The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)

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.

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:

• 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.  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.

• 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.

• Plans C and F are NOT being discontinued.  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.

• 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.

• 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.  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.

Until next time,

Andrew Herman, President

AH Insurance Services, Inc.

2020 Medicare Part B Premium and Deductible Amounts

The 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).

Medicare Part B Premium Levels

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.

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:

For individuals with this income:	Or joint filers with this income:		Monthly premium:
$87,000 to $109,000		$174,000 to $218,000	$202.40
$109,000 to $136,000		$218,000 to $272,000	$289.20
$136,000 to $163,000		$272,000 to $326,000	$376.00
$163,000 to $500,000		$326,000 to $750,000	$462.70
Over $500,000		Over $750,000	$491.60

Medicare Part B Deductible

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.

Until next time,

Andrew Herman
President, AH Insurance Services Inc.

Pineapple Placements – Gulf Coast Business Providing FREE Senior Living Referrals

We 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:

- Comprehensive Assessment
- Educational meetings to explore senior living options
- Guided tours of local communities
- Helping family members implement the best senior living arrangement for their loved ones

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.

If you need senior living advice or placement, help is on the way!  Call Amber at 727.360.3715, email to info@pineappleplacements.com or visit https://www.pineappleplacements.com.

Until next time,

Andrew Herman, President
AH Insurance Services, Inc.

CMS Releases National Health Expenditures Projections for 2018-2027

Health 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.

According to CMS, from 2018 to 2027:

• Total national health spending is projected to grow at an average annual rate of 5.5 percent,
reaching nearly $6.0 trillion by 2027.

• Health spending is projected to grow at a rate of 0.8 percent faster than Gross Domestic
Product (GDP) per year, and the health share of GDP is expected to increase from 17.9 percent
in 2017 to 19.4 percent by 2027.

• Prices for health care goods and services are projected to increase at a rate of 2.5 percent,
compared to 1.1 percent for 2014-2017.

• Average annual spending in Medicare is expected to grow 7.4 percent due to projected
enrollment growth. In comparison, average annual spending in Medicaid is expected to grow at
a rate of 5.5 percent, and in private health insurance at a rate of 4.8 percent.

• The share of health care spending sponsored by federal, state, and local governments is
expected to increase by 2 percent, reaching 47 percent by 2027. This projected increase is
primarily due to expected growth in Medicare enrollment.

• The share of individuals with health insurance coverage is expected to remain stable, at around
90 percent.

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).

Click on this web page to retrieve the official 2018-2027 NHE Projections.

Until next time,

Andrew Herman, President
AH Insurance Services, Inc.