required Minimum
Distributions (RMDs on Qualified Annuities), or other terms as specified in the
Annuity contract.<o:p></o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 12.0pt;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";">When choosing a MYGA
product, it is important to review all contract guarantees and terms including how
funds are disbursed if the Annuitant (person insured by the Annuity) dies before
the end of the accumulation period.<span style="mso-spacerun: yes;"> </span>Some
MYGAs pay a death benefit equal to the full account value without any surrender
penalty.<o:p></o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 12.0pt;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";">When the guarantee period
ends, consumer-friendly tax laws allow accumulated funds to be rolled over without
tax consequence into a new Annuity contract (this is known as a 1035 exchange).<span style="mso-spacerun: yes;"> </span>The customer has other options as well, such
as annuitizing the payout over a specified number of years (or for lifetime) or
receiving a lump sum payment.<span style="mso-spacerun: yes;"> </span>As noted
above, distributions are taxed first on gains. In the case of a Qualified
Annuity, or IRA-type account, the entire distribution is taxable since none of
the contract funds had been taxed previously.<o:p></o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: 12.6pt; margin-bottom: 3.0pt; margin-left: 0in; margin-right: 0in; margin-top: 3.0pt; mso-outline-level: 4;"><b><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.25pt; mso-fareast-font-family: "Times New Roman";">FIAs</span></b><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.25pt; mso-fareast-font-family: "Times New Roman";">, like MYGAs, are Fixed Annuity contracts that
accumulate interest on a tax-deferred basis; and they often are designed for a
longer time horizon compared to MYGAs.<span style="mso-spacerun: yes;">
</span>The main difference, though, is that FIA contracts base investment
returns on the performance of a selected Index such as S&P 500.<span style="mso-spacerun: yes;"> </span>Unlike direct investment in equity or bond
markets, FIAs generally are protected against investment losses. In exchange, only
a portion of Index growth is credited to the Annuity contract when the Index increases
in value.<span style="mso-spacerun: yes;"> </span>Index measurement for interest
crediting purposes often is on a one-year point-to-point basis with an annual
reset for the next year.<o:p></o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: 12.6pt; margin-bottom: 3.0pt; margin-left: 0in; margin-right: 0in; margin-top: 3.0pt; mso-outline-level: 4;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.25pt; mso-fareast-font-family: "Times New Roman";"><o:p> </o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: 12.6pt; margin-bottom: 3.0pt; margin-left: 0in; margin-right: 0in; margin-top: 3.0pt; mso-outline-level: 4;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.25pt; mso-fareast-font-family: "Times New Roman";">When purchasing an FIA, it is important to
review all terms including contractual surrender charges, availability of
penalty-free withdrawals, the portion of Index gain credited to the contract, guarantees
regarding annuitization (payout) of funds in the future, and how the death
benefit is calculated.<o:p></o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: 12.6pt; margin-bottom: 3.0pt; margin-left: 0in; margin-right: 0in; margin-top: 3.0pt; mso-outline-level: 4;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.25pt; mso-fareast-font-family: "Times New Roman";"><o:p> </o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: 12.6pt; margin-bottom: 3.0pt; margin-left: 0in; margin-right: 0in; margin-top: 3.0pt; mso-outline-level: 4;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.25pt; mso-fareast-font-family: "Times New Roman";"><i><b>FIAs are especially attractive in times of a
mature bull market, since history shows market corrections occur and the
downward trend usually is short-lived.</b></i><span style="mso-spacerun: yes;">
</span>For example, consider an investor with $100,000 who purchases an FIA
contract participating in a stock Index, and with downside protection, rather than
investing directly in the Index itself.<span style="mso-spacerun: yes;">
</span>If the underlying Index were to drop 20% in the following year, the FIA
contract value is still $100,000 and has not suffered any of the 20% market
loss which could take years to recoup.<o:p></o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: 12.6pt; margin-bottom: 3.0pt; margin-left: 0in; margin-right: 0in; margin-top: 3.0pt; mso-outline-level: 4;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.25pt; mso-fareast-font-family: "Times New Roman";"><o:p> </o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: 12.6pt; margin-bottom: 3.0pt; margin-left: 0in; margin-right: 0in; margin-top: 3.0pt; mso-outline-level: 4;"><a name="_Hlk71202644"><b><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.25pt; mso-fareast-font-family: "Times New Roman";">Investing in a MYGA vs.
FIA Contract<o:p></o:p></span></b></a></p>
<span style="mso-bookmark: _Hlk71202644;"></span>
<p class="MsoNormal" style="background: white; line-height: 12.6pt; margin-bottom: 3.0pt; margin-left: 0in; margin-right: 0in; margin-top: 3.0pt; mso-outline-level: 4;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.25pt; mso-fareast-font-family: "Times New Roman";"><o:p> </o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: 12.6pt; margin-bottom: 3.0pt; margin-left: 0in; margin-right: 0in; margin-top: 3.0pt; mso-outline-level: 4;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.25pt; mso-fareast-font-family: "Times New Roman";">Purchasing a <b>MYGA</b> contract makes the
most sense when there is a shorter timeline for needing access to funds and/or
the investor wants to know exactly how the investment will grow.<span style="mso-spacerun: yes;"> </span>MYGAs can be compared to Bank Certificates of
Deposit (CDs), which operate similarly in that an interest rate is guaranteed
for a specified period.<span style="mso-spacerun: yes;"> </span>Currently, MYGAs
are available with much higher credited rates compared to Bank CDs; and, as
noted earlier, Annuity contracts grow on a tax deferred basis unlike most investments
including Bank CDs.<o:p></o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: 12.6pt; margin-bottom: 3.0pt; margin-left: 0in; margin-right: 0in; margin-top: 3.0pt; mso-outline-level: 4;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.25pt; mso-fareast-font-family: "Times New Roman";"><o:p> </o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: 12.6pt; margin-bottom: 3.0pt; margin-left: 0in; margin-right: 0in; margin-top: 3.0pt; mso-outline-level: 4;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.25pt; mso-fareast-font-family: "Times New Roman";">Purchasing an <b>FIA </b>contract is most suitable
when the investor has a longer time horizon and would like some exposure to
market upside but without risk of losing principal.<span style="mso-spacerun: yes;"> </span>The long-run return on FIAs tends to be higher
than investments in MYGAs; and there is no need to worry about a steep market
loss during the contract period.<o:p></o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: 12.6pt; margin-bottom: 3.0pt; margin-left: 0in; margin-right: 0in; margin-top: 3.0pt; mso-outline-level: 4;"><br /></p>
<p class="MsoNormal" style="background: white; line-height: 12.6pt; margin-bottom: 3.0pt; margin-left: 0in; margin-right: 0in; margin-top: 3.0pt; mso-outline-level: 4;"><b><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.25pt; mso-fareast-font-family: "Times New Roman";">Annuity Tax Advantages</span></b></p>
<p class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 12.0pt;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";">Annuities can be purchased
with non-qualified or tax-qualified funds. <span style="mso-spacerun: yes;"> </span>With Non-Qualified Annuities, the amount invested
comes from after-tax money; and only investment gains are taxed when money is withdrawn.<span style="mso-spacerun: yes;"> </span>With Qualified Annuities -- like traditional IRAs
-- the entire amount of money withdrawn is subject to taxation as the
investment was funded initially with pre-tax dollars.<o:p></o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 12.0pt;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";">Tax deferral inherent in
both Non-Qualified and Qualified Annuity products helps to accelerate asset
accumulation through “Triple-Compounding”, which includes earning interest on
the principal, interest on the interest, and interest on what would have been
paid to taxes.<o:p></o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 12.0pt;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";">Distributions from an Annuity
during the accumulation phase are taxed on what is known as a last in, first
out (LIFO) basis. <span style="mso-spacerun: yes;"> </span>This means withdrawals
from an Annuity are made on earnings (gains) first, and the owner is taxed at
regular income rates on the payments until all earnings have been distributed.<o:p></o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 12.0pt;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";">It should be noted that for
people under the age 59 ½, withdrawals from an Annuity may be assessed a 10%
penalty applicable to the taxable portion of the withdrawal.<o:p></o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: 12.6pt; margin-bottom: 3.0pt; margin-left: 0in; margin-right: 0in; margin-top: 3.0pt; mso-outline-level: 4;"><b><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.25pt; mso-fareast-font-family: "Times New Roman";">Annuity Tax Advantages for Qualified Long
Term Care Expenses<o:p></o:p></span></b></p>
<p class="MsoNormal" style="background: white; line-height: 12.6pt; margin-bottom: 3.0pt; margin-left: 0in; margin-right: 0in; margin-top: 3.0pt; mso-outline-level: 4;"><span style="font-family: Arial, sans-serif; letter-spacing: -0.1pt;"><br /></span></p><p class="MsoNormal" style="background: white; line-height: 12.6pt; margin-bottom: 3.0pt; margin-left: 0in; margin-right: 0in; margin-top: 3.0pt; mso-outline-level: 4;"><span style="font-family: Arial, sans-serif; letter-spacing: -0.1pt;">Fixed Annuities also can be
purposed to protect against the high cost of Long-Term Care services.</span><span style="font-family: Arial, sans-serif; letter-spacing: -0.1pt;"> </span><span style="font-family: Arial, sans-serif; letter-spacing: -0.1pt;">One well-known product is a “Hybrid”
Annuity/Long-Term Care Insurance policy, which can be funded with a single
premium that buys a base policy plus a continuation of benefits rider to pay Long-Term
Care expenses for additional time if the base funds are exhausted.</span><span style="font-family: Arial, sans-serif; letter-spacing: -0.1pt;"> </span><span style="font-family: Arial, sans-serif; letter-spacing: -0.1pt;">Limited health underwriting applies, so
applicants who are not in good health may not be eligible to purchase a Hybrid
product.</span></p>
<p class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 12.0pt;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";">With Hybrid Annuities,
distributions for Long-Term Care services are not subjected to a surrender
penalty and are income tax free.<span style="mso-spacerun: yes;"> </span>This
would not be the case if paying for these costs from IRA or 401(K) assets.<o:p></o:p></span></p>
<p class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 12.0pt;"><a name="_Hlk71265962"><b><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";">Non-Underwritten
Fixed Indexed Annuities with a “Boost” benefit for Long-Term Care<o:p></o:p></span></b></a></p>
<span style="mso-bookmark: _Hlk71265962;"></span>
<p class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 12.0pt;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";">Insurance carriers also
have begun offering non-underwritten Fixed Indexed Annuities featuring a “Boost”
to income payout amounts when the annuitant cannot perform Activities of Daily
Living (ADLs) or has cognitive impairment.<span style="mso-spacerun: yes;">
</span>Here is an example of one company’s product design:<o:p></o:p></span></p>
<ul style="margin-top: 0in;" type="disc">
<li class="MsoNormal" style="background: white; color: black; line-height: normal; margin-bottom: 12.0pt; mso-list: l0 level1 lfo1;"><span style="font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";">Wellness
Withdrawals can be triggered if you or your spouse cannot perform at least
two of six Activities of Daily Living.<span style="mso-spacerun: yes;">
</span>These withdrawals serve to double your guaranteed monthly payout
and are available for up to five 5 consecutive policy years.<o:p></o:p></span></li>
<li class="MsoNormal" style="background: white; color: black; line-height: normal; margin-bottom: 12.0pt; mso-list: l0 level1 lfo1;"><span style="font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";">Investment
performance with the Annuity can be tied to the Barclays Atlas global
diversified index, as well as S&P 500 (funds can be allocated in any
proportion between the two).<o:p></o:p></span></li>
<li class="MsoNormal" style="background: white; color: black; line-height: normal; margin-bottom: 12.0pt; mso-list: l0 level1 lfo1;"><span style="font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";">Penalty-free
withdrawals can be taken for any reason up to 5% of the account value each
year beginning on the first policy anniversary.<o:p></o:p></span></li>
</ul>
<p class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 12.0pt;"><b><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";">Summary<o:p></o:p></span></b></p>
<p class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 12.0pt;"><span style="color: black; font-family: "Arial",sans-serif; letter-spacing: -.1pt; mso-fareast-font-family: "Times New Roman";">All Fixed Annuities offer safety
of principal, tax-deferred growth, and innovative product designs not available
with most other investments.<span style="mso-spacerun: yes;"> </span>With Fixed
Indexed Annuities, investors can participate in the upside of equity markets while
avoiding the risk of losing invested principal.<o:p></o:p></span></p>Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-29943258479423961782021-04-05T20:26:00.001-04:002021-04-05T20:26:24.735-04:00SECURE Act Impact on U.S. Retirement System<p>The Setting Every Community Up for Retirement Enhancement (SECURE) Act went into effect on January 1, 2020 and makes a notable impact on our nation's retirement system. Three important changes are outlined below:</p><p><b>1) The new age for RMDs is now 72</b></p><p>Under the SECURE Act, the "begin date" to start taking RMDs from your pretax retirement plan accounts and IRAs is the year you turn 72 (the previous age was 70½).</p><p><b>2) Age limits for contributing to traditional IRAs are eliminated</b></p><p>For tax year 2020 and beyond, the law removes the age limit at which you can contribute to a traditional IRA. Prior to this change, you could not make a traditional IRA contribution after age 70½ (although you can contribute to a Roth IRA if you meet the income limitations). The new law allows anyone who is working and has earned income to contribute to a traditional IRA regardless of age.</p><p><b>3) Non-Spouse beneficiaries who inherit a retirement account must withdraw the entire balance within 10 years</b></p><p>Under prior rules, beneficiaries could elect a "stretch IRA" planning strategy which allowed non-spouse heirs inheriting a pretax retirement plan or IRA to stretch withdrawals over their life expectancy. That meant younger heirs could potentially leave much of that money growing tax-deferred for decades.</p><p>Now, non-spouse heirs must empty inherited accounts within 10 years following the year of the owner's death. Heirs who remain under the old rules include spouses; the disabled or chronically ill; minor children (not grandchildren) generally until the age of 18, and beneficiaries who are not more than 10 years younger than the deceased. The prior rules apply if you inherited an account before 2020.</p><p>Until next time,</p><p>Andrew Herman</p>Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-2687543410676023662020-12-05T12:06:00.002-05:002020-12-05T12:14:01.913-05:00Shedding Light on Medicare Part D – Why pharmacy copays may not match to published plan copays; and why actual out-of-pocket differs from the Medicare TrOOP (True Out-Of-Pocket)<p>Medicare’s prescription drug benefit is known as Part D and
is provided by private insurers.
