Medicare Part B Premiums Projected To Go Up For 2017 ― Insurance Companies Participating In Obamacare Going Down

By Kenton Henry, editor

A double whammy is expected to impact the medical insurance market for 2017. There is bad news for the consumer on both the Medicare and the Under Age 65 ends of the medical insurance spectrum.

One positive note ― more than 60 million Medicare recipients are projected to receive a cost of living adjustment in their Social Security Benefit! But if you’re part of this group … don’t spend all your new found increase in one place. It’s projected to be a minuscule 0.2 percent! What the government giveth . . .  (well, you can see this coming!) The flip side is, their monthly Part B premiums would go to $107.60 in 2017 ― a $2.70 increase.

On the other hand, 30% of recipients, which includes those new to Medicare in 2017; those who do not have their Part B premiums deducted from their Social Security Income Account in 2016; and those with higher incomes may see increases in premium to $149.00 for the lowest tax bracket; from $166.30 ― to $204.40 per month for the next; and from $380.20 to $467.20 in the highest bracket. Whether these projections―which amount to as much as a 22% increase for the highest income earners―are realized will not be known until October.

Part B premiums are extremely relevant when one has the option of remaining on one’s (or one’s spouse’s) company group health insurance beyond age 65 and into retirement and is weighing the cost of such against the cost of transitioning fully to Medicare Part A and B.

For guidance in this consideration please feel free to consult with the author / editor. *(see featured article from the Wall Street Journal below)

And for those still not age 65, or otherwise eligible for Medicare―and not covered by an employer’s group health insurance plan―your options for coverage are scheduled to diminish along with competition in the individual and family Affordable Care Act (ACA) compliant insurance market. If realized, the  proposed mergers between Anthem and Cigna and between Aetna and Humana would reduce your options. This on top of Unitedhealthcare’s (America’s largest insurer) announcement it is pulling out of 90% of its current markets in 2017. Furthermore, BlueCross BlueShield Association announced they may also decline or diminish  participation in the marketplace. Lastly (until our next episode), to cast further doubts on what options will remain for the consumer, both Aetna and Humana have announced they may pull out of the majority of their individual and family markets regardless of whether their proposed merger is approved. Humana issued a statement just last week to the effect they would be limiting coverage to 156 counties this month compared the 1,351 they participate in currently. **(please refer to feature article on Humana below)

For these reasons, and because the majority of my individual and family clients have been forced to migrate to Health Maintenance Organization plans (where their providers and treatment are rationed) I have been advising those who are business owners to transition to group health insurance where they not only have more options relative to benefits but can still benefit from Preferred Provider Organization (PPO) coverage. With the PPO plans, they have the final say on their providers and, thereby, better control the quality of their treatment. Small Business (less than 50 employees) owners should take note that if they enroll during the Small Business Open Enrollment Period (November 15th ― December 15th) they will not have to meet the 75% full-time employee participation rate or the 50% of employee premium contribution requirement. The only requirement is that a minimum of 2 full time, W-2 employees be covered on the plan. This is an excellent opportunity for small, closely held companies who want to improve their family’s health insurance but cannot afford coverage for all employees.

Again, please feel free to contact our office for further insight and guidance on this issue.

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Feature Article #1

WALL STREET JOURNAL

By Anne Tergesen

Updated June 22, 2016 5:12 p.m. ET    

Nearly a third of all Medicare beneficiaries face a steep increase in their premiums next year, the result of a policy that in certain circumstances requires some beneficiaries, including higher earners, to shoulder the burden of rising costs.

The government health-care plan’s trustees projected in a report Wednesday that premiums would rise by as much as 22% for wealthier beneficiaries of Medicare Part B, which covers doctor visits and other types of outpatient care.

The projected increase results from an intersection of the rules governing Medicare and Social Security, said Tricia Neuman, senior vice president and an expert on Medicare at the Kaiser Family Foundation.

