At the end of another successful year, we like to do a team dinner with our staff and significant others. In prior year's, we have gone to a nice steakhouse and had a nice meal.
This year, we tried something different and hosted at our house with a Private Chef, Brett Smith. It was an amazing meal/experience.
I met Brett years ago, training together at a gym. He is a likable, hard-working guy. I began following him on Social Media and watched him start his business in 2021. The pictures of his meals look absolutely amazing so I had to give it a try this year for our team dinner.
I don't consider myself a 'foodie' or food critic, so I am not going to go in a lot of detail, but the flavors and presentations were just amazing all night.
Brett's assistant, Brandon was also fabulous. He helped prepare the food, serve the food, pour drinks, clean the dishes, and just about anything we needed. He helped make an unforgettable night.
In our business (like most small businesses), referrals & testimonials are so important.
If you are looking for a unique & amazing dinner experience, I highly recommend Chef Brett Smith. You can contact Brett directly for more details.
2022 was another busy year for Medicare and for Senior Advisors.
Some of the key highlights can be found in the short video above.
We hope everyone has a fantastic 2023!
Every year in Sept/Oct, we send out reminders to our clients to complete their updated Rx form so we can review their Part D Plans for the following year.
Oct 15 to Dec 7 is the one opportunity each year to review and change the Part D Plan for the following year. This is a very important opportunity because the Part D Plans change every year; so even if your drugs haven't changed, your current Part D Plan may not be the best Part D Plan for the following year.
Since 2018, we have been tracking the Savings Projections for the Part D Recommendations we send our clients each year. If someone's current Part D Plan is still the most cost-effective Plan for the following year, it is not included in the Savings calculation. The Savings calculation just includes Savings Projection for Part D Recommendations that save people money versus keeping their current Part D Plan.
We are very excited that we have saved our clients nearly $10M over the last 5-years with our Annual Part D reviews.
Last week, the state of NJ released their 2023 income levels for State Prescription Assistance Programs. These are very helpful programs for individuals that have lower income and expensive medications.
EFFECTIVE JANUARY 1, 2023
The PAAD income eligibility limits for calendar year 2023 are:
The SENIOR GOLD income eligibility limits for calendar year 2023 are:
Application for both programs can be made via the NJ SAVE paper application, or on-line.
- MORE INFO CAN BE FOUND HERE
- APPLY ONLINE HERE
CMS just announced the updated Part B premiums for 2023.
The main reason for the reduction in the Part B Premiums for 2023 was the very large increase in 2022 due to an Alzheimer's medication, which has since reduced in price and coverage with Medicare.
The Income Related Monthly Adjustment Amounts (IRMAAs) were also updated for 2023. You can find the tables below for individuals with income greater than $97,000 (or joint filers with income greater than $194,000). This income is based on your MAGI (Modified Adjusted Gross Income) from your 2021 Tax Return. These IRMAAs only affect about 7% of people with Medicare Part B.
If you are in one of the higher income brackets for the Part B IRMAAs, there is an additional IRMAA for the Part D Drug Coverage. The updated table for 2023 can be found below.
The table below shows the sum of the Part B Premium, Part B IRMAA, and Part D IRMAA for the higher income brackets for 2023.
The other changes for 2023 that were included in the announcement are below.
If you have a Medicare Supplement Plan F, Plan G, or Plan N, the Part A cost-sharing is fully covered by the Supplement so these changes below will not impact you.
You may have seen in the news there is new legislation that may be passing soon in Washington DC called "Inflation Reduction Act of 2022". The House has already passed the bill (when it was called the Build Back Better Act) and it is close to being passed in the Senate. If it gets passed in the Senate, the President will sign it into law.
You can find the full text of the bill here, and below is a brief summary (link to Source).
The bill would raise revenue from:
- Imposing a 15% corporate minimum tax rate for companies with higher than $1 billion annual revenue – $313 billion
- Prescription drug price reform to lower prices, including Medicare negotiation of drug prices – $288 billion
- Increased tax enforcement – $124 billion
- Imposing a 1% excise tax on stock buybacks - $73 billion
It would spend this revenue on:
- Continuing for three more years the expansion of Affordable Care Act subsidies originally expanded under the American Rescue Plan Act of 2021 – $64 billion
- Addressing domestic energy security and climate change – $369 billion
- Funding for drought relief - $5 billion
- Deficit reduction – $306 billion
Impacts to Medicare Beneficiaries
There are two main impacts to Medicare Beneficiaries in the bill.