Medicare Part D was signed into law as part of the Medicare Prescription
Drug Improvement and Modernization Act of 2003; and it can be purchased stand-alone
or integrated with a Medicare Advantage plan (also known as Medicare Part
C). Medicare Part D has distinct
coverage phases, including a Coverage Gap (or “Donut Hole”) that has been vastly
improved for consumers under more recent legislation.</p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal">As of 2020, enrollees with Standard Part D coverage and in
the Donut Hole pay 25% of the cost of their drugs until they reach the Catastrophic
Coverage phase (as opposed to paying the full cost while in the Donut Hole,
which had been the case before the Affordable Care Act started closing the gap).<o:p></o:p></p>
<p class="MsoNormal">For background, Medicare Part D plans may impose an Initial Deductible
up to $445 in 2021 (an increase of $10 from 2020).<span style="mso-spacerun: yes;"> </span>The deductible is the amount you must pay before the plan begins to share in costs.<span style="mso-spacerun: yes;"> </span>Some plans (generally with higher monthly
premiums) do not impose any deductible; and it is common for Part D plans to feature
a plan deductible, but only apply it to medicines classified in the plan’s higher Drug Tiers (Part D plan sponsors typically assign medicines into five Tier levels).<o:p></o:p></p>
<p class="MsoNormal">Once the Initial Deductible is met, consumers are charged copays
or coinsurance as published in each Part D plan’s Summary of Benefits.<span style="mso-spacerun: yes;"> </span>Copay amounts may vary based on the plan’s pharmacy
network (preferred vs. standard, or mail order service), as well as Drug Tier
level.<span style="mso-spacerun: yes;"> </span><b><i>Consumers sometimes
inquire, why doesn’t my copay at the pharmacy match to the amount shown in my
plan’s Summary of Benefits document?<span style="mso-spacerun: yes;">
</span>Answer:<span style="mso-spacerun: yes;"> </span>If the pharmacy drug cost
is lower, you pay the lower amount.<o:p></o:p></i></b></p>
<p class="MsoNormal">The standard Medicare Part D plan structure also includes an
element called the Initial Coverage Limit, or ICL, which is $4,130 in 2021 (an
increase of $110 from the 2020 ICL of $4,020).<span style="mso-spacerun: yes;">
</span>The ICL marks the point where you enter the Donut Hole.<span style="mso-spacerun: yes;"> </span>More specifically, you enter the Donut Hole
when the total negotiated retail value of your covered annual prescription drugs exceeds your plan’s ICL.<span style="mso-spacerun: yes;"> </span>At the
inception of the Medicare Part D program, consumers generally bore all costs in
the Donut Hole.<o:p></o:p></p>
<p class="MsoNormal"><b>So, will you enter the 2021 Donut Hole?<o:p></o:p></b></p>
<p class="MsoNormal">If your prescribed medications for 2021 have a retail value exceeding
$350/month, you are likely to enter the Donut Hole during 2021.<span style="mso-spacerun: yes;"> </span>Generally, less than one-quarter of Medicare beneficiaries
with Part D coverage enter the Donut Hole each year.<span style="mso-spacerun: yes;"> </span>Consumers sometimes avoid entering it by seeking out lower cost options (such as pharmacy coupons) instead of using
their plan for certain drugs.<o:p></o:p></p>
<p class="MsoNormal"><b><i>If you reach the Donut Hole phase of your 2021 Part
D coverage, the drug discount is 75%.</i></b></p><p class="MsoNormal">While
in the Donut Hole, generic formulary drug costs are 25% of your plan's
negotiated retail prices.<span style="mso-spacerun: yes;"> </span>For example,
if you are in the 2021 Donut Hole and your generic medication has a retail cost
of $100, the Standard Part D plan benefit requires you to pay $25 for a
refill.<span style="mso-spacerun: yes;"> </span>And the $25 that you spend for a
covered formulary drug counts toward your 2021 out-of-pocket limit (or TrOOP,
explained below).</p>
<p class="MsoNormal">While in the Donut Hole, the 2021 brand-name drug discount also
is 75%, meaning that you pay 25% of your plan’s negotiated brand drug retail
costs.<span style="mso-spacerun: yes;"> </span>The pharmaceutical industry pays
for 70% of the cost of these medications in the Donut Hole; and you receive credit
for 95% of the retail drug cost toward meeting your 2021 TrOOP (the 25% of
retail costs you pay plus the 70% drug manufacturer discount).<o:p></o:p></p>
<p class="MsoNormal">For example, if you reach the 2021 Donut Hole and purchase a
brand name medication with a retail cost of $100, you will pay $25 for the
formulary medication, and receive $95 credit toward meeting your 2021 TrOOP
(which is the Donut Hole exit point).<o:p></o:p></p>
<p class="MsoNormal"><b><i>So, what exactly is “TrOOP” and is it the same as my
actual out-of-pocket drug costs?<o:p></o:p></i></b></p>
<p class="MsoNormal">There is not a short answer to this question, so please read
on!<o:p></o:p></p>
<p class="MsoNormal">TrOOP is the Medicare Part D program’s annual "Total
out-of-pocket costs" and is known as "True out-of-pocket costs".<o:p></o:p></p>
<p class="MsoNormal">In general, TrOOP includes all payments for medications
listed on your Part D plan's formulary and purchased through a preferred or
standard network pharmacy.<span style="mso-spacerun: yes;"> </span>Both the payments
you make, and payments that Pharma companies make on your behalf, count towards
TrOOP.<span style="mso-spacerun: yes;"> </span>If you switch Medicare Part D
plans during a plan year, your TrOOP will be transferred to your new plan (it
travels with you).<o:p></o:p></p>
<p class="MsoNormal"><b><i>TrOOP is important because after it reaches $6,550 in
2021 (an increase of $200 from the 2020 level), you move to the final state of
your Medicare Part D coverage, known as Catastrophic Coverage. </i></b><span style="mso-spacerun: yes;"> </span>In the Catastrophic Coverage stage, your
medication costs are reduced to $3.70 for generics or $9.20 for brand-name
drugs (or 5% of the drug cost - whichever is greater).<o:p></o:p></p>
<p class="MsoNormal">The components of TrOOP are as follows: <span style="mso-spacerun: yes;"> </span>it includes the amount of your Initial
Deductible (if any) and your co-payments or co-insurance during the ICL phase;
and as noted above it includes what you pay and a portion of what the
Pharma companies pay while you are in the Donut Hole (of the 75% Donut Hole
discount on brand-name drugs, 70% of that counts towards TrOOP as that portion
is paid by the drug manufacturer). The additional 5% Donut Hole discount on
brand-name drugs and the 75% Donut Hole discount on generics do not count
toward TrOOP, as they are paid by your Medicare Part D plan.<o:p></o:p></p>
<p class="MsoNormal">TrOOP also includes payments made for your drugs by any of
the following programs or organizations: "Extra Help" from Medicare;
Indian Health Service; AIDS drug assistance programs; most charities; and most
State Pharmaceutical Assistance Programs (SPAPs).<o:p></o:p></p>
<p class="MsoNormal">TrOOP does not include monthly premiums or non-formulary drug
purchases.<o:p></o:p></p>
<p class="MsoNormal"><b><i>Because TrOOP includes the lion’s share of what drug
manufacturer’s pay on your behalf for brand-name drugs while in the Donut Hole, your actual
out-of-pocket costs at time of Donut Hole exit likely will be much lower.<o:p></o:p></i></b></p>
<p class="MsoNormal"><b>Will you exit the Donut Hole and enter the 2021
Catastrophic Coverage phase?<o:p></o:p></b></p>
<p class="MsoNormal">Based on CMS drug cost estimates, if your monthly retail
formulary drug costs approach $850, you are likely to exit the 2021 Donut Hole
and enter Catastrophic Coverage.<o:p></o:p></p>
<p class="MsoNormal">Medicare Part D plan sponsors can offer the
Standard Part D plan design, or a design under which the measured actuarial
value equals or exceeds the actuarial value of Standard Part D coverage.<span style="mso-spacerun: yes;"> </span>Actuarial equivalence is a required test to
confirm that expected paid claims under the plan sponsor's prescription drug
coverage are at least as much as expected paid claims under the standard design.
<span style="mso-spacerun: yes;"> </span>Plans sponsors with multiple benefit
options must apply the actuarial value test for each option.</p>
<p class="MsoNormal">Until next time,</p><p class="MsoNormal">Andrew Herman</p>Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-54856605712613440042020-11-08T18:36:00.002-05:002020-11-08T18:37:52.123-05:002021 Medicare Part B Premiums Increase by $3.90/Month<p><span style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px;">On November 6th, The Centers for Medicare & Medicaid Services (CMS) announced the 2021 monthly Medicare Parts A and B premiums, deductibles, and coinsurance amounts.</span></p><p><strong style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; min-height: 0px; min-width: 0px;">Medicare Part B Premiums/Deductibles</strong></p><p style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A. </span></p><p style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">The standard monthly premium for Medicare Part B enrollees will increase from $144.60 in 2020 to $148.50 in 2021, an increase of $3.90 per month. Recent legislation signed by President Donald Trump significantly dampens the 2021 Medicare Part B premium increase that would have occurred given the estimated growth in Medicare spending next year. According to CMS, Medicare spending is estimated to grow due to people seeking care they may have delayed during the COVID-19 public health emergency, availability of more COVID-19 treatments, and availability of COVID-19 vaccines.</span></p><p style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;">CMS also announced that the annual deductible for Medicare Part B enrollees will increase from $198 in 2020 to $203 in 2021, an increase of $5. The additional $5 in 2021 will be borne by enrollees as an out-of-pocket expense under all Medicare Supplement Insurance plans (also known as 'Medigap') available to newly eligible Medicare beneficiaries.</p><p style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;"><strong style="min-height: 0px; min-width: 0px;">Medicare Part A Premiums/Deductibles</strong></p><p style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">Medicare Part A covers inpatient hospital, skilled nursing facility, and some home health care services. About 99 percent of Medicare beneficiaries do not pay a Part A premium since they have at least 40 quarters of Medicare-covered employment.</span></p><p style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">The Medicare Part A inpatient deductible that beneficiaries will pay when admitted to the hospital is $1,484 in 2021, an increase of $76 from $1,408 in 2020. Medigap plans automatically adjust benefits in 2021 so that the higher inpatient deductible is covered.</span></p><p style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;"><strong style="min-height: 0px; min-width: 0px;">Medicare Annual Election Period (10/15 - 12/7)</strong></span></span></span></p><p style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">Medicare beneficiaries can choose to enroll in fee-for-service Original Medicare (Parts A and B) or can select a private Medicare Advantage plan to receive their Medicare benefits. Premiums and deductibles for Medicare Advantage and Medicare Prescription Drug plans (Medicare Part D) are already finalized and are unaffected by this announcement.</span></p><p style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">During the ongoing Medicare Annual Election Period, which began on October 15th and ends on December 7th, Medicare beneficiaries can compare coverage options like Original Medicare (Part A and Part B) and Medicare Advantage, and choose health and prescription drug plans for 2021. Medicare health and drug plan costs and covered benefits can change from year-to-year. Over the past three years, CMS has redesigned its useful Medicare Plan Finder so that Medicare beneficiaries may:</span></p><ul style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 1em 0px; min-height: 0px; min-width: 0px; padding: 0px 0px 0.25em 15px;"><li style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">Compare pricing between Original Medicare, Medicare Advantage plans, Medicare prescription drug plans (Medicare Part D), and Medigap policies;</span></li><li style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">Compare coverage options on their smartphones and tablets;</span></li><li style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">Compare up to three Medicare Part D drug plans or three Medicare Advantage plans side-by-side;</span></li><li style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">Get plan costs and benefits, including which Medicare Advantage plans offer extra benefits;</span></li><li style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">Build a personal drug list and find Medicare Part D prescription drug coverage that best meets their needs.</span></li></ul><p style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 0px 0px 1.2em; min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">Highlights for 2021 Open Enrollment include:</span></p><ul style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin: 1em 0px; min-height: 0px; min-width: 0px; padding: 0px 0px 0.25em 15px;"><li style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">A 34 percent decrease in average monthly premiums for Medicare Advantage plans since 2017.</span></li><li style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">More than 4,800 Medicare Advantage plans are offered for 2021, nearly double the offerings in 2017. Similarly, more Medicare Part D plans are available, and the average basic Part D premium has dropped 12 percent since 2017. </span></li><li style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;">Medicare beneficiaries can join a prescription drug plan that will offer many types of insulin at a maximum copayment of $35 for a 30-day supply. More than 1,600 Medicare Advantage and Part D prescription drug plans are participating in the Part D Senior Savings Model for 2021. People who enroll in a participating plan could save up to an </span>estimated $446 a year in out-of-pocket costs on insulin. CMS has added a new “Insulin Savings” filter on Medicare Plan Finder to display plans that will offer the capped out-of-pocket costs for insulin. Beneficiaries can use the Medicare Plan Finder to view plan options and look for a participating plan in their area that covers their insulin at no more than a $35 monthly copay.</li></ul><div><span style="color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif;">At AH Insurance Services Inc., we are available to make it easy for Medicare Beneficiaries to learn more about 2021 plan options. We can help you determine whether a Medicare Advantage plan -- or a Medigap policy plus a Part D plan -- will be most suitable to meet your medical needs. Additionally, we can assist in projecting your 2021 out-of-pocket drug costs based on your current medicine list and preferred pharmacy. There is no obligation to buy.</span></div><div><br /></div><div><span style="color: #323a45; font-family: Muli, Helvetica Neue, Arial, sans-serif;"><i>Contact us at (850) 450-3622 or info@ahinsuranceservices.com.</i></span></div><div><span style="color: #323a45; font-family: Muli, Helvetica Neue, Arial, sans-serif;"><br /></span></div><div><span style="color: #323a45; font-family: Muli, Helvetica Neue, Arial, sans-serif;">Until next time,</span></div><div><span style="color: #323a45; font-family: Muli, Helvetica Neue, Arial, sans-serif;"><br /></span></div><div><span style="color: #323a45; font-family: Muli, Helvetica Neue, Arial, sans-serif;">Andrew Herman</span></div><div><span style="color: #323a45; font-family: Muli, Helvetica Neue, Arial, sans-serif;">President, AH Insurance Services, Inc.</span></div><div><span style="color: #323a45; font-family: Muli, Helvetica Neue, Arial, sans-serif;"><br /></span></div><div><br /></div>Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-51165106342634539592019-12-27T12:58:00.001-05:002019-12-27T12:58:22.439-05:00The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)<br />
<div class="MsoNormal">
Changes to Medicare Supplement policies (also known as
Medigap) go into effect on January 1, 2020, nearly five years after the
bipartisan legislation known as MACRA was signed into law.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
In addition to creating a Quality Payment Program and
removing Social Security numbers from government-issued Medicare cards, MACRA
authorized the following changes to Medigap:<o:p></o:p></div>
<div class="MsoNormal">
</div>
<ul>
<li><span style="text-indent: -0.25in;">Medigap plans are prohibited from providing first
dollar coverage of the Medicare Part B deductible for newly eligible Medicare
beneficiaries on or after January 1, 2020.</span><span style="text-indent: -0.25in;">
</span><span style="text-indent: -0.25in;">Since Medigap Plans C and F traditionally have included coverage for 100%
of the Medicare Part B deductible, these two plans no longer will be available to newly
eligible beneficiaries.</span></li>
</ul>
<ul>
<li><span style="text-indent: -0.25in;">Newly eligible beneficiaries who will not be able to purchase Medigap Plans C and F include those turning age 65 on or
after January 1, 2020 and anyone gaining eligibility for Medicare benefits
due to disability or End-Stage Renal Disease on or after January 1, 2020.</span></li>
</ul>
<ul>
<li><span style="text-indent: -0.25in;">Plans C and F are NOT being discontinued.</span><span style="text-indent: -0.25in;"> </span><span style="text-indent: -0.25in;">Medicare beneficiaries currently enrolled in
either Plan C or Plan F will retain access to their plan; additionally, all
beneficiaries who became eligible for Medicare prior to January 1, 2020 still have the option to purchase either plan.</span></li>
</ul>
<ul>
<li><span style="text-indent: -0.25in;">For newly eligible beneficiaries, Plans D and G
are available and feature similar health benefits to Plans C and F except for 100% payment
of the Medicare Part B Deductible.</span></li>
</ul>
<ul>
<li><span style="text-indent: -0.25in;">Medigap Plan G will now have a “High Deductible”
option, since Medigap Plan F has a High Deductible coverage option and can no longer be purchased
by newly eligible Medicare beneficiaries.</span><span style="text-indent: -0.25in;"> </span><span style="text-indent: -0.25in;">Under the new Plan G High Deductible option,
the Medicare Part B deductible is paid by the Medicare beneficiary and counts toward the plan's deductible amount.</span></li>
</ul>
<div style="text-indent: -24px;">
<br /></div>
<br />
<div class="MsoListParagraphCxSpLast" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<o:p></o:p></div>
<div class="MsoNormal">