Under the Social Security Act’s “hold harmless” provision, Medicare can’t pass along premium increases greater than what most participants would receive through Social Security’s annual cost-of-living adjustment. That adjustment is expected to be just 0.2% in 2017 thanks to low inflation. As a result, Medicare couldn’t pass along any premium increase greater than the dollar increase in Social Security payments to the estimated 70% of beneficiaries who will qualify for hold harmless treatment in 2017, Ms. Neuman said.

Instead, Medicare must spread much of the projected increase in its costs across the remaining 30%. Those who are paying the standard $121.80 a month for Medicare Part B this year would be charged $149 a month in 2017 if the trustees’ predictions come to pass.

Higher earners would pay more. The trustees project individuals earning between $85,001 and $107,000 and couples earning between $170,001 and $214,000 would have their 2016 monthly premiums rise from $170.50 a person this year to about $204.40 in 2017. For those earning more than $214,000, or $428,000 for couples, the projected increase is to about $467.20 a month, from $389.00 in 2016.

This isn’t the first time there has been such a disparity in Part B premiums between Medicare recipients.

Last year, Congress staved off a 52% premium increase for Medicare beneficiaries not covered by the hold harmless provision via a deal in the budget agreement that raised premiums by 16% for them instead. Those covered by the hold harmless provision, in contrast, pay $104.90 a month—the same amount they paid in 2014 due to the fact that there was no Social Security cost-of-living increase in 2016.

The projected increase in Part B premiums affects several other groups of Medicare beneficiaries, including those who receive Medicare but have deferred or aren’t eligible for Social Security benefits. It also would apply to those who are new to Medicare in 2017 and lower-income Medicare beneficiaries whose premiums are paid by state Medicaid programs.

In the latter case, the increase would be paid by Medicaid, Ms. Neuman said.

Paul Van de Water, senior fellow at the nonprofit Center on Budget and Policy Priorities, said the final Social Security cost-of-living adjustment won’t be known until October. If inflation rises by more than the trustees expect between now and then, it could “reduce the spike in the premium” for those who aren’t held harmless, he said.

Acting Administrator for the Centers for Medicare and Medicaid Services Andy Slavitt said at a news conference Wednesday, “We will continue to monitor the data and explore administrative options as needed.”

The Medicare trustees are projecting that the base Medicare Part B premium will reset for everyone at $124.40 a month in 2018, because they expect higher Social Security cost-of-living increases.

Medicare covered 55 million people last year, according to the trustees’ report. Part B covered nearly 51 million. In 2017 Medicare is expected to have 58.7 million total participants and 53.5 million in Part B.

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Feature Article # 2

Humana beats 2Q forecasts, details ACA-related scale back

Tom Murphy, AP Health Writer

Published 9:09 am, Wednesday, August 3, 2016

Humana beat second-quarter earnings expectations and reaffirmed its forecast for 2016, even as the health insurer set aside an additional $208 million to cover expenses in its individual, commercial coverage.

The company also said Wednesday it was scaling back that individual business for next year and would only offer it in 156 counties, compared to 1,351 this year. The insurer also said it will sell coverage on Affordable Care Act individual exchanges in 11 states next year, down from 15 this year.

Humana, based in Louisville, Kentucky, provides individual coverage for nearly 500,000 people through the exchanges. It covers an additional 200,000 individual customers off the exchanges, a small slice of its total medical membership of 14.2 million.

Other major insurers like UnitedHealth Group and Anthem also have recently detailed struggles with coverage they sell on the ACA’s state-based exchanges, which have helped millions of consumers gain insurance since they opened for enrollment in the fall of 2013. Aetna, which is trying to buy Humana, said Tuesday that it cancelled its exchange expansion plans for 2017 and was taking a hard look at the markets in which it is currently participating.

Insurers have been struggling with higher-than-expected claims on the exchanges and lower-than-expected support from government programs, among other issues.

Humana also is one of the nation’s largest providers of Medicare Advantage plans, which are privately run versions of the government’s Medicare program for people over age 65 or disabled. The company said Wednesday that its core businesses remained strong in the second quarter.

Overall, Humana earnings plunged 28 percent to $311 million compared to last year’s quarter, when it booked a $267 million gain from a business sale.

Earnings, adjusted for non-recurring costs and amortization costs, came to $2.30 per share.