<o:p>Until next time,</o:p></div>
<div class="MsoNormal">
<o:p><br /></o:p></div>
<div class="MsoNormal">
<o:p>Andrew Herman, President</o:p></div>
<div class="MsoNormal">
<o:p>AH Insurance Services, Inc.</o:p></div>
<br />Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-60558735108623728162019-11-22T21:50:00.004-05:002019-11-22T21:50:58.664-05:002020 Medicare Part B Premium and Deductible AmountsThe 2020 premium levels and deductible for Medicare Part B, which covers medically-necessary services including doctors' services and tests, outpatient care, home health services and durable medical equipment, have been published by the Centers for Medicare and Medicaid Services (CMS).<br />
<br />
<b>Medicare Part B Premium Levels</b><br />
<br />
For most Medicare Beneficiaries, the premium due for Medicare Part B in 2020 will be $144.60 per month. This amount is up $9.10 per month from 2019's $135.50 standard amount.<br />
<br />
Beneficiaries with higher than standard annual income have to pay more for their monthly Part B premiums. The table below illustrates how some Beneficiaries will owe as much as $491.60 in monthly premiums in 2020, based on income as reported on their federal tax return for 2018:<br />
<br />
<table align="left" border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="background: white; border-collapse: collapse; margin-left: 6.75pt; margin-right: 6.75pt; mso-table-anchor-horizontal: margin; mso-table-anchor-vertical: margin; mso-table-left: center; mso-table-lspace: 9.0pt; mso-table-rspace: 9.0pt; mso-table-top: -33.3pt; mso-yfti-tbllook: 1184; width: 599px;">
<thead>
<tr>
<td style="background: #222222; border: solid #333333 1.0pt; mso-border-alt: solid #333333 .75pt; padding: 7.5pt 7.5pt 7.5pt 7.5pt; width: 161.6pt;" width="215">
<div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: 9.0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: -33.3pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: center;">
<b><span style="color: white; font-family: "Segoe UI",sans-serif; font-size: 9.5pt; mso-fareast-font-family: "Times New Roman";">For individuals with this income:<o:p></o:p></span></b></div>
</td>
<td colspan="2" style="background: #222222; border-left: none; border: solid #333333 1.0pt; mso-border-alt: solid #333333 .75pt; mso-border-left-alt: solid #333333 .75pt; padding: 7.5pt 7.5pt 7.5pt 7.5pt; width: 228.4pt;" width="305">
<div class="MsoNormal" style="line-height: normal; margin-bottom: 9.0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: -33.3pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;">
<b><span style="color: white; font-family: "Segoe UI",sans-serif; font-size: 9.5pt; mso-fareast-font-family: "Times New Roman";">Or joint filers with this income:<o:p></o:p></span></b></div>
</td>
<td style="background: #222222; border-left: none; border: solid #333333 1.0pt; mso-border-alt: solid #333333 .75pt; mso-border-left-alt: solid #333333 .75pt; padding: 7.5pt 7.5pt 7.5pt 7.5pt; width: 59.6pt;" width="79">
<div class="MsoNormal" style="line-height: normal; margin-bottom: 9.0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: -33.3pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;">
<b><span style="color: white; font-family: "Segoe UI",sans-serif; font-size: 9.5pt; mso-fareast-font-family: "Times New Roman";">Monthly premium:<o:p></o:p></span></b></div>
</td>
</tr>
</thead>
<tbody>
<tr>
<td colspan="2" style="border-top: none; border: solid #DDDDDD 1.0pt; mso-border-alt: solid #DDDDDD .75pt; mso-border-top-alt: solid #DDDDDD .75pt; padding: 7.5pt 7.5pt 7.5pt 7.5pt; width: 166.1pt;" width="221">
<div class="MsoNormal" style="line-height: normal; margin-bottom: 9.0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: -33.3pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;">
<span style="font-family: "Segoe UI", sans-serif; font-size: 12pt;">$87,000 to $109,000<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid #DDDDDD 1.0pt; border-left: none; border-right: solid #DDDDDD 1.0pt; border-top: none; mso-border-alt: solid #DDDDDD .75pt; mso-border-left-alt: solid #DDDDDD .75pt; mso-border-top-alt: solid #DDDDDD .75pt; padding: 7.5pt 7.5pt 7.5pt 7.5pt; width: 223.9pt;" width="299">
<div class="MsoNormal" style="line-height: normal; margin-bottom: 9.0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: -33.3pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;">
<span style="font-family: "Segoe UI", sans-serif; font-size: 12pt;">$174,000 to $218,000<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid #DDDDDD 1.0pt; border-left: none; border-right: solid #DDDDDD 1.0pt; border-top: none; mso-border-alt: solid #DDDDDD .75pt; mso-border-left-alt: solid #DDDDDD .75pt; mso-border-top-alt: solid #DDDDDD .75pt; padding: 7.5pt 7.5pt 7.5pt 7.5pt; width: 59.6pt;" width="79">
<div class="MsoNormal" style="line-height: normal; margin-bottom: 9.0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: -33.3pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;">
<span style="font-family: "Segoe UI", sans-serif; font-size: 12pt;">$202.40<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td colspan="2" style="border-top: none; border: solid #DDDDDD 1.0pt; mso-border-alt: solid #DDDDDD .75pt; mso-border-top-alt: solid #DDDDDD .75pt; padding: 7.5pt 7.5pt 7.5pt 7.5pt; width: 166.1pt;" width="221">
<div class="MsoNormal" style="line-height: normal; margin-bottom: 9.0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: -33.3pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;">
<span style="font-family: "Segoe UI", sans-serif; font-size: 12pt;">$109,000 to $136,000<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid #DDDDDD 1.0pt; border-left: none; border-right: solid #DDDDDD 1.0pt; border-top: none; mso-border-alt: solid #DDDDDD .75pt; mso-border-left-alt: solid #DDDDDD .75pt; mso-border-top-alt: solid #DDDDDD .75pt; padding: 7.5pt 7.5pt 7.5pt 7.5pt; width: 223.9pt;" width="299">
<div class="MsoNormal" style="line-height: normal; margin-bottom: 9.0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: -33.3pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;">
<span style="font-family: "Segoe UI", sans-serif; font-size: 12pt;">$218,000 to $272,000<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid #DDDDDD 1.0pt; border-left: none; border-right: solid #DDDDDD 1.0pt; border-top: none; mso-border-alt: solid #DDDDDD .75pt; mso-border-left-alt: solid #DDDDDD .75pt; mso-border-top-alt: solid #DDDDDD .75pt; padding: 7.5pt 7.5pt 7.5pt 7.5pt; width: 59.6pt;" width="79">
<div class="MsoNormal" style="line-height: normal; margin-bottom: 9.0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: -33.3pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;">
<span style="font-family: "Segoe UI", sans-serif; font-size: 12pt;">$289.20<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td colspan="2" style="border-top: none; border: solid #DDDDDD 1.0pt; mso-border-alt: solid #DDDDDD .75pt; mso-border-top-alt: solid #DDDDDD .75pt; padding: 7.5pt 7.5pt 7.5pt 7.5pt; width: 166.1pt;" width="221">
<div class="MsoNormal" style="line-height: normal; margin-bottom: 9.0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: -33.3pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;">
<span style="font-family: "Segoe UI", sans-serif; font-size: 12pt;">$136,000 to $163,000<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid #DDDDDD 1.0pt; border-left: none; border-right: solid #DDDDDD 1.0pt; border-top: none; mso-border-alt: solid #DDDDDD .75pt; mso-border-left-alt: solid #DDDDDD .75pt; mso-border-top-alt: solid #DDDDDD .75pt; padding: 7.5pt 7.5pt 7.5pt 7.5pt; width: 223.9pt;" width="299">
<div class="MsoNormal" style="line-height: normal; margin-bottom: 9.0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: -33.3pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;">
<span style="font-family: "Segoe UI", sans-serif; font-size: 12pt;">$272,000 to $326,000<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid #DDDDDD 1.0pt; border-left: none; border-right: solid #DDDDDD 1.0pt; border-top: none; mso-border-alt: solid #DDDDDD .75pt; mso-border-left-alt: solid #DDDDDD .75pt; mso-border-top-alt: solid #DDDDDD .75pt; padding: 7.5pt 7.5pt 7.5pt 7.5pt; width: 59.6pt;" width="79">
<div class="MsoNormal" style="line-height: normal; margin-bottom: 9.0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: -33.3pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;">
<span style="font-family: "Segoe UI", sans-serif; font-size: 12pt;">$376.00<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td colspan="2" style="border-top: none; border: solid #DDDDDD 1.0pt; mso-border-alt: solid #DDDDDD .75pt; mso-border-top-alt: solid #DDDDDD .75pt; padding: 7.5pt 7.5pt 7.5pt 7.5pt; width: 166.1pt;" width="221">
<div class="MsoNormal" style="line-height: normal; margin-bottom: 9.0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: -33.3pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;">
<span style="font-family: "Segoe UI", sans-serif; font-size: 12pt;">$163,000 to $500,000<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid #DDDDDD 1.0pt; border-left: none; border-right: solid #DDDDDD 1.0pt; border-top: none; mso-border-alt: solid #DDDDDD .75pt; mso-border-left-alt: solid #DDDDDD .75pt; mso-border-top-alt: solid #DDDDDD .75pt; padding: 7.5pt 7.5pt 7.5pt 7.5pt; width: 223.9pt;" width="299">
<div class="MsoNormal" style="line-height: normal; margin-bottom: 9.0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: -33.3pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;">
<span style="font-family: "Segoe UI", sans-serif; font-size: 12pt;">$326,000 to $750,000<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid #DDDDDD 1.0pt; border-left: none; border-right: solid #DDDDDD 1.0pt; border-top: none; mso-border-alt: solid #DDDDDD .75pt; mso-border-left-alt: solid #DDDDDD .75pt; mso-border-top-alt: solid #DDDDDD .75pt; padding: 7.5pt 7.5pt 7.5pt 7.5pt; width: 59.6pt;" width="79">
<div class="MsoNormal" style="line-height: normal; margin-bottom: 9.0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: -33.3pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;">
<span style="font-family: "Segoe UI", sans-serif; font-size: 12pt;">$462.70<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td colspan="2" style="border-top: none; border: solid #DDDDDD 1.0pt; mso-border-alt: solid #DDDDDD .75pt; mso-border-top-alt: solid #DDDDDD .75pt; padding: 7.5pt 7.5pt 7.5pt 7.5pt; width: 166.1pt;" width="221">
<div class="MsoNormal" style="line-height: normal; margin-bottom: 9.0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: -33.3pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;">
<span style="font-family: "Segoe UI", sans-serif; font-size: 12pt;">Over $500,000<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid #DDDDDD 1.0pt; border-left: none; border-right: solid #DDDDDD 1.0pt; border-top: none; mso-border-alt: solid #DDDDDD .75pt; mso-border-left-alt: solid #DDDDDD .75pt; mso-border-top-alt: solid #DDDDDD .75pt; padding: 7.5pt 7.5pt 7.5pt 7.5pt; width: 223.9pt;" width="299">
<div class="MsoNormal" style="line-height: normal; margin-bottom: 9.0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: -33.3pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;">
<span style="font-family: "Segoe UI", sans-serif; font-size: 12pt;">Over $750,000<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid #DDDDDD 1.0pt; border-left: none; border-right: solid #DDDDDD 1.0pt; border-top: none; mso-border-alt: solid #DDDDDD .75pt; mso-border-left-alt: solid #DDDDDD .75pt; mso-border-top-alt: solid #DDDDDD .75pt; padding: 7.5pt 7.5pt 7.5pt 7.5pt; width: 59.6pt;" width="79">
<div class="MsoNormal" style="line-height: normal; margin-bottom: 9.0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: -33.3pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;">
<span style="font-family: "Segoe UI", sans-serif; font-size: 12pt;">$491.60<o:p></o:p></span></div>
</td>
</tr>
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<td style="border: none;" width="299"></td>
<td style="border: none;" width="79"></td>
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<b><br /></b>
<b>Medicare Part B Deductible</b><br />
<br />
The Medicare Part B deductible is subject to change each year, and reflects the up-front amount that must be paid in a calendar year under the Original Medicare program before 80/20 co-insurance applies. In 2020, the Medicare Part B deductible will be $198, an increase of $13 from this year's $185 Part B deductible. Medicare Beneficiaries enrolled in Medicare Advantage HMOs and PPOs (Part C of Medicare) typically do not pay the Medicare Part B deductible directly; rather Part C plan members pay co-pays and other out-of-pocket costs according to the specific terms of the plan.<br />
<br />
Until next time,<br />
<br />
Andrew Herman<br />
President, AH Insurance Services Inc.<br />
<br />Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-10744013156225445182019-04-25T20:55:00.001-04:002019-04-25T20:55:41.476-04:00Pineapple Placements – Gulf Coast Business Providing FREE Senior Living ReferralsWe are pleased to recommend Pineapple Placements, a trusted local Senior Living Referral Company for Independent Living, Assisted Living, Alzheimer’s/Dementia Care, Rehab Services, Skilled Nursing Care, Home Health, Hospice and much more. Complimentary services available include:<br />
<br />
- Comprehensive Assessment<br />
- Educational meetings to explore senior living options<br />
- Guided tours of local communities<br />
- Helping family members implement the best senior living arrangement for their loved ones<br />
<br />
I’ve had the pleasure of meeting with Amber Geier, Senior Living Specialist and President of Pineapple Placements, LLC. She shared her experience of having to place her own loved ones, and how that helped her understand how changing care needs can burden seniors and their family members. In 2018, Amber opened Pineapple Placements with the goal of helping people with effortless transitions. While many clients contact Amber in crisis-management mode, there is no need to wait for that as she is happy to advise families as they plan ahead for future living needs.<br />
<br />
If you need senior living advice or placement, help is on the way! Call Amber at 727.360.3715, email to <a href="mailto:info@pineappleplacement.com"><span style="color: blue;">info@pineappleplacements.com</span></a> or visit <a href="https://www.pineappleplacements.com/"><span style="color: blue;">https://www.pineappleplacements.com</span></a>.<br />
<br />
Until next time,<br />
<br />
Andrew Herman, President<br />
AH Insurance Services, Inc.<br />
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Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-58603796581920725642019-03-14T12:48:00.000-04:002019-03-15T07:59:35.715-04:00CMS Releases National Health Expenditures Projections for 2018-2027Health spending to GDP is expected to increase from 17.9% in 2017 to 19.4% in 2027, as recently announced by the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary. Actual ratios likely are higher than reported since official National Health Expenditures (NHEs) may not include all health spending such as non-prescription vitamins, supplements, Yoga classes, and other health-related expenditures generally not covered under government or private insurance programs.<br />
<br />
According to CMS, from 2018 to 2027:<br />
<br />
• Total national health spending is projected to grow at an average annual rate of 5.5 percent,<br />
reaching nearly $6.0 trillion by 2027.<br />
<br />
• Health spending is projected to grow at a rate of 0.8 percent faster than Gross Domestic<br />
Product (GDP) per year, and the health share of GDP is expected to increase from 17.9 percent<br />
in 2017 to 19.4 percent by 2027.<br />
<br />
• Prices for health care goods and services are projected to increase at a rate of 2.5 percent,<br />
compared to 1.1 percent for 2014-2017.<br />
<br />
• Average annual spending in Medicare is expected to grow 7.4 percent due to projected<br />
enrollment growth. In comparison, average annual spending in Medicaid is expected to grow at<br />
a rate of 5.5 percent, and in private health insurance at a rate of 4.8 percent.<br />
<br />
• The share of health care spending sponsored by federal, state, and local governments is<br />
expected to increase by 2 percent, reaching 47 percent by 2027. This projected increase is<br />
primarily due to expected growth in Medicare enrollment.<br />
<br />
• The share of individuals with health insurance coverage is expected to remain stable, at around<br />
90 percent.<br />
<br />
The Office of the Actuary in the Centers for Medicare & Medicaid Services annually produces projections of health care spending for categories within the National Health Expenditure Accounts, which track health spending by source of funds (for example, private health insurance, Medicare, Medicaid), by type of service (hospital, physician, prescription drugs, etc.), and by sponsor (businesses, households, governments).<br />
<br />
Click on this <a href="https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsProjected.html"><span style="color: blue;">web page</span></a> to retrieve the official 2018-2027 NHE Projections.<br />
<br />
Until next time,<br />
<br />
Andrew Herman, President<br />
AH Insurance Services, Inc.<br />
<br />
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<br />
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<br />
<br />Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-71045069618703440302018-12-17T21:00:00.001-05:002018-12-17T21:00:29.667-05:00U.S. District Court Rules ACA UnconstitutionalA federal judge for the U.S. District Court for the Northern District of Texas has ruled in favor of a lawsuit filed by his state and 19 others which claimed that Congress’ recent repeal of the ACA’s tax penalty has undone the rationale of the Supreme Court’s 2012 decision that the law is constitutional.<br />
<br />
<div>
<div>
U.S. District Court Judge Reed O'Connor issued a decision on December 14 in Texas v. Azar declaring the individual mandate for health insurance coverage unconstitutional and ruling further that the mandate cannot be severed from the rest of the ACA, rendering the entire law invalid.</div>
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<br /></div>
<div>
The original lawsuit by the states was filed against the U.S. Department of Health and Human Services (HHS) and the Internal Revenue Service (IRS). Its claim against the ACA’s constitutionality rests upon the U.S. Supreme Court ruling that the individual mandate was constitutional under the powers of taxation held by Congress; however, elimination of the individual mandate’s enforcement mechanism in last year's Tax Cuts and Jobs Act did not actually eliminate the mandate. Rather, it simply dropped the tax penalty for not having qualifying health insurance to $0 beginning in 2019.</div>
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<br /></div>
<div>
Therefore, the lawsuit argued that the individual mandate has been retained and rendered unconstitutional, as it no longer exercises Congress’ powers of taxation. Judge O'Connor agreed with the lawsuit’s plaintiffs and issued partial summary judgement in their favor; although he did not order an injunction against the ACA as requested in the lawsuit.</div>
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<br /></div>
<div>
Following the December 14 ruling, HHS stated it “will continue administering and enforcing all aspects of the ACA as it had before the court issued its decision.” The ruling is expected to be appealed by various state attorneys general and possibly will end up back at the Supreme Court.</div>
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<br /></div>
</div>
Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-19344929486836569532018-10-13T18:54:00.000-04:002018-10-13T18:55:24.118-04:002019 Medicare Parts A & B Premiums and Deductibles<div class="text-align-center" style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px; text-align: center;">
Source for this blog post is the CMS.gov website:</div>
<div class="text-align-center" style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px; text-align: center;">
https://www.cms.gov/newsroom/fact-sheets/2019-medicare-parts-b-premiums-and-deductibles</div>
<div style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Yesterday, the Centers for Medicare & Medicaid Services (CMS) released the 2019 premiums, deductibles, and coinsurance amounts for the Medicare Part A and B programs.</span></div>
<div style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;"><strong style="min-height: 0px; min-width: 0px;">Medicare Part B Premiums/Deductibles</strong></span></span></div>
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<span style="min-height: 0px; min-width: 0px;">Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A. </span></div>
<div style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">The standard monthly premium for Medicare Part B enrollees will be $135.50 for 2019, an increase of $1.50 from $134 in 2018. An estimated 2 million Medicare beneficiaries (about 3.5%) will pay less than the full Part B standard monthly premium amount in 2019 due to the statutory hold harmless provision, which limits certain beneficiaries’ increase in their Part B premium to be no greater than the increase in their Social Security benefits. The annual deductible for all Medicare Part B beneficiaries is $185 in 2019, an increase of $2 from the annual deductible $183 in 2018. Premiums and deductibles for Medicare Advantage and Medicare Prescription Drug plans are already finalized and are unaffected by this announcement.</span></div>
<div style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Since 2007, a beneficiary’s Part B monthly premium is based on his or her income. These income-related monthly adjustment amounts (IRMAA) affect roughly 5 percent of people with Medicare Part B. The total premiums for high income beneficiaries for 2019 are shown in the following table:</span></div>
<table style="background-color: #fafafa; border-collapse: collapse; border-spacing: 0px; border: 0px; color: #323a45; font-family: "Lucida Grande", "Lucida Sans Unicode", Verdana, sans-serif; font-size: 0.857em; margin: 10px 0px; min-height: 0px; min-width: 0px; width: 639.2px;"><tbody style="min-height: 0px; min-width: 0px;">
<tr style="background: rgba(0, 0, 0, 0.063); border-bottom: 1px solid rgb(204, 204, 204); min-height: 0px; min-width: 0px; padding: 0.1em 0.6em;"><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;"><strong style="min-height: 0px; min-width: 0px;">Beneficiaries who file </strong></span></span><br />
<span style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;"><strong style="min-height: 0px; min-width: 0px;">individual tax returns with income:</strong></span></span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;"><strong style="min-height: 0px; min-width: 0px;">Beneficiaries who file</strong></span></span><br />
<span style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;"><strong style="min-height: 0px; min-width: 0px;">joint tax returns with income:</strong></span></span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;"><strong style="min-height: 0px; min-width: 0px;">Income-related monthly adjustment amount</strong></span></span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;"><strong style="min-height: 0px; min-width: 0px;">Total monthly premium amount</strong></span></span></div>
</td></tr>
<tr style="background: rgba(0, 0, 0, 0.063); border-bottom: 1px solid rgb(204, 204, 204); min-height: 0px; min-width: 0px; padding: 0.1em 0.6em;"><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Less than or equal to $85,000</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Less than or equal to $170,000</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$0.00</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$135.50</span></div>
</td></tr>
<tr style="background: rgba(0, 0, 0, 0.063); border-bottom: 1px solid rgb(204, 204, 204); min-height: 0px; min-width: 0px; padding: 0.1em 0.6em;"><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Greater than $85,000 and less than or equal to $107,000</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Greater than $170,000 and less than or equal to $214,000</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$54.10</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$189.60</span></div>
</td></tr>
<tr style="background: rgba(0, 0, 0, 0.063); border-bottom: 1px solid rgb(204, 204, 204); min-height: 0px; min-width: 0px; padding: 0.1em 0.6em;"><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Greater than $107,000 and less than or equal to $133,500</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Greater than $214,000 and less than or equal to $267,000</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$135.40</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$270.90</span></div>
</td></tr>
<tr style="background: rgba(0, 0, 0, 0.063); border-bottom: 1px solid rgb(204, 204, 204); min-height: 0px; min-width: 0px; padding: 0.1em 0.6em;"><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Greater than $133,500 and less than or equal to $160,000</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Greater than $267,000 and less than or equal to $320,000</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$216.70</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$352.20</span></div>
</td></tr>
<tr style="background: rgba(0, 0, 0, 0.063); border-bottom: 1px solid rgb(204, 204, 204); min-height: 0px; min-width: 0px; padding: 0.1em 0.6em;"><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Greater than $160,000 and less than $500,000</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Greater than $320,000 and less than $750,000</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$297.90</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$433.40</span></div>
</td></tr>
<tr style="background: rgba(0, 0, 0, 0.063); border-bottom: 1px solid rgb(204, 204, 204); min-height: 0px; min-width: 0px; padding: 0.1em 0.6em;"><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Greater than or equal to $500,000</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Greater than or equal to $750,000</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$325.00</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$460.50</span></div>
</td></tr>
</tbody></table>
<div style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Premiums for high-income beneficiaries who are married and lived with their spouse at any time during the taxable year, but file a separate return, are as follows:</span></div>
<table style="background-color: #fafafa; border-collapse: collapse; border-spacing: 0px; border: 0px; color: #323a45; font-family: "Lucida Grande", "Lucida Sans Unicode", Verdana, sans-serif; font-size: 0.857em; margin: 10px 0px; min-height: 0px; min-width: 0px; width: 639.2px;"><tbody style="min-height: 0px; min-width: 0px;">
<tr style="background: rgba(0, 0, 0, 0.063); border-bottom: 1px solid rgb(204, 204, 204); min-height: 0px; min-width: 0px; padding: 0.1em 0.6em;"><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;"><strong style="min-height: 0px; min-width: 0px;">Beneficiaries who are married and lived with their spouses at any time during the year, but who file separate tax returns from their spouses:</strong></span></span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;"><strong style="min-height: 0px; min-width: 0px;">Income-related monthly adjustment amount</strong></span></span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;"><strong style="min-height: 0px; min-width: 0px;">Total monthly premium amount</strong></span></span></div>
</td></tr>
<tr style="background: rgba(0, 0, 0, 0.063); border-bottom: 1px solid rgb(204, 204, 204); min-height: 0px; min-width: 0px; padding: 0.1em 0.6em;"><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Less than or equal to $85,000</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$0.00</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$135.50</span></div>
</td></tr>
<tr style="background: rgba(0, 0, 0, 0.063); border-bottom: 1px solid rgb(204, 204, 204); min-height: 0px; min-width: 0px; padding: 0.1em 0.6em;"><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Greater than $85,000 and less than $415,000</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$297.90</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$433.40</span></div>
</td></tr>
<tr style="background: rgba(0, 0, 0, 0.063); border-bottom: 1px solid rgb(204, 204, 204); min-height: 0px; min-width: 0px; padding: 0.1em 0.6em;"><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Greater than or equal to $415,000</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$325.00</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$460.50</span></div>
</td></tr>
</tbody></table>
<div style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;"><strong style="min-height: 0px; min-width: 0px;">Medicare Part A Premiums/Deductibles</strong></span></span></div>
<div style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Medicare Part A covers inpatient hospital, skilled nursing facility, and some home health care services. About 99 percent of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment.</span></div>
<div style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">The Medicare Part A inpatient hospital deductible that beneficiaries will pay when admitted to the hospital will be $1,364 in 2019, an increase of $24 from $1,340 in 2018. The Part A inpatient hospital deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period. In 2019, beneficiaries must pay a coinsurance amount of $341 per day for the 61<span style="font-size: 12px; line-height: 0; min-height: 0px; min-width: 0px; position: relative; top: -0.5em; vertical-align: baseline;">st</span>through 90<span style="font-size: 12px; line-height: 0; min-height: 0px; min-width: 0px; position: relative; top: -0.5em; vertical-align: baseline;">th</span> day of a hospitalization ($335 in 2018) in a benefit period and $682 per day for lifetime reserve days ($670 in 2018). For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $170.50 in 2019 ($167.50 in 2018).</span></div>
<table style="background-color: #fafafa; border-collapse: collapse; border-spacing: 0px; border: 0px; color: #323a45; font-family: "Lucida Grande", "Lucida Sans Unicode", Verdana, sans-serif; font-size: 0.857em; margin: 10px 0px; min-height: 0px; min-width: 0px; width: 639.2px;"><tbody style="min-height: 0px; min-width: 0px;">
<tr style="background: rgba(0, 0, 0, 0.063); border-bottom: 1px solid rgb(204, 204, 204); min-height: 0px; min-width: 0px; padding: 0.1em 0.6em;"><td colspan="3" style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div class="text-align-center" style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px; text-align: center;">
<span style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;"><span style="min-height: 0px; min-width: 0px;"><strong style="min-height: 0px; min-width: 0px;">Part A Deductible and Coinsurance Amounts for Calendar Years 2018 and 2019<br style="min-height: 0px; min-width: 0px;" />by Type of Cost Sharing</strong></span></span></span></div>
</td></tr>
<tr style="background: rgba(0, 0, 0, 0.063); border-bottom: 1px solid rgb(204, 204, 204); min-height: 0px; min-width: 0px; padding: 0.1em 0.6em;"><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<br /></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">2018</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">2019</span></div>
</td></tr>
<tr style="background: rgba(0, 0, 0, 0.063); border-bottom: 1px solid rgb(204, 204, 204); min-height: 0px; min-width: 0px; padding: 0.1em 0.6em;"><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Inpatient hospital deductible</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$1,340</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">$1,364</span></div>
</td></tr>
<tr style="background: rgba(0, 0, 0, 0.063); border-bottom: 1px solid rgb(204, 204, 204); min-height: 0px; min-width: 0px; padding: 0.1em 0.6em;"><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Daily coinsurance for 61<span style="font-size: 12px; line-height: 0; min-height: 0px; min-width: 0px; position: relative; top: -0.5em; vertical-align: baseline;">st</span>-90<span style="font-size: 12px; line-height: 0; min-height: 0px; min-width: 0px; position: relative; top: -0.5em; vertical-align: baseline;">th</span> Day</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">335</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">341</span></div>
</td></tr>
<tr style="background: rgba(0, 0, 0, 0.063); border-bottom: 1px solid rgb(204, 204, 204); min-height: 0px; min-width: 0px; padding: 0.1em 0.6em;"><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Daily coinsurance for lifetime reserve days</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">670</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">682</span></div>
</td></tr>
<tr style="background: rgba(0, 0, 0, 0.063); border-bottom: 1px solid rgb(204, 204, 204); min-height: 0px; min-width: 0px; padding: 0.1em 0.6em;"><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Skilled Nursing Facility coinsurance</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">167.50</span></div>
</td><td style="border: 1px solid rgb(255, 255, 255); min-height: 0px; min-width: 0px; padding: 4px 9px;"><div style="font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">170.50</span></div>
</td></tr>
</tbody></table>
<div style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="min-height: 0px; min-width: 0px;">Enrollees age 65 and over who have fewer than 40 quarters of coverage and certain persons with disabilities pay a monthly premium in order to voluntarily enroll in Medicare Part A. Individuals who had at least 30 quarters of coverage or were married to someone with at least 30 quarters of coverage may buy into Part A at a reduced monthly premium rate, which will be $240 in 2019, an $8 increase from 2018. Certain uninsured aged individuals who have less than 30 quarters of coverage and certain individuals with disabilities who have exhausted other entitlement will pay the full premium, which will be $437 a month, a $15 increase from 2018.</span></div>
<div style="background-color: #fafafa; color: #323a45; font-family: Muli, "Helvetica Neue", Arial, sans-serif; font-size: 16px; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="font-family: "muli" , "helvetica neue" , "arial" , sans-serif;">Until next time,</span></div>
<div style="background-color: #fafafa; margin-bottom: 1.2em; min-height: 0px; min-width: 0px;">
<span style="font-size: 16px; min-height: 0px; min-width: 0px;"><span style="color: #323a45; font-family: "muli" , "helvetica neue" , "arial" , sans-serif;">Andrew Herman, President</span></span></div>
Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-81417902496282033192018-01-11T12:33:00.000-05:002018-01-11T12:35:01.165-05:002018 Medicare Update<br />
<span style="font-family: inherit;">The chart below provides a summary of <b>2018 Medicare premiums, deductibles and co-insurance</b>, along with average increase to monthly Social Security benefits in 2018:</span><br />
<br />
<table align="center" cellpadding="0" cellspacing="0"><tbody>
<tr><td colspan="1" rowspan="1" style="border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0); border-top: 1px solid rgb(0, 0, 0);" width="300"><b>Medicare Part A Premium</b><br />
<br /></td><td colspan="1" rowspan="1" style="border-top: 1px solid rgb(0, 0, 0);" width="10"></td><td colspan="1" rowspan="1" style="border-right: 1px solid rgb(0, 0, 0); border-top: 1px solid rgb(0, 0, 0);" width="420">Most people do not have to pay a monthly premium for Part A. If you buy Part A, you will pay <b>up to $422 each month</b> ($422/month if you paid Medicare taxes for less than 30 quarters or $232/month if you paid Medicare taxes for 30-39 quarters)<br />
<div>
<br /></div>
</td></tr>
<tr><td colspan="1" rowspan="1" style="border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);" width="300"><b>Medicare Part A Inpatient Hospital Deductible and Co-Insurance</b></td><td colspan="1" rowspan="1" width="10"></td><td colspan="1" rowspan="1" style="border-right: 1px solid rgb(0, 0, 0);" valign="top" width="420"><b>$1,340 deductible</b> and no coinsurance for days 1-60 of each benefit period</td></tr>
<tr><td colspan="1" rowspan="1" style="border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);" width="300"><br /></td><td colspan="1" rowspan="1" width="10"><br /></td><td colspan="1" rowspan="1" style="border-right: 1px solid rgb(0, 0, 0);" valign="top" width="420">Days 1 - 60 co-insurance for each benefit period: <strong>$0</strong></td></tr>
<tr><td colspan="1" rowspan="1" style="border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);" width="300"></td><td colspan="1" rowspan="1" width="10"></td><td colspan="1" rowspan="1" style="border-right: 1px solid rgb(0, 0, 0);" valign="top" width="420">Days 61 - 90 co-insurance per day for each benefit period: <strong>$335</strong></td></tr>
<tr><td colspan="1" rowspan="1" style="border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);" width="300"><br /></td><td colspan="1" rowspan="1" width="10"></td><td colspan="1" rowspan="1" style="border-right: 1px solid rgb(0, 0, 0);" valign="top" width="420">Days 91 and beyond: <strong>$670</strong> co-insurance per each "lifetime reserve day" (up to 60 days over your lifetime)</td></tr>