Analysts expected, on average, earnings of $2.22 per share, according to Zacks Investment Research.

The health insurer posted revenue of $14.01 billion in the period, which topped the average Wall Street forecast for $13.63 billion.

The company also said Wednesday that it still expects full-year earnings to total at least $9.25 per share.

Shares of Humana edged up 52 cents to $170.09 Wednesday morning while broader indexes were flat.

Humana shares have decreased 5 percent since the beginning of the year, while the Standard & Poor’s 500 index has climbed 5.5 percent.

https://healthandmedicareinsurance.com

https://allplanhealthinsurance.com

https://thewoodlandstxhealthinsurance.com

Obamacare and Medicare Don’t Mix!

OBAMACARE VS MEDICARE

A cautionary message is conveyed in today’s feature article:
Do not confuse Obamacare with Medicare and complicate your situation! If you are a Medicare recipient – Obamacare, or the Affordable Care Act (ACA,) does not apply to you. It only applies to Americans below the age of 65 or otherwise not on Medicare. If you are on Medicare – do nothing at all! Steer clear of the Marketplace where people will go to apply for the new health care compliant plans. Even though the enrollment periods for Medicare Advantage and Part D Prescription Drug Plans over-lap with the ACA health plans this fall – your benefits are already covered by Medicare and–at least for now–are not changing.

 
Admin. – Kenton Henry
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WALL STREET JOURNAL
September 7, 2013, 8:36 p.m. ET
Don’t Confuse Medicare With Obamacare
Covered by Medicare? Don’t Give the New Health Insurance Marketplace Another Thought.
BY JENNIFER WATERS
October is an important medical-insurance sign-up month for millions of Americans, both under and over 65 years old.
The annual Medicare open-enrollment period, which runs from Oct. 15 through Dec. 7, overlaps this year with the initial registration for the Health Insurance Marketplace, a cornerstone of the Affordable Care Act (aka Obamacare).
But don’t confuse the two. They serve different populations.
If you’re already covered by Medicare, you needn’t give the Marketplace another thought. That’s for people under the age of 65 who don’t have any health insurance. Enrollment starts Oct. 1 and runs through March 31.
“We want to reassure Medicare beneficiaries that they are already covered, that their benefits aren’t changing and that the Marketplace doesn’t require them to do anything different,” says Richard Olague, spokesman for the Centers for Medicare and Medicaid Services. “Specifically, they do not have to change their Medicare coverage or enroll in any Marketplace plan.”
The Medicare open-enrollment period is the window for the 50 million covered to review their policies for any modifications in costs, coverage and benefits.
“It’s the one time of the year to look at other options available and make a change for a new plan that will take effect Jan. 1,” says Paula Muschler, manager of the Allsup Medicare Advisor, a Medicare plan selection service.
Even if you’re comfortable with the plan you have, study it to make sure it hasn’t been reworked. Ms. Muschler helped a woman last year switch to another plan, saving $7,000 in out-of-pocket expenses when her first plan did away with covering costly brand-name medications she regularly used.
The Medicare open-enrollment period also differs from the initial enrollment requirements. For those new to Medicare, there is a seven-month window to register that starts three months before your 65th-birthday month and ends the third month after your birthday month.
These enrollment periods are also prime time for swindlers to rip you off, so take heed to this warning from CMS: “It’s against the law for someone who knows that you have Medicare to sell you a Marketplace plan.”

http://allplaninsurance.com

The Foxes Long Ago Took Over the Hen House

08.06.2013
Last Friday, the President met behind closed doors with Congress to grant they and their staff (who have incomes of $100,000 or more) a waiver from paying for participation in health insurance exchanges. Supposedly, 75% of their premium will be paid by us – regardless of their income.You already knew he had reserved the right to grant waivers to unions and donor corporations, correct? And he has done that over 1,200 times to date. Well now he has done it for our employees who ultimately determine their own salaries and benefits. News of this was not released until they had left town under cover of darkness for their month long recess.
It is anticipated this special dispensation will be formally acknowledged next week by President Obama’s Office of Personnel Management (OPM)–one in the same as the federal government’s H.R. department–which is charged with administering federal benefits within the government.