<tr><td colspan="1" rowspan="1" style="border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);" width="300"><br /></td><td colspan="1" rowspan="1" width="10"></td><td colspan="1" rowspan="1" style="border-right: 1px solid rgb(0, 0, 0);" valign="top" width="420"><br /></td></tr>
<tr><td colspan="1" rowspan="1" style="border-color: rgb(0, 0, 0); border-style: none solid solid; border-width: 0px 1px 1px;" width="300"><b>Skilled Nursing Facility</b></td><td colspan="1" rowspan="1" style="border-bottom: 1px solid rgb(0, 0, 0);" width="10"></td><td colspan="1" rowspan="1" style="border-bottom: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);" valign="top" width="420"><strong>$0</strong> for Days 1 - 20 of each benefit period; then <strong>$167.50</strong> per day for Days 21-100 (after Day 100 Medicare beneficiary pays all costs)</td></tr>
<tr><td colspan="1" rowspan="1" style="border-bottom: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);" width="300"><strong>Medicare Part B Premium*</strong></td><td colspan="1" rowspan="1" style="border-bottom: 1px solid rgb(0, 0, 0);" width="10"></td><td colspan="1" rowspan="1" style="border-bottom: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);" valign="center" width="420">Standard Part B premium will be <b>$134</b> (or higher based on your income). However, some people who receive Social Security benefits will pay less <strong>($130/average)</strong></td></tr>
<tr><td colspan="1" rowspan="1" style="border-bottom: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);" width="300"><strong>Medicare Part B Deductible</strong></td><td colspan="1" rowspan="1" style="border-bottom: 1px solid rgb(0, 0, 0);" width="10"></td><td colspan="1" rowspan="1" style="border-bottom: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);" width="420"><strong>$183.00</strong></td></tr>
<tr><td colspan="1" rowspan="6" style="border-bottom: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);" width="300"><strong>Medicare Part D Benefits</strong></td><td colspan="1" rowspan="1" width="10"></td><td colspan="1" rowspan="1" style="border-right: 1px solid rgb(0, 0, 0);" width="420">Initial deductible: <strong>$405</strong></td></tr>
<tr><td colspan="1" rowspan="1" width="10"></td><td colspan="1" rowspan="1" style="border-right: 1px solid rgb(0, 0, 0);" width="420">Initial coverage limit: <strong>$3,750</strong></td></tr>
<tr><td colspan="1" rowspan="1" width="10"></td><td colspan="1" rowspan="1" style="border-right: 1px solid rgb(0, 0, 0);" width="420">Out of pocket threshold (or TrOOP): <strong>$5,000</strong></td></tr>
<tr><td colspan="1" rowspan="1" width="10"></td><td colspan="1" rowspan="1" style="border-right: 1px solid rgb(0, 0, 0);" width="420">Coverage gap: begins once you reach your Medicare Part D plan's initial coverage limit ($3,750 in 2018) and ends when you spend a total of $5,000 in 2018.</td></tr>
<tr><td colspan="1" rowspan="1" width="10"></td><td colspan="1" rowspan="1" style="border-right: 1px solid rgb(0, 0, 0);" width="420">In 2018, Part D enrollees will receive a 65% discount on the total cost of their brand-name drugs purchased while in the donut hole. The 50% discount paid by the brand-name drug manufacturer will apply to getting out of the donut hole, however the additional 15% paid by your Medicare Part D plan will not count toward your TrOOP.</td></tr>
<tr><td colspan="1" rowspan="1" style="border-bottom: 1px solid rgb(0, 0, 0);" width="10"></td><td colspan="1" rowspan="1" style="border-bottom: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);" width="420">Minimum cost sharing in Catastrophic portion: <strong>5% or $3.35</strong> for generic or preferred drug that is multi-source drug and the greater of 5% or <strong>$8.35 for all other drugs.</strong></td></tr>
<tr><td colspan="1" rowspan="1" style="border-bottom: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);" width="300"><strong>Average Monthly Social Security Increase</strong></td><td colspan="1" rowspan="1" style="border-bottom: 1px solid rgb(0, 0, 0);" width="10"></td><td colspan="1" rowspan="1" style="border-bottom: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);" width="420"><b>All Retired Workers - </b>2.0% increase to $1,404 (from $1,377 in 2017)<br />
<b>All Disabled Workers - </b>2.0% increase to $1,197 (from $1,173 in 2017) </td></tr>
</tbody></table>
<br />
<br />
* From CMS: "The standard monthly premium for Medicare Part B enrollees will be $134 for 2018, the same amount as in 2017. However, a statutory 'hold harmless' provision applies each year to about 70% of enrollees. For these enrollees, any increase in Part B premiums must be lower than the increase in their Social Security benefits. After several years of no or very small increases, Social Security benefits will increase by 2% percent in 2018 due to the cost-of-living adjustment (COLA). Therefore, some beneficiaries who were held harmless against Part B premiums increases in prior years will have a premium increase in 2018."<br />
<br />
According to CMS, Part B enrollees who are not subject to the hold-harmless provision will pay the full premium of $134 per month in 2018 while Part B enrollees who were held harmless in 2016 and 2017 will see an increase in the monthly Part B premium from the roughly $109, on average, they paid in 2017.<br />
<br />
CMS estimates that 42% of all Part B enrollees are subject to the hold-harmless provision in 2018 and will pay the standard monthly premium of $134 (an increase of about $25), because the increase in their Social Security benefit will be greater than or equal to an increase in their Part B premiums up to the full 2018 amount. Additionally, CMS estimates 28% of all Part B enrollees are subject to the hold-harmless provision in 2018 and will pay less than the full monthly premium of $134, because the increase in their Social Security benefit will not be large enough to cover the full Part B premium increase.<br />
<br />
Medicare Part B enrollees will pay the standard $134 Part B premium amount in 2018 (or higher depending on income) if:<br />
<br />
<div style="background-color: white; border: 0px; color: #4c4c4c; font-family: Arial, Verdana; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<ul style="border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; list-style-image: initial; list-style-position: initial; margin: 0px 0px 9px 10px; outline: 0px; padding: 0px; vertical-align: baseline;">
<li style="background: url("/Resources/Medicare/Images/home/bulletSprite.png") 0px -173px no-repeat transparent; border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; line-height: 1.5em; list-style: none; margin: 0px 0px 5px; outline: 0px; padding: 0px 0px 0px 20px; vertical-align: baseline;"><span style="font-size: xx-small;">You enroll in Part B for the first time in 2018.</span></li>
<li style="background: url("/Resources/Medicare/Images/home/bulletSprite.png") 0px -173px no-repeat transparent; border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; line-height: 1.5em; list-style: none; margin: 0px 0px 5px; outline: 0px; padding: 0px 0px 0px 20px; vertical-align: baseline;"><span style="font-size: xx-small;">You don't get Social Security benefits.</span></li>
<li style="background: url("/Resources/Medicare/Images/home/bulletSprite.png") 0px -173px no-repeat transparent; border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; line-height: 1.5em; list-style: none; margin: 0px 0px 5px; outline: 0px; padding: 0px 0px 0px 20px; vertical-align: baseline;"><span style="font-size: xx-small;">You're directly billed for your Part B premiums (meaning they aren't taken out of your Social Security benefits).</span></li>
<li style="background: url("/Resources/Medicare/Images/home/bulletSprite.png") 0px -173px no-repeat transparent; border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; line-height: 1.5em; list-style: none; margin: 0px 0px 5px; outline: 0px; padding: 0px 0px 0px 20px; vertical-align: baseline;"><span style="font-size: xx-small;">You have Medicare and Medicaid, and Medicaid pays your premiums. (Your state will pay the standard premium amount of $134.)</span></li>
<li style="background: url("/Resources/Medicare/Images/home/bulletSprite.png") 0px -173px no-repeat transparent; border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; line-height: 1.5em; list-style: none; margin: 0px 0px 5px; outline: 0px; padding: 0px 0px 0px 20px; vertical-align: baseline;"><span style="font-size: xx-small;">Your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount. If so, you’ll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.</span></li>
</ul>
<div style="border: 0px; font-family: Arial, Helvetica, sans-serif; font-style: inherit; font-weight: inherit; line-height: 25.875px; margin-bottom: 9px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: xx-small;">If you're in 1 of these 5 groups, here's what you'll pay:</span></div>
<table style="border-collapse: collapse; border-spacing: 0px; border: 1px solid rgb(204, 204, 204); font-family: inherit; font-style: inherit; font-weight: inherit; margin: 0px 0px 15px; max-width: 100%; outline: 0px; padding: 0px; vertical-align: baseline; width: auto !important;"><tbody style="border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<tr style="border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th colspan="3" id="yearly" scope="colgroup" style="background: rgb(223, 229, 236); border: 1px solid rgb(204, 204, 204); font-family: inherit; font-size: 14px; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; text-align: left; vertical-align: baseline; width: 901px;"><span style="font-size: xx-small;">If your yearly income in 2016 (for what you pay in 2018) was</span></th><th rowspan="2" scope="col" style="background: rgb(223, 229, 236); border: 1px solid rgb(204, 204, 204); font-family: inherit; font-size: 14px; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; text-align: left; vertical-align: baseline; width: 66px;"><span style="font-size: xx-small;">You pay each month (in 2018)</span></th></tr>
<tr style="border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th id="individual" scope="col" style="background: rgb(223, 229, 236); border: 1px solid rgb(204, 204, 204); font-family: inherit; font-size: 14px; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; text-align: left; vertical-align: baseline; width: 245px;"><span style="font-size: xx-small;">File individual tax return</span></th><th id="joint" scope="col" style="background: rgb(223, 229, 236); border: 1px solid rgb(204, 204, 204); font-family: inherit; font-size: 14px; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; text-align: left; vertical-align: baseline; width: 241px;"><span style="font-size: xx-small;">File joint tax return</span></th><th headers="yearly joint" id="170000" style="background: rgb(223, 229, 236); border: 1px solid rgb(204, 204, 204); font-family: inherit; font-size: 14px; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; text-align: left; vertical-align: baseline; width: 411px;"><span style="font-size: xx-small;">File married & separate tax return</span></th></tr>
<tr style="border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td headers="yearly individual" id="85000" style="border: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 245px;"><span style="font-size: xx-small;">$85,000 or less</span></td><td headers="yearly joint" id="170000" style="border: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 241px;"><span style="font-size: xx-small;">$170,000 or less</span></td><td headers="yearly joint" id="170001" style="border: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 411px;"><span style="font-size: xx-small;">$85,000 or less</span></td><td headers="85000 170000" style="border: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 66px;"><span style="font-size: xx-small;">$134</span></td></tr>
<tr style="border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td headers="yearly individual" id="85001" style="border: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 245px;"><span style="font-size: xx-small;">above $85,000 up to $107,000</span></td><td headers="yearly joint" id="170001" style="border: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 241px;"><span style="font-size: xx-small;">above $170,000 up to $214,000</span></td><td headers="yearly joint" id="214001" style="border: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 411px;"><span style="font-size: xx-small;">Not applicable</span></td><td headers="850010 170001" style="border: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 66px;"><span style="font-size: xx-small;">$187.50</span></td></tr>
<tr style="border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td headers="yearly individual" id="107001" style="border: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 245px;"><span style="font-size: xx-small;">above $107,000 up to $133,500</span></td><td headers="yearly joint" id="214001" style="border: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 241px;"><span style="font-size: xx-small;">above $214,000 up to $267,000</span></td><td headers="yearly joint" id="320001" style="border: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 411px;"><span style="font-size: xx-small;">Not applicable</span></td><td headers="107001 214001" style="border: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 66px;"><span style="font-size: xx-small;">$267.90</span></td></tr>
<tr style="border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td headers="yearly individual" id="160001" style="border: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 245px;"><span style="font-size: xx-small;">above $133,500 up to $160,000</span></td><td headers="yearly joint" id="320001" style="border: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 241px;"><span style="font-size: xx-small;">above $267,000 up to $320,000</span></td><td style="border: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 411px;"><span style="font-size: xx-small;">Not applicable</span></td><td headers="160001 320001" style="border: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 66px;"><span style="font-size: xx-small;">$348.30</span></td></tr>
<tr style="border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td style="border-bottom: none; border-image: initial; border-left: 1px solid rgb(204, 204, 204); border-right: 1px solid rgb(204, 204, 204); border-top: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 245px;"><span style="font-size: xx-small;">above $160,000</span></td><td style="border-bottom: none; border-image: initial; border-left: 1px solid rgb(204, 204, 204); border-right: 1px solid rgb(204, 204, 204); border-top: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 241px;"><span style="font-size: xx-small;">above $320,000</span></td><td style="border-bottom: none; border-image: initial; border-left: 1px solid rgb(204, 204, 204); border-right: 1px solid rgb(204, 204, 204); border-top: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 411px;"><span style="font-size: xx-small;">above $85,000</span></td><td style="border-bottom: none; border-image: initial; border-left: 1px solid rgb(204, 204, 204); border-right: 1px solid rgb(204, 204, 204); border-top: 1px solid rgb(204, 204, 204); color: #333333; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px; vertical-align: baseline; width: 66px;"><span style="font-size: xx-small;">$428.60</span></td></tr>
</tbody></table>
</div>
<br />
Click on the following link for additional information on Medicare Part B costs:<br />
<b><br /></b>
<span style="color: blue;"><a href="https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-costs.html"><i><b>https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-costs.html</b></i></a></span><br />
<span style="color: cyan;"><br /></span>
<br />
Or for further information on 2018 Social Security benefits click this link:<br />
<br />
<i><u><span style="color: blue;"><a href="https://www.ssa.gov/news/press/factsheets/colafacts2018.pdf"><b>https://www.ssa.gov/news/press/factsheets/colafacts2018.pdf</b></a></span></u></i><br />
<br />
<br />
Until next time,<br />
<br />
Andrew Herman, President<br />
AH Insurance Services, Inc.<br />
<br />Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-31884069476239947372017-08-09T09:25:00.000-04:002017-08-09T09:25:40.873-04:002018 Medicare ID Card Changes<i><b>New Medicare ID Cards To Be Issued Next Year</b></i><br />
<br />
Beginning in April 2018, new Medicare cards without Social Security numbers will be sent to beneficiaries. Instead of the Social Security-based Health Insurance Claim Number (HICN), the new cards will use a unique, randomly assigned combination of letters and digits that will be known as the Medicare Beneficiary Identifier (MBI).<br />
<br />
<i><b>How Will The MBI Look?</b></i><br />
<i><b><br /></b></i>
The MBI will be:<br />
<br />
<ul>
<li>Clearly different from the HICN number</li>
<li>11-characters in length</li>
<li>Made up only of numbers and uppercase letters (no special characters) </li>
</ul>
<br />
The Centers for Medicare and Medicaid Services (CMS) has promised an easy transition for Medicare providers. Through December 2019, providers will be allowed to use either the MBI or the old HICN.<br />
<br />
<i><b>How Will The Process Work?</b></i><br />
<br />
Currently there are nearly 60 million people enrolled in the Medicare program, so it is no small task to develop a new Medicare identifier and issue new cards to all Medicare beneficiaries; but a 2015 law passed by Congress (The Medicare Access and CHIP Reauthorization Act) gave CMS four years to accomplish it.<br />
<br />
The first step will be to implement the new identification number and new Medicare card with the non-Social Security number identifier for new enrollees. From there, CMS must issue a new Medicare card to every current enrollee by April 2019.<br />
<br />
The new Medicare card will work exactly like the old one, but will safeguard private information of interest to identity thieves. If you are currently enrolled in Medicare, you’ll receive information directly from CMS about when to expect your new Medicare card.<br />
<br />
<b><i>For more information about the new Medicare ID card, please see:</i></b><br />
<br />
<i><a href="https://www.cms.gov/Medicare/New-Medicare-Card/index.html"><span style="color: blue;">https://www.cms.gov/Medicare/New-Medicare-Card/index.html</span></a></i><br />
<br />
Until next time,<br />
<br />
Andrew Herman, President<br />
AH Insurance Services, Inc.<br />
<br />Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-69980485106265976002016-12-31T12:11:00.000-05:002016-12-31T12:11:20.952-05:00The Affordable Care Act (ACA) – What Would a Replacement Program Look Like – And Is One Needed?<div class="MsoNormal">
Georgia Congressman Tom Price, a fierce critic of the ACA
and a leading advocate of repealing and replacing the controversial 2010 health
care law, recently was chosen by President-elect Donald Trump to lead the
Department of Health and Human Services (HHS).
On track to be behind the wheel at HHS, Price may be the one who authors
final rules implementing whatever legislation ultimately replaces the ACA (known
informally as “ObamaCare”).<o:p></o:p></div>
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<br /></div>
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Congressman Price, a former orthopedic surgeon, personally introduced
legislation to repeal and replace ObamaCare in the current Congress and
previous sessions. His 2015 proposal is
called the <i><a href="http://tomprice.house.gov/sites/tomprice.house.gov/files/Section%20by%20Section%20of%20HR%202300%20Empowering%20Patients%20First%20Act%202015.pdf" target="_blank"><span style="color: blue;">Empowering Patients First Act</span></a> </i>and served as the basis for a subsequent health care proposal
unveiled in June of this year by House Speaker Paul Ryan.<o:p></o:p></div>
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A key feature of ObamaCare is that it spreads out the costs of health insurance across generations, with subsidization of older sicker people
who use more health care by healthier young people. Prior to the ACA’s implementation, most
states permitted an age band rating with a 5:1 ratio; meaning that insurers could
charge insureds at the highest issue ages up to five times what the youngest
insureds pay in premium. The ACA
compressed the permitted age band rating to a 3:1 ratio, forcing companies to
subsidize older people with higher premium levels for younger people. Price’s proposal would eliminate that, which might be viewed favorably even by ObamaCare's proponents who now recognize they are fighting an uphill battle trying to convince young adults to buy coverage at an exorbitant premium cost.<o:p></o:p></div>
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Price has spoken out against the ACA’s approach to insert the
government in the middle of the doctor-patient relationship. In June of this year Price stated, “They
believe the government ought to be in control of health care” and continued
with "we believe that patients and doctors should be in control of health
care. People have coverage, but they
don't have care." More recently, he
declared “ObamaCare is failing” in a <i><span style="color: blue;"><a href="http://townhall.com/columnists/tomprice/2016/11/01/obamacare-is-failing-lets-try-a-better-way-n2240314" target="_blank"><b>November 1st op-ed on the Townhall website.</b></a><o:p></o:p></span></i></div>
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Some of the key points from Prices' health care proposal are as follows:</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
</div>
<ul>
<li>Fixed tax credits for people to use to buy insurance on the private market, with credits starting at $900 a year below age 18 and rising with age. People on Medicaid, Medicare, Tricare or the Veterans Affairs (VA) program could opt for tax credits to buy private insurance.</li>
</ul>
<br />
<div class="MsoNormal">
</div>
<ul>
<li>Expansion of health savings accounts, which allow people to save money for health care costs on a pre-tax basis. People covered by existing government programs including Medicare and the VA could contribute to their health savings accounts to pay for premiums and copayments.</li>
</ul>
<br />
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</div>
<ul>
<li>No denying coverage to people with pre-existing medical conditions provided they had maintained continuous insurance for 18 months prior to selecting a new policy. Otherwise, for people who had not maintained such continuous insurance, coverage of a pre-existing condition could be excluded for up to 18 months after enrolling in a new health plan.</li>
</ul>
<br />
<div class="MsoNormal">
</div>
<ul>
<li>Companies can take a tax deduction of up to $20,000 for a family health plan and $8,000 for an individual. The limit is intended to discourage overly generous employer health insurance plans.</li>
</ul>
<br />
<div class="MsoNormal">
</div>
<ul>
<li>States would receive federal funds to create “high-risk pools”, which are government-run health plans for people with pre-existing medical conditions who cannot find affordable health insurance on the private market. </li>
</ul>
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<div class="MsoNormal">
Effective implementation of Price’s plan seemingly would
require an initial open enrollment period that achieves broad success in covering Americans
not already insured under employer-sponsored programs or government health care plans such as
Medicare and Tricare. Following the
initial program enrollment, Price’s plan would make it difficult for people to try to game
the new system by purchasing insurance only upon discovery of an illness.<o:p></o:p></div>
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<br /></div>
<div class="MsoNormal">
Price concluded his op-ed
with the following:<o:p></o:p></div>
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<br /></div>
<div class="MsoNormal">
“We solve the insurance challenges of portability and
pre-existing conditions by applying the same coverage rules that already exist
in the employer-sponsored market – real, sustainable protections that mean no
one can be priced out of the health insurance market if they have a bad
diagnosis or injury. And, for those on a government health care program, we
offer reforms that will empower states with the flexibility to best serve their
Medicaid populations while offering Medicare beneficiaries more choices that
will help save, strengthen, and secure this vital program in the years to come.”<o:p></o:p></div>
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<br /></div>
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Let us hope that Price’s words do not prove to ring hollow,
like President Obama’s statement from March 2010 in his <b><i><a href="https://www.whitehouse.gov/the-press-office/weekly-address-health-reform-will-benefit-american-families-and-businesses-year" target="_blank">Weekly Address: Health Reform Will Benefit American Families and Businesses This Year</a>:</i></b> “What
won’t change when this bill is signed this:
if you like the insurance plan you have now, you can keep it. If you like your doctor, you can keep your
doctor. Because nothing should get in
the way of the relationship between a family and their doctor.”<o:p></o:p></div>
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<br /></div>
<div class="MsoNormal">
For the record, as a licensed sales agent I have assisted dozens of Americans in obtaining insurance through the ACA’s Health Insurance
Marketplace. I have been authorized to
conduct Marketplace business since the fall of 2013 when agents initially were certified. Since that time, my
existing individual policy was canceled, and the premium for the lowest cost
(non-subsidized) ACA compliant plan for sale in my area is more than double what I had paid
prior to 2014. Further, my 2017 plan (I
chose the lowest cost) does not include coverage for the orthopedic surgeon who
successfully repaired a torn labrum for me more than a decade ago; nor does my plan include coverage for
any physician I have visited in nearly 20 years living in Florida. To add insult to injury, today I often work
harder for an individual or family to assist with a health insurance plan enrollment;
yet my compensation is less than a third of what I received for
similar work performed prior to ObamaCare.
I do not believe that insurance company executives are making less money now, and I definitely do not recall hearing President Obama
admit that his proclamation noted above turned out to be totally false. It is disappointing to me that accountability
only applies to regular people, and not to those at the highest positions in our country.</div>
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<br /></div>
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After having conducted a thorough examination of the issues, I would say that a program to replace ObamaCare indeed is needed.</div>
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<br /></div>
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Until next time,<o:p></o:p></div>
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<br /></div>
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Andrew Herman</div>
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<br /></div>
Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-24656441731539385902016-12-11T09:38:00.000-05:002016-12-11T09:41:32.081-05:002017 Medicare Parts A, B and D Updates<span style="font-family: inherit;">The official 2017 Medicare and You handbook published by CMS (Centers for Medicare and Medicaid Services) is available in several formats. Here are links to the English and Spanish versions:</span><br />
<span style="font-family: inherit;"></span><br />
<span style="color: #3d85c6; font-family: inherit;"><em>English: </em></span><a href="https://www.medicare.gov/pubs/pdf/10050-Medicare-and-You.pdf"><span style="color: #3d85c6; font-family: inherit;"><em>https://www.medicare.gov/pubs/pdf/10050-Medicare-and-You.pdf</em></span></a><br />
<span style="font-family: inherit;"><em></em></span><br />
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<span style="font-family: inherit;"><span lang="ES" style="color: #212121; font-family: "inherit" , serif; mso-ansi-language: ES; mso-bidi-font-family: "Courier New"; mso-fareast-font-family: "Times New Roman";"><span style="color: #3d85c6;"><em>Español: </em></span><a href="https://www.medicare.gov/pubs/pdf/10050-S-Medicare-and-You.pdf"><span style="color: #3d85c6;"><em>https://www.medicare.gov/pubs/pdf/10050-S-Medicare-and-You.pdf</em></span></a></span></span></div>
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<span style="font-family: inherit;"><span lang="ES" style="color: #212121; font-family: "inherit" , serif; mso-ansi-language: ES; mso-bidi-font-family: "Courier New"; mso-fareast-font-family: "Times New Roman";"></span></span> </div>
<span style="font-family: inherit;">
The chart below provides a summary of 2017 Medicare deductibles and co-insurance amounts, along with the Medicare Part B premium and average monthly increase to Social Security benefits:</span><br />
<br />
<table align="center" cellpadding="0" cellspacing="0"><tbody>
<tr><td colspan="1" rowspan="1" style="border-left-color: rgb(0, 0, 0); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px; border-top-color: rgb(0, 0, 0); border-top-style: solid; border-top-width: 1px;" width="300"><strong>Medicare Part A</strong></td><td colspan="1" rowspan="1" style="border-top-color: rgb(0, 0, 0); border-top-style: solid; border-top-width: 1px;" width="10"> </td><td colspan="1" rowspan="1" style="border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px; border-top-color: rgb(0, 0, 0); border-top-style: solid; border-top-width: 1px;" width="420"> </td></tr>
<tr><td colspan="1" rowspan="1" style="border-left-color: rgb(0, 0, 0); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" width="300">Inpatient hospital deductible and co-insurance</td><td colspan="1" rowspan="1" width="10"> </td><td colspan="1" rowspan="1" style="border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" valign="top" width="420"><strong>$1,316</strong> deductible for each benefit period</td></tr>
<tr><td colspan="1" rowspan="1" style="border-left-color: rgb(0, 0, 0); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" width="300"> </td><td colspan="1" rowspan="1" width="10"> </td><td colspan="1" rowspan="1" style="border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" valign="top" width="420">Days 1 - 60 co-insurance for each benefit period <strong>$0</strong></td></tr>
<tr><td colspan="1" rowspan="1" style="border-left-color: rgb(0, 0, 0); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" width="300"> </td><td colspan="1" rowspan="1" width="10"> </td><td colspan="1" rowspan="1" style="border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" valign="top" width="420">Days 61 - 90 co-insurance per day for each benefit period <strong>$329</strong></td></tr>
<tr><td colspan="1" rowspan="1" style="border-left-color: rgb(0, 0, 0); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" width="300"> </td><td colspan="1" rowspan="1" width="10"> </td><td colspan="1" rowspan="1" style="border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" valign="top" width="420">Days 91 and beyond; <strong>$658</strong> co-insurance per "each lifetime reserve day"</td></tr>
<tr><td colspan="1" rowspan="1" style="border-left-color: rgb(0, 0, 0); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" width="300"> </td><td colspan="1" rowspan="1" width="10"> </td><td colspan="1" rowspan="1" style="border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" valign="top" width="420"> </td></tr>
<tr><td colspan="1" rowspan="1" style="border-color: rgb(0, 0, 0); border-style: none solid solid; border-width: 0px 1px 1px;" width="300">Skilled Nursing Facility</td><td colspan="1" rowspan="1" style="border-bottom-color: rgb(0, 0, 0); border-bottom-style: solid; border-bottom-width: 1px;" width="10"> </td><td colspan="1" rowspan="1" style="border-bottom-color: rgb(0, 0, 0); border-bottom-style: solid; border-bottom-width: 1px; border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" valign="top" width="420"><strong>$0</strong> for days 1 - 20; thereafter, days 21 - 100 <strong>$164.50</strong> per day</td></tr>
<tr><td colspan="1" rowspan="1" style="border-bottom-color: rgb(0, 0, 0); border-bottom-style: solid; border-bottom-width: 1px; border-left-color: rgb(0, 0, 0); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" width="300"><strong>Part B Premium</strong></td><td colspan="1" rowspan="1" style="border-bottom-color: rgb(0, 0, 0); border-bottom-style: solid; border-bottom-width: 1px;" width="10"> </td><td colspan="1" rowspan="1" style="border-bottom-color: rgb(0, 0, 0); border-bottom-style: solid; border-bottom-width: 1px; border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" valign="center" width="420">2017 standard Part B premium will be <strong>$134</strong> (<strong>or higher based</strong> on your income). However, most people who receive Social Security benefits will pay less than this amount <strong>($109/average)</strong></td></tr>
<tr><td colspan="1" rowspan="1" style="border-bottom-color: rgb(0, 0, 0); border-bottom-style: solid; border-bottom-width: 1px; border-left-color: rgb(0, 0, 0); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" width="300"><strong>Part B Deductible</strong></td><td colspan="1" rowspan="1" style="border-bottom-color: rgb(0, 0, 0); border-bottom-style: solid; border-bottom-width: 1px;" width="10"> </td><td colspan="1" rowspan="1" style="border-bottom-color: rgb(0, 0, 0); border-bottom-style: solid; border-bottom-width: 1px; border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" width="420"><strong>$183.00</strong></td></tr>
<tr><td colspan="1" rowspan="6" style="border-bottom-color: rgb(0, 0, 0); border-bottom-style: solid; border-bottom-width: 1px; border-left-color: rgb(0, 0, 0); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" width="300"><strong>Part D</strong></td><td colspan="1" rowspan="1" width="10"> </td><td colspan="1" rowspan="1" style="border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" width="420">Initial deductible: <strong>$400</strong></td></tr>
<tr><td colspan="1" rowspan="1" width="10"> </td><td colspan="1" rowspan="1" style="border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" width="420">Initial coverage limit: <strong>$3,700</strong></td></tr>
<tr><td colspan="1" rowspan="1" width="10"> </td><td colspan="1" rowspan="1" style="border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" width="420">Out of pocket threshold: <strong>$4,950</strong></td></tr>
<tr><td colspan="1" rowspan="1" width="10"> </td><td colspan="1" rowspan="1" style="border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" width="420">Coverage gap: begins once you reach your Medicare Part D plan's initial coverage limit ($3,700 in 2017) and ends when you spend a total of $4,950 in 2017.</td></tr>
<tr><td colspan="1" rowspan="1" width="10"> </td><td colspan="1" rowspan="1" style="border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" width="420"><strong>In 2017</strong>, Part D enrollees will receive a 60% discount on the total cost of their brand-name drugs purchased while in the donut hole. The 50% discount paid by the <strong>brand-name</strong> drug manufacturer will apply to getting out of the donut hole, however the additional 10% paid by your Medicare Part D plan will not count toward your TrOOP.</td></tr>
<tr><td colspan="1" rowspan="1" style="border-bottom-color: rgb(0, 0, 0); border-bottom-style: solid; border-bottom-width: 1px;" width="10"> </td><td colspan="1" rowspan="1" style="border-bottom-color: rgb(0, 0, 0); border-bottom-style: solid; border-bottom-width: 1px; border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" width="420">Minimum cost sharing in Catastrophic portion: <strong>5% or $3.30</strong> for generic or preferred drug that is multi-source drug and the greater of 5% or <strong>$8.25 for all other drugs.</strong></td></tr>
<tr><td colspan="1" rowspan="1" style="border-bottom-color: rgb(0, 0, 0); border-bottom-style: solid; border-bottom-width: 1px; border-left-color: rgb(0, 0, 0); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" width="300"><strong>Average Monthly Social Security Increase</strong></td><td colspan="1" rowspan="1" style="border-bottom-color: rgb(0, 0, 0); border-bottom-style: solid; border-bottom-width: 1px;" width="10"> </td><td colspan="1" rowspan="1" style="border-bottom-color: rgb(0, 0, 0); border-bottom-style: solid; border-bottom-width: 1px; border-right-color: rgb(0, 0, 0); border-right-style: solid; border-right-width: 1px;" width="420"><strong>0.3% increase to $1,360</strong> (from $1,355)</td></tr>
</tbody></table>
<br />
<br />
Until next time,<br />
<br />
Andrew Herman, President<br />
AH Insurance Services, Inc.Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0tag:blogger.com,1999:blog-7256283160262089031.post-8360207911294831832016-03-30T23:00:00.000-04:002016-03-30T23:00:41.576-04:00Questions and Answers about Health Care Forms 1095-A, 1095-B, and 1095-C<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 0in; margin-top: 11.25pt; vertical-align: baseline;">
<span style="font-family: inherit , serif; font-size: 10pt;">This Post re-prints information from the IRS website published on January 11, 2016. Here is a Link to the Source Page:</span><br />
<br />
<div style="text-align: center;">
<span style="font-family: inherit , serif; font-size: 10pt;"><i><a href="https://www.irs.gov/Affordable-Care-Act/Questions-and-Answers-about-Health-Care-Information-Forms-for-Individuals">https://www.irs.gov/Affordable-Care-Act/Questions-and-Answers-about-Health-Care-Information-Forms-for-Individuals</a></i></span></div>
<div style="text-align: center;">
<span style="font-family: inherit , serif; font-size: 10pt;"><br /></span></div>
<span style="font-size: 10pt; line-height: 12pt;">We suggest you consult with a Tax Accountant to be sure that your 2015 health insurance premiums -- in particular any federal health insurance premium subsidies received -- are reported and reconciled as required on your 2015 tax return.</span><br />
<br />
____________________________________________________________________________<br />
<br />
<b><span style="color: magenta;">Q&A:</span></b></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 0in; margin-top: 11.25pt; vertical-align: baseline;">
<b style="line-height: 12pt;"><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">1. Will I receive any new health care tax forms in 2016 to help me
complete my tax return?</span></b></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 0in; margin-top: 11.25pt; vertical-align: baseline;">
<span style="font-family: inherit , serif; font-size: 10pt;">Starting early in
2016, you may receive one or more forms providing information about the health
care coverage that you had or were offered during the previous year. Much like
Form W-2 and Form 1099, which include information about the income you
received, these new health care forms provide information that you may need
when you file your individual income tax return. Also like Forms W-2 and 1099,
these new forms will be provided to the IRS by the entity that provides the
form to you.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 0in; margin-top: 11.25pt; vertical-align: baseline;">
<span style="font-family: inherit , serif; font-size: 10pt;">The new forms are:</span><br />
<span style="font-family: inherit , serif; font-size: 10pt;"><br /></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><a href="https://www.irs.gov/pub/irs-prior/f1095a--2015.pdf"><span style="color: #336699; font-family: "inherit" , serif; font-size: 10.0pt;">Form 1095-A</span></a><span style="font-family: inherit , serif; font-size: 10pt;">, <i><span style="border: none windowtext 1.0pt; mso-border-alt: none windowtext 0in; padding: 0in;">Health Insurance Marketplace Statement</span></i>. The
Health Insurance Marketplace (Marketplace) sends this form to individuals who
enrolled in coverage there, with information about the coverage, who was
covered, and when.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><a href="https://www.irs.gov/pub/irs-prior/f1095b--2015.pdf"><span style="color: #336699; font-family: "inherit" , serif; font-size: 10.0pt;">Form 1095-B</span></a><span style="font-family: inherit , serif; font-size: 10pt;">, <i><span style="border: none windowtext 1.0pt; mso-border-alt: none windowtext 0in; padding: 0in;">Health Coverage</span></i>. Health insurance providers (for
example, health insurance companies) send this form to individuals they cover,
with information about who was covered and when.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><a href="https://www.irs.gov/pub/irs-prior/f1095c--2015.pdf"><span style="color: #336699; font-family: "inherit" , serif; font-size: 10.0pt;">Form 1095-C</span></a><span style="font-family: inherit , serif; font-size: 10pt;">, <i><span style="border: none windowtext 1.0pt; mso-border-alt: none windowtext 0in; padding: 0in;">Employer-Provided Health Insurance Offer and Coverage</span></i>.