For a succinct and cogent summation of what the unintended consequences of full Affordable Care Act implementation mean to the quality of our nation’s health care, please view this video of Michigan’ Congressman Rodgers as he makes his opening statement to the Chair on health care reform:

http://safeshare.tv/w/zwhKdMtFHf
Admin. – Kenton Henry
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Feature Article

Grassfire

08.05.2013

Moments before shuttering Capitol Hill for a month-long recess, Congress exempted 11,000 members and staff from ObamaCare. News of Friday’s last-minute deal making is especially frustrating since part of ObamaCare’s original sell to the American people was that lawmakers and aides had to use the plan.
According to The Wall Street Journal, both parties went ballistic when they learned staff would incur dramatically higher healthcare costs. “Democrats in particular, begged for help,” and President Obama leapt into action telling them in a closed-door meeting that “he would personally moonlight as H.R. manager and resolve the issue.”

He did … for Congress.

“A behind-closed-doors deal announced after Congress is safely away from the crime scene. This is exactly why America rightly hates Washington,” charged Sen. David Vitter (R-LA) in a press release posted on his official website. “Obamacare’s a train wreck, even for Congress. So it gets fixed … FOR CONGRESS ONLY” (emphasis in original).
Vitter is right. All Americans should be extended the same “resolution” that Congress is getting.

But with Congress safely tucked away in their districts, the countdown continues for the “less fortunate” Americans who, on October 1, start enrolling in ObamaCare.

* Congress returns on Monday, August 9

What will my health insurance premiums go to January 1?

07.23.2013
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What will your health insurance premiums be come January 1? If you are covered by a small business (less than 50 employees)group plan – projections are you can expect your company’s premiums to increase by a minimum of 8%. If you are not covered by an employer group plan, you will be forced to buy from a federal, state or partnership (between the two) exchange or directly from the private market. While premiums are predicted to go down in as many as 10 states, that leaves 40 where potentially they will not. The question remains – what will your premiums go to? The federal exchange which–will be the source for plans in 34 states which are not creating their own exchange–is yet to release their premiums for the plans which must be available by October 1st. The word is that you better qualify for a subsidy or you are looking at rates at least 30% higher for those currently covered.
As our feature article details, the debate still continues as to how accurate and complete is the information we are being fed as to what our costs will be.
Admin. – Kenton Henry
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Feature Article:
GOP: Obama administration selective with health law data
By Tom Howell Jr. – The Washington Times
Congressional Republicans on Monday accused the Obama administration of withholding data on insurance premiums because it would undermine positive trends the White House touted last week while promoting the health care law.
Citing news reports, three senior GOP senators and the chairmen of House health-related committees said the administration has collected premium filings for 34 states that will use a federally run or federal-state partnership exchange — a market where those without employer-based insurance can buy coverage with the help of government subsidies — but it will not release the information until September as it negotiates the final rates.
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SPECIAL COVERAGE: Health Care Reform
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“We believe it is essential that the U.S. Department of Health and Human Services provide transparent pricing as soon as possible for the millions of Americans who will be impacted by this law,” they said in a letter to HHS Secretary Kathleen Sebelius, arguing many Americans’ premiums will rise under the Affordable Care Act.
They also accused the Obama administration of negotiating rates in secret, something the Wall Street Journal editorial page described as “running Obamacare as a black-ops mission.”
Supporters of the law have been buoyed by news out of New York, where officials last week said premiums on the state’s health care exchange in 2014 will be about 50 percent lower than last year’s direct-pay rates for individuals.
The Obama administration then released a report showing that, on average, premiums would drop by 18 percent in about 10 states and the District of Columbia. Those states have made information available for the individual market in 2014, when their health exchanges open under “Obamacare.”
Since then, Republicans have cited states where early data suggest that premiums will rise.
“Instead of selectively highlighting provisions and data that paint a rosy picture, we encourage the administration to give the American people as much information as possible so they can plan and prepare, and so that we can continue the necessary oversight,” the senior Republicans said in their letter.

http://allplanhealthinsurance.com