Certain employers send this form to certain employees, with information about
what coverage the employer offered. Employers that offer health coverage
referred to as “self-insured coverage” send this form to individuals they
cover, with information about who was covered and when.<o:p></o:p></span></div>
<span style="font-family: inherit , serif; font-size: 10pt; line-height: 12pt;"><br /></span>
<b style="line-height: 12pt;"><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">2. When will I receive these health care tax forms?</span></b><br />
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 0in; margin-top: 11.25pt; vertical-align: baseline;">
<span style="font-family: inherit , serif; font-size: 10pt;">The deadline for the
Marketplace to provide Form 1095-A is February 1, 2016. The deadline for
insurers, other coverage providers and certain employers to provide Forms
1095-B and 1095-C has been extended to March 31, 2016. Individual taxpayers
will generally not be affected by this extension and should file their returns
as they normally would.<br />
<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; vertical-align: baseline;">
<b><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">3. Must I wait to file until I receive these forms?</span></b><span style="font-family: inherit , serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 0in; margin-top: 11.25pt; vertical-align: baseline;">
<span style="font-family: inherit , serif; font-size: 10pt;">If you are expecting
to receive a Form 1095-A, you should wait to file your 2015 income tax return
until you receive that form. However, it is not necessary to wait for
Forms 1095-B or 1095-C in order to file.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 0in; margin-top: 11.25pt; vertical-align: baseline;">
<span style="font-family: inherit , serif; font-size: 10pt;">Some taxpayers may
not receive a Form 1095-B or Form 1095-C by the time they are ready to file
their 2015 tax return. While the information on these forms may assist in
preparing a return, they are not required. Individual taxpayers will generally
not be affected by this extension and should file their returns as they
normally would.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 0in; margin-top: 11.25pt; vertical-align: baseline;">
<span style="font-family: inherit , serif; font-size: 10pt;">Like last year,
taxpayers can prepare and file their returns using other information about
their health insurance. You should not attach any of these forms to your tax
return.</span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 0in; margin-top: 11.25pt; vertical-align: baseline;">
<b><span style="font-size: 10pt; line-height: 12pt;">4. </span><span style="font-size: 10pt; line-height: 12pt;"><span style="border-image-outset: initial; border-image-repeat: initial; border-image-slice: initial; border-image-source: initial; border-image-width: initial; border: 1pt none windowtext; padding: 0in;">What are the health care tax forms that I
might receive and how do I use them?</span></span></b></div>
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<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; mso-padding-alt: 0in 0in 0in 0in; mso-yfti-tbllook: 1184; width: 579px;">
<tbody>
<tr>
<td style="padding: 0in 0in 0in 0in; width: 87.75pt;" valign="top" width="117"><div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center; vertical-align: baseline;">
<b><span style="border: none 1.0pt; font-family: "inherit" , serif; font-size: 12.0pt; padding: 0in;">Health Care Form</span></b><span style="font-family: "inherit" , serif; font-size: 12.0pt;"><o:p></o:p></span></div>
</td>
<td style="padding: 0in 0in 0in 0in; width: 93.0pt;" valign="top" width="124"><div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center; vertical-align: baseline;">
<b><span style="border: none 1.0pt; font-family: "inherit" , serif; font-size: 12.0pt; padding: 0in;">Sent To</span></b><span style="font-family: "inherit" , serif; font-size: 12.0pt;"><o:p></o:p></span></div>
</td>
<td style="padding: 0in 0in 0in 0in; width: 125.25pt;" valign="top" width="167"><div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center; vertical-align: baseline;">
<b><span style="border: none 1.0pt; font-family: "inherit" , serif; font-size: 12.0pt; padding: 0in;">Sent By</span></b><span style="font-family: "inherit" , serif; font-size: 12.0pt;"><o:p></o:p></span></div>
</td>
<td style="padding: 0in 0in 0in 0in; width: 144.75pt;" valign="top" width="193"><div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center; vertical-align: baseline;">
<b><span style="border: none 1.0pt; font-family: "inherit" , serif; font-size: 12.0pt; padding: 0in;">What to do with this form</span></b><span style="font-family: "inherit" , serif; font-size: 12.0pt;"><o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="padding: 0in 0in 0in 0in; width: 87.75pt;" valign="top" width="117"><div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<a href="https://www.irs.gov/pub/irs-prior/f1095a--2015.pdf"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">Form
1095-A</span></a><span style="font-family: "inherit" , serif; font-size: 12.0pt;">,
Health Insurance Marketplace Statement<o:p></o:p></span></div>
</td>
<td style="padding: 0in 0in 0in 0in; width: 93.0pt;" valign="top" width="124"><div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "inherit" , serif; font-size: 12.0pt;">Individuals who
enrolled in health coverage for themselves or their family members through
the </span><a href="https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/The-Health-Insurance-Marketplace"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">Marketplace</span></a><span style="font-family: "inherit" , serif; font-size: 12.0pt;"><o:p></o:p></span></div>
</td>
<td style="padding: 0in 0in 0in 0in; width: 125.25pt;" valign="top" width="167"><div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "inherit" , serif; font-size: 12.0pt;">Marketplace<o:p></o:p></span></div>
</td>
<td style="padding: 0in 0in 0in 0in; width: 144.75pt;" valign="top" width="193"><div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<span style="font-family: "inherit" , serif; font-size: 12.0pt;">This form provides information about your Marketplace
coverage.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<span style="font-family: "inherit" , serif; font-size: 12.0pt;">Use Form 1095-A to complete </span><a href="https://www.irs.gov/pub/irs-prior/f8962--2015.pdf"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">Form
8962</span></a><span style="font-family: "inherit" , serif; font-size: 12.0pt;"> and
reconcile advance payments of the </span><a href="https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/The-Premium-Tax-Credit"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">premium
tax credit</span></a><span style="font-family: "inherit" , serif; font-size: 12.0pt;"> or
claim the premium tax credit on your tax return.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<span style="font-family: "inherit" , serif; font-size: 12.0pt;">Use Form 1095-A for information on whether you and your
family members had coverage that satisfies the </span><a href="https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/Individual-Shared-Responsibility-Provision"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">individual
shared responsibility provision</span></a><span style="font-family: "inherit" , serif; font-size: 12.0pt;">.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 15pt; text-indent: -0.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10.0pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal;"> </span></span><span style="font-family: "inherit" , serif; font-size: 12.0pt;">If Form 1095-A shows coverage for you and everyone in your
family for the entire year, check the full-year coverage box on your tax
return.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 15pt; text-indent: -0.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10.0pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-family: "inherit" , serif; font-size: 12.0pt;">If there are months when you or your family members did
not have coverage, determine if you qualify for an </span><a href="https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/ACA-Individual-Shared-Responsibility-Provision-Exemptions"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">exemption</span></a><span style="font-family: "inherit" , serif; font-size: 12.0pt;"> or must make
an </span><a href="https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/Individual-Shared-Responsibility-Provision"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">i</span></a><a href="https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/ACA-Individual-Shared-Responsibility-Provision-Calculating-the-Payment"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">ndividual
shared responsibility payment</span></a><span style="font-family: "inherit" , serif; font-size: 12.0pt;">.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<span style="font-family: "inherit" , serif; font-size: 12.0pt;">Do not attach Form 1095-A to your tax return – keep it
with your tax records.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<br /></div>
</td>
</tr>
<tr>
<td style="padding: 0in 0in 0in 0in; width: 87.75pt;" valign="top" width="117"><div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<a href="https://www.irs.gov/pub/irs-prior/f1095b--2015.pdf"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">Form
1095-B</span></a><span style="font-family: "inherit" , serif; font-size: 12.0pt;">,
Health Coverage<o:p></o:p></span></div>
</td>
<td style="padding: 0in 0in 0in 0in; width: 93.0pt;" valign="top" width="124"><div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "inherit" , serif; font-size: 12.0pt;">Individuals who had
health coverage for themselves or their family members that is not reported
on Form 1095-A or Form 1095-C.<o:p></o:p></span></div>
</td>
<td style="padding: 0in 0in 0in 0in; width: 125.25pt;" valign="top" width="167"><div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<span style="font-family: "inherit" , serif; font-size: 12.0pt;">Health Coverage Providers –<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 15pt; text-indent: -0.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10.0pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal;"> </span></span><span style="font-family: "inherit" , serif; font-size: 12.0pt;">Insurance companies outside the Marketplace<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 15pt; text-indent: -0.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10.0pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal;"> </span></span><span style="font-family: "inherit" , serif; font-size: 12.0pt;">Government agencies such as Medicare or CHIP<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 15pt; text-indent: -0.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10.0pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal;"> </span></span><span style="font-family: "inherit" , serif; font-size: 12.0pt;">Employers who provide certain kinds of health coverage
(sometimes referred to as “self-insured coverage”) but are not required to
send Form 1095-C (see below).<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 15pt; text-indent: -0.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10.0pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal;"> </span></span><span style="font-family: "inherit" , serif; font-size: 12.0pt;">Other coverage providers<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<br /></div>
</td>
<td style="padding: 0in 0in 0in 0in; width: 144.75pt;" valign="top" width="193"><div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<span style="font-family: "inherit" , serif; font-size: 12.0pt;">This form provides information about your health coverage.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<span style="font-family: "inherit" , serif; font-size: 12.0pt;">Use Form 1095-B for information on whether you and your
family members had health coverage that satisfies the </span><a href="https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/Individual-Shared-Responsibility-Provision"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">i</span></a><a href="https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/Individual-Shared-Responsibility-Provision"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">ndividual
shared responsibility provision</span></a><span style="font-family: "inherit" , serif; font-size: 12.0pt;">.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<br /></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 15pt; text-indent: -0.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10.0pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-family: "inherit" , serif; font-size: 12.0pt;">If Form 1095-B shows coverage for you and everyone in your
family for the entire year, check the full-year coverage box on your tax
return.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 15pt; text-indent: -0.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10.0pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-family: "inherit" , serif; font-size: 12.0pt;">If there are months when you or your family members did
not have coverage, determine if you qualify for an </span><a href="https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/ACA-Individual-Shared-Responsibility-Provision-Exemptions"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">exemption</span></a><span style="font-family: "inherit" , serif; font-size: 12.0pt;"> or must make
an </span><a href="https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/ACA-Individual-Shared-Responsibility-Provision-Calculating-the-Payment"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">individual
shared responsibility payment</span></a><span style="font-family: "inherit" , serif; font-size: 12.0pt;">.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<span style="font-family: "inherit" , serif; font-size: 12.0pt;">Do not attach Form 1095-B to your tax return - keep it
with your tax records.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<br /></div>
</td>
</tr>
<tr>
<td style="padding: 0in 0in 0in 0in; width: 87.75pt;" valign="top" width="117"><div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<a href="https://www.irs.gov/pub/irs-prior/f1095c--2015.pdf"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">Form
1095-C</span></a><span style="font-family: "inherit" , serif; font-size: 12.0pt;">,
Employer-Provided Health Insurance Offer and Coverage<o:p></o:p></span></div>
</td>
<td style="padding: 0in 0in 0in 0in; width: 93.0pt;" valign="top" width="124"><div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "inherit" , serif; font-size: 12.0pt;">Certain employees
of applicable large employers (See next column). <o:p></o:p></span></div>
</td>
<td style="padding: 0in 0in 0in 0in; width: 125.25pt;" valign="top" width="167"><div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<a href="https://www.irs.gov/Affordable-Care-Act/Employers/Determining-if-an-Employer-is-an-Applicable-Large-Employer"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">Applicable
large employer</span></a><a href="https://www.irs.gov/Affordable-Care-Act/Employers/Determining-if-an-Employer-is-an-Applicable-Large-Employer"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">s</span></a><span style="font-family: "inherit" , serif; font-size: 12.0pt;">– generally those
with 50 or more full-time employees, including full-time equivalent
employees <o:p></o:p></span></div>
</td>
<td style="padding: 0in 0in 0in 0in; width: 144.75pt;" valign="top" width="193"><div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<span style="font-family: "inherit" , serif; font-size: 12.0pt;">Form 1095-C provides information about the health coverage
offered by your employer and, in some cases, about whether you enrolled in
this coverage.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<span style="font-family: "inherit" , serif; font-size: 12.0pt;">Use Form 1095-C to help determine your eligibility for the </span><a href="https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/The-Premium-Tax-Credit"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">premium
tax credit</span></a><span style="font-family: "inherit" , serif; font-size: 12.0pt;">.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<br /></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 15pt; text-indent: -0.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10.0pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal;"> </span></span><span style="font-family: "inherit" , serif; font-size: 12.0pt;">If you enrolled in a health plan in the Marketplace, you
may need the information in Part II of Form 1095-C to help determine your
eligibility for the premium tax credit.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 15pt; text-indent: -0.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10.0pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal;"> </span></span><span style="font-family: "inherit" , serif; font-size: 12.0pt;">If you did not enroll in a health plan in the
Marketplace, the information in Part II of your Form 1095-C is not relevant
to you.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<span style="font-family: "inherit" , serif; font-size: 12.0pt;">Use Form 1095-C for information on whether you or any
family members enrolled in certain kinds of coverage offered by your employer
(sometimes referred to as “self-insured coverage”).<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 15pt; text-indent: -0.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10.0pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal;"> </span></span><span style="font-family: "inherit" , serif; font-size: 12.0pt;">If Form 1095-C shows coverage for you and everyone in your
family for the entire year, check the full-year coverage box on your tax
return. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 15pt; text-indent: -0.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10.0pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal;"> </span></span><span style="font-family: "inherit" , serif; font-size: 12.0pt;">If there are months when you or your family members did
not have coverage, determine if you qualify for an </span><a href="https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/ACA-Individual-Shared-Responsibility-Provision-Exemptions"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">exemption</span></a><span style="font-family: "inherit" , serif; font-size: 12.0pt;"> or must make
an </span><a href="https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/ACA-Individual-Shared-Responsibility-Provision-Calculating-the-Payment"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">i</span></a><a href="https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/ACA-Individual-Shared-Responsibility-Provision-Calculating-the-Payment"><span style="color: #336699; font-family: "inherit" , serif; font-size: 12.0pt;">ndividual
shared responsibility payment</span></a><span style="font-family: "inherit" , serif; font-size: 12.0pt;">.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<span style="font-family: "inherit" , serif; font-size: 12.0pt;">Do not attach Form 1095-C to your tax return - keep it
with your tax records.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; vertical-align: baseline;">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 0in; margin-top: 11.25pt; vertical-align: baseline;">
<br /></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; vertical-align: baseline;">
<b><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">5. How will I receive these forms?</span></b><span style="font-family: inherit , serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 0in; margin-top: 11.25pt; vertical-align: baseline;">
<span style="font-family: inherit , serif; font-size: 10pt;">The Marketplace,
health coverage providers and applicable large employers will mail (or hand
deliver) these forms to you or provide them electronically to you, if you have
consented to electronic delivery.</span><br />
<span style="font-family: inherit , serif; font-size: 10pt;"><br /></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; vertical-align: baseline;">
<b><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">6. My employer or health coverage provider has suggested that I
opt to receive these forms electronically rather than on paper. Are they
allowed to ask me that? </span></b><span style="font-family: inherit , serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 0in; margin-top: 11.25pt; vertical-align: baseline;">
<span style="font-family: inherit , serif; font-size: 10pt;">Yes. Employers and
health coverage providers may ask for your consent to receive the forms
electronically. This is entirely acceptable and may be more convenient for you.
Electronic forms provide the same information that is provided in the paper
forms.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 0in; margin-top: 11.25pt; vertical-align: baseline;">
</div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; vertical-align: baseline;">
<b><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">7. Will I get at least one form?</span></b><span style="font-family: inherit , serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 0in; margin-top: 11.25pt; vertical-align: baseline;">
<span style="font-family: inherit , serif; font-size: 10pt;">Maybe. If you were
enrolled in health coverage for 2015, you should receive a Form 1095-A, 1095-B,
or 1095-C. In addition, if you were an employee of an employer that was
an applicable large employer in 2015, you may receive a Form 1095-C. If
you don’t fall in either of these categories, you won’t receive a form.</span><br />
<span style="font-family: inherit , serif; font-size: 10pt;"><br /></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; vertical-align: baseline;">
<b><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">8. Will I get more than one form?</span></b><span style="font-family: inherit , serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 0in; margin-top: 11.25pt; vertical-align: baseline;">
<span style="font-family: inherit , serif; font-size: 10pt;">Maybe. You are
likely to get more than one form if you had coverage from more than one
coverage provider or if you worked for more than one employer that offered
coverage. You are also likely to get more than one form if you changed coverage
or employers during the year or if different members of your family received
coverage from different coverage providers.<o:p></o:p></span></div>
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<span style="font-family: inherit , serif; font-size: 10pt;">The following
examples illustrate when you may get more than one Form 1095 and what to do
with the information on those forms.<o:p></o:p></span><br />
<span style="font-family: inherit , serif; font-size: 10pt;"><br /></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; vertical-align: baseline;">
<b><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">Example 1</span></b><span style="font-family: inherit , serif; font-size: 10pt;">: You are single with two dependent children. At the
beginning of 2015, you were unemployed, and you and your children were enrolled
in coverage through the Marketplace. You received the benefit of advance
payments of the premium tax credit to help pay for your coverage. In August of
2015, you started working 40 hours per week for an employer with 300 employees
(an applicable large employer) that offered health insurance coverage to you
and your children. However, that offer of coverage was considered unaffordable
to you for purposes of the premium tax credit, so you did not enroll in it and
instead continued your Marketplace coverage with advance payments of the
premium tax credit. Early in 2016, you receive Form 1095-A (from the
Marketplace) and Form 1095-C (from your employer).<o:p></o:p></span></div>
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<span style="font-family: inherit , serif; font-size: 10pt;">When you complete
Form 8962, Premium Tax Credit, you will use the information on Form 1095-A to
reconcile advance payments of the premium tax credit and to verify that you had
health coverage for the entire year. You will use Form 1095-C to verify that
your employer coverage was unaffordable for you. You will not attach Form
1095-A or 1095-C to your return, but you should keep these forms with your tax
records.<o:p></o:p></span><br />
<span style="font-family: inherit , serif; font-size: 10pt;"><br /></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; vertical-align: baseline;">
<b><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">Example 2:</span></b><span style="font-family: inherit , serif; font-size: 10pt;"> You are single with no dependents. At the beginning
of 2015, you were employed by employer A, which has 20 employees (and therefore
is not an applicable large employer). You had coverage through A’s
employer-sponsored plan, which is insurance that A purchases from health
insurance issuer Q (i.e., not a “self-insured plan”). In June of 2015,
you changed jobs and started working 40 hours per week for employer B, which
has 500 employees (and so is an applicable large employer). You immediately
began receiving coverage through that employer’s plan, which is insurance it
purchases from insurance issuer R. Early in 2016, both insurance companies will
send you a Form 1095-B providing information about the coverage in which you
were enrolled. You also will receive a Form 1095-C from employer B, the
applicable large employer, providing information about the health coverage B
offered you.<o:p></o:p></span></div>
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<span style="font-family: inherit , serif; font-size: 10pt;">You will use the
information on Forms 1095-B to verify that you had health coverage for each
month during the year and will check the full-year coverage box on your tax
return. You will not need to use Form 1095-C to help complete your return
because the information about the offer of health coverage made by your
employer relates to whether you are eligible for the premium tax credit and you
cannot get a premium tax credit if you were not enrolled in a health plan in
the Marketplace. You will not attach Form 1095-B or Form 1095-C to your tax
return, but you should keep both forms with your tax records.<o:p></o:p></span></div>
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</div>
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<b style="line-height: 12pt;"><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">9. Will I get a Form 1095-C from each of my employers?</span></b></div>
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<span style="font-family: inherit , serif; font-size: 10pt;">Not necessarily. You
will only receive a Form 1095-C from your employer if that employer is an
applicable large employer, meaning it had 50 or more full-time employees
(including full-time equivalent employees) in the year before the year to which
the form relates. Most employers have fewer than 50 employees and therefore are
not applicable large employers required to provide Form 1095-C to their
full-time employees.<o:p></o:p></span></div>
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<span style="font-family: inherit , serif; font-size: 10pt;">Even if your employer
is an applicable large employer, you will only receive a Form 1095-C for that
employer if you were a full-time employee for that employer for at least one
month of the year or if you are enrolled in an applicable large employer’s
self-insured health plan, even if you are a part-time employee. <o:p></o:p></span></div>
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<b style="line-height: 12pt;"><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">10. How are the forms similar?</span></b><br />
<b style="line-height: 12pt;"><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;"><br /></span></b></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l4 level1 lfo1; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">They all provide information about your health coverage during the
prior year.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l4 level1 lfo1; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">They are all used to determine if you, your spouse and your
dependents had health coverage for the entire year and if not, for which months
you did have coverage. (The Form 1095-C includes this information
only if your employer is an applicable large employer and the coverage you
enrolled in was a certain kind of coverage referred to as “self-insured
coverage”).<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l4 level1 lfo1; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">None of these forms should be filed with your tax return; they
should be kept for your records with your other tax documents.<o:p></o:p></span></div>
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<b style="line-height: 12pt;"><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">11. How are the forms different?</span></b><br />
<b style="line-height: 12pt;"><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;"><br /></span></b></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l2 level1 lfo2; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: inherit , serif; font-size: 10pt;">The forms are provided by different entities.</span><span style="font-family: "symbol"; font-size: 10pt; line-height: 12pt; text-indent: -0.25in;"><span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt; line-height: 12pt; text-indent: -0.25in;"> </span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 37.5pt; margin-right: 0in; margin-top: 0in; mso-list: l3 level2 lfo3; tab-stops: list 1.0in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "courier new"; font-size: 10pt;">o<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: inherit , serif; font-size: 10pt;">Form 1095-A, Health Insurance Marketplace Statement, is provided by the Marketplace to individuals who enrolled or who have enrolled a
family member in health coverage through the Marketplace.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 37.5pt; margin-right: 0in; margin-top: 0in; mso-list: l3 level2 lfo3; tab-stops: list 1.0in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "courier new"; font-size: 10pt;">o<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: inherit , serif; font-size: 10pt;">Form 1095-B, Health Coverage, is provided by insurance companies
and other coverage providers. However, if your coverage was
insurance purchased through the Marketplace or was a type of coverage referred
to as “self-insured coverage” that was provided by an applicable large
employer, you will receive a different form.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: 12.0pt; margin-left: 37.5pt; margin-right: 0in; margin-top: 0in; mso-list: l3 level2 lfo3; tab-stops: list 1.0in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "courier new"; font-size: 10pt;">o<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: inherit , serif; font-size: 10pt;">Form 1095-C, Employer-Provided Health Insurance Offer and
Coverage, is issued by applicable large employers to their full-time employees
and, in some cases, to other employees.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l3 level1 lfo3; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">The forms are provided to different groups of people.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l3 level1 lfo3; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">Form 1095-A - Only individuals who enroll in coverage through the
Marketplace will get this form.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l3 level1 lfo3; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">Form 1095-B – Individuals who have health coverage outside of the
Marketplace will get this form (except for employees of applicable large
employers that provide self-insured coverage, who will receive Form 1095-C
instead).<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l3 level1 lfo3; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">Form 1095-C - Individuals who work full-time for applicable large
employers will get this form. Also, part-time employees also will get
this form if they enroll in self-insured coverage provided by an applicable
large employer.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l1 level1 lfo4; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">The forms contain some different information. Form 1095-A,
Form 1095-B, and some Forms 1095-C show who in your family enrolled in health
coverage and for what months. Form 1095-A also provides premium information and
other information you will need to reconcile advance payments of premium tax
credit and claim the premium tax credit on Form 8962. And Form 1095-C
shows coverage that your employer offered to you even if you chose not to take
that coverage.<o:p></o:p></span></div>
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<b style="line-height: 12pt;"><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">12. What do I need to do with these forms?</span></b></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; vertical-align: baseline;">
<b><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;"><br /></span></b></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo5; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">You will use the information on these forms to verify that you,
your spouse and any dependents had coverage for each month during the year.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo5; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">Like last year, if you and your family members had </span><a href="https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/ACA-Individual-Shared-Responsibility-Provision-Minimum-Essential-Coverage"><span style="color: #336699; font-family: "inherit" , serif; font-size: 10.0pt;">minimum essential
coverage</span></a><span style="font-family: inherit , serif; font-size: 10pt;"> for every month of the year, you will check a box on your
return to report that coverage. If you or any family members did not have
coverage for the entire year, a coverage exemption may apply for the months
without coverage. If you or any family members did not have coverage or
an </span><a href="https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/ACA-Individual-Shared-Responsibility-Provision-Exemptions"><span style="color: #336699; font-family: "inherit" , serif; font-size: 10.0pt;">exemption</span></a><span style="font-family: inherit , serif; font-size: 10pt;">, you may have to
make an </span><a href="https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/ACA-Individual-Shared-Responsibility-Provision-Calculating-the-Payment"><span style="color: #336699; font-family: "inherit" , serif; font-size: 10.0pt;">individual shared
responsibility payment</span></a><span style="font-family: inherit , serif; font-size: 10pt;">.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo5; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">If you or anyone in your family receives a Form 1095-A from the
Marketplace, you will use the information on the form to complete a Form 8962
to reconcile any advance payments of the premium tax credit or to claim the
premium tax credit.</span><br />
<span style="font-family: "symbol"; font-size: 10pt; line-height: 12pt; text-indent: -0.25in;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt; line-height: 12pt; text-indent: -0.25in;">Do not file these forms with your tax return. Keep them in your
records with your other important tax documents.</span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo5; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<span style="font-family: inherit , serif; font-size: 10pt;"><br /></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; vertical-align: baseline;">
<b><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">13. What should I do if:</span></b><span style="font-family: inherit , serif; font-size: 10pt;"><o:p></o:p></span><br />
<b><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;"><br /></span></b></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><b><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">I have a question about the form I received,</span></b><span style="font-family: inherit , serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><b><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">I think I should have gotten a form but did not get it,</span></b><span style="font-family: inherit , serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><b><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">I need a replacement form, or</span></b><span style="font-family: inherit , serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><b><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">I believe the form I received has an error?</span></b><span style="font-family: inherit , serif; font-size: 10pt;"><o:p></o:p></span></div>
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<span style="font-family: inherit , serif; font-size: 10pt;">In any of these situations,
you should contact the provider of the form (or the entity that you think
should have provided you a form, if you think you should have gotten a form but
did not get it):<o:p></o:p></span><br />
<span style="font-family: inherit , serif; font-size: 10pt;"><br /></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">For questions about the Form 1095-A, contact the Marketplace.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">For questions about the Form 1095-B, contact the coverage provider
(see line 18 of the Form 1095-B for a contact telephone number).<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">For questions about the Form 1095-C, contact your employer (see
line 10 of Form 1095-C for a contact telephone number).<o:p></o:p></span></div>
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</div>
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<b style="line-height: 12pt;"><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">14. Can I file my tax return if I have not received any or all of
these forms?</span></b></div>
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<span style="font-family: inherit , serif; font-size: 10pt;">If you enrolled in
coverage through the Marketplace you will need the information on Form 1095-A
to complete Form 8962 to reconcile any advance payments of the premium tax
credit or claim the premium tax credit, and to file a complete and accurate tax
return. If you need a copy of your Form 1095-A, you should go to HealthCare.gov
or your state Marketplace website and log into your Marketplace account, or
call your Marketplace call center. Although information from the Form 1095-C –
information about an offer of employer provided coverage - can assist you
in determining eligibility for the premium tax credit, it is not necessary to
have Form 1095-C to file your return. See </span><a href="https://www.irs.gov/pub/irs-pdf/p974.pdf"><span style="color: #336699; font-family: "inherit" , serif; font-size: 10.0pt;">Publication 974</span></a><span style="font-family: inherit , serif; font-size: 10pt;"> for additional
information on claiming the premium tax credit. <o:p></o:p></span></div>
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<span style="font-family: inherit , serif; font-size: 10pt;">You do not have to
wait for either Form 1095-B or 1095-C from your coverage provider or employer to
file your individual income tax return. You can use other forms of
documentation, in lieu of the Form 1095 information returns to prepare your tax
return. Other forms of documentation that would provide proof of your
insurance coverage include:<o:p></o:p></span><br />
<span style="font-family: inherit , serif; font-size: 10pt;"><br /></span></div>
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<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">insurance cards,<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">explanation of benefits<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">statements from your insurer,<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">W-2 or payroll statements reflecting health insurance deductions,<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">records of advance payments of the premium tax credit and<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">other statements indicating that you, or a member of your family,
had health care coverage.<o:p></o:p></span></div>
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<span style="font-family: inherit , serif; font-size: 10pt;">If you and your
entire family were covered for the entire year, you may check the full-year
coverage box on your return. If you or your family members did not
have coverage for one or more months of the calendar year, you may claim an
exemption or make an individual shared responsibility payment.<o:p></o:p></span></div>
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<span style="font-family: inherit , serif; font-size: 10pt;">You will not need to
send the IRS proof of your health coverage. However, you should keep any
documentation with your other tax records. This includes records of your
family’s employer-provided coverage, premiums paid, and type of coverage.</span><br />
<span style="font-family: inherit , serif; font-size: 10pt;"><br /></span></div>
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<b><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">15. Am I required to file a tax return if I receive one of these
forms?</span></b><span style="font-family: inherit , serif; font-size: 10pt;"><o:p></o:p></span><br />
<b><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;"><br /></span></b></div>
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<span style="font-family: inherit , serif; font-size: 10pt; line-height: 12pt;">If you receive a Form
1095-A, Health Insurance Marketplace Statement, showing that advance payments
of the premium tax credit were paid for coverage for you or your family member,
you generally must file an individual income tax return and submit a Form 8962
to reconcile those advance payments, even if you would not otherwise be
required to file a tax return. You also must file an individual income
tax return and submit a Form 8962 to claim the premium tax credit, even if no
advance payments of the premium tax credit were made for your coverage.
For more information, see the </span><a href="https://www.irs.gov/pub/irs-pdf/i8962.pdf" style="line-height: 12pt;"><span style="color: #336699; font-family: "inherit" , serif; font-size: 10.0pt;">i</span></a><a href="https://www.irs.gov/pub/irs-prior/i8962--2015.pdf" style="line-height: 12pt;"><span style="color: #336699; font-family: "inherit" , serif; font-size: 10.0pt;">nstructions</span></a><span style="font-family: inherit , serif; font-size: 10pt; line-height: 12pt;"> to Form 8962,</span></div>
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<span style="font-family: inherit , serif; font-size: 10pt;">However, you are not
required to file a tax return solely because you received a Form 1095-B or a
Form 1095-C. For example, if you are enrolled in Medicaid you will receive a
Form 1095-B. If you do not have a tax filing requirement, you do not have to
file a tax return solely because you received the Form 1095-B reflecting your
Medicaid coverage.<o:p></o:p></span></div>
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<span style="font-family: inherit , serif; font-size: 10pt;">The health care law
tax filing requirements are the same as last year. <o:p></o:p></span><br />
<span style="font-family: inherit , serif; font-size: 10pt;"><br /></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">If you enrolled in coverage through the Marketplace, you must file
a tax return and reconcile any advance payments of the premium tax credit that
were paid on your behalf. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">If you have a filing requirement and everyone in your family had
coverage for the entire year, you should check the full-year coverage box on
your tax return. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.0pt; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; tab-stops: list .5in; text-indent: -.25in; vertical-align: baseline;">
<!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 10pt;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><span style="font-family: inherit , serif; font-size: 10pt;">If you or any family members did not have coverage for the entire
year, you should claim any applicable coverage exemption or make an individual
shared responsibility payment.<o:p></o:p></span></div>
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<b style="line-height: 12pt;"><span style="border: 1pt none; font-family: inherit , serif; font-size: 10pt; padding: 0in;">16. Should I attach Form 1095-A, 1095-B or 1095-C to my tax
return?</span></b></div>
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<span style="font-family: inherit , serif; font-size: 10pt;">No. Although you may
use the information on the forms to help complete your tax return, these forms
should not be attached to your return or sent to the IRS. The issuers of the
forms are required to send the information to the IRS separately. You should
keep the forms for your records with your other important tax documents.<o:p></o:p></span><br />
<span style="font-family: inherit , serif; font-size: 10pt;"><br /></span>
<span style="font-family: inherit , serif; font-size: 10pt;">___________________________________________________________________________</span><br />
<br />
<br />
<span style="font-family: inherit , serif; font-size: 10pt;">Until next time,</span><br />
<span style="font-family: inherit , serif; font-size: 10pt;"><br /></span>
<span style="font-family: inherit , serif; font-size: 10pt;">Andrew Herman, President</span><br />
<span style="font-family: inherit , serif; font-size: 10pt;">AH Insurance Services, Inc.</span><br />
<br /></div>
Andrew Hermanhttp://www.blogger.com/profile/07384635942356715801noreply@blogger.com0