My concerns with the Bill are below.
I really hope my pessimism is incorrect. If the bill does get passed, I hope these changes work and generate the additional $600 Billion in Tax revenue (plus the other $200 Billion projected). Otherwise, the additional spending in this bill will continue to drive increased Inflation for many years to come.
Each year, there are changes to the Part D Prescription Drug Coverage of Medicare. We won't have visibility to the actual Part D Plans until October 1, but there are some structural changes that occur each year with Part D. Key updates for 2023 are below.
The government sets a maximum deductible amount for the Part D Plans. In 2022, the maximum deductible was $480. In 2023, this is increasing $25 to $505. On most of the Part D Plans, the deductible only applies to higher tiered drugs (e.g. Tiers 3, 4, 5). Also, some Part D Plans have a $0 deductible, or other amounts lower than the maximum deductible.
Initial Coverage Level
The Initial Coverage Level will increase $230 from $4,430 in 2022 to $4,660 in 2023. This amount is based on the Retail Cost of the Medication for the year (Calendar Year). Most people (about 85%) do not exceed the Initial Coverage Level and thus continue to pay their Copay/Coinsurance amount for the entire year. However, for the people that have very expensive medications that exceed the Initial Coverage Level, they will reach the Part D Coverage Gap, aka Donut Hole where they have to pay 25% the cost of their medications. The increase of $230 to the Initial Coverage level will have a minimal impact on Drug Costs in 2023. Basically, for those 15% of people with expensive medications, there will be a slight delay to reaching the Part D Donut Hole.
True Out of Pocket Limit (Tro-oP)
The True Out of Pocket limit will increase $350 from $7,050 in 2022 to $7,400 in 2023. The Tro-Op is used to determine when someone exits the Part D Coverage Gap, aka Donut Hole, and moves into Catastrophic Coverage where they only have to pay 5% the cost of their medications. The increase of $350 in the Tro-oP only effects about 5% of people (those that would reach Catastrophic Coverage), and it creates a slight delay for when they will reach Catastrophic coverage.
The net impact to these individuals with expensive drugs is likely about $100 cost increase for the year.
Click the link to the video for a more detailed explanation of these changes, including a detailed example for someone who reaches the Part D Donut Hole.
The Office of Inspector General within Health and Human Services (HHS) recently released a report outlining an audit of service denials from Medicare Advantage Organizations. The full report can be found using this link.
Some of the key highlights from the report can be found below (and summarized in the video above).
The Top 3 impacted areas for these denials were:
There were three recommendations that the Inspector General is requesting of CMS (Center for Medicare and Medicaid Services).
CMS has acknowledged and agreed to implement these recommendations.
Hopefully, this improves the overall experience for Medicare Advantage Plans going forward.
This short articles (and video above) covers two Press Releases came out this week from the government. One from the Social Security Administration (SSA) and one from CMS (Center for Medicare and Medicaid Services).
(1) SSA Re-opening offices on Thursday, April 7, 2022
(2) OTC Covid Test Kits available with Medicare Part B
SSA Offices Re-opening on April 7, 2022
Social Security offices were essentially shut down during the beginning of the Public Health Emergency (PHE). They re-opened about a year ago, but were still not taking walk-ins. There were very limited appointment time slots, which sometimes resulted in waiting 6-8 weeks to meet with someone. This press release is positive news because the offices will be re-opening for walk-ins starting on Thursday, April 7, 2022. SSA is still strongly encouraging individuals to use the online tools when possible to find answers and/or to book an appointment with Social Security. The SSA press release also mentions the migration to a new phone system which has resulted in some technical issues for phone calls with SSA. Hopefully, these issues get resolved soon!
Over-the-counter COVID test kits available with Medicare Part B
CMS announced Medicare enrollees (in Medicare Part B) can get up to eight (8) COVID test kits per month as long as the Public Health Emergency continues. You must be enrolled in Medicare Part B to qualify. (Even if you are enrolled in a Medicare Advantage Plan, you can still get the free test kits and the pharmacy will bill Medicare directly.) You just have to go to a participating pharmacy and show them your red, white, and blue Medicare card. You can find participating pharmacies using this link:
We hope you found this information helpful.
Secure Act 2.0 (HR-2954) passed the House of Representatives on March 29, 2022 by an overwhelming majority 414 to 5.
This bill is intended to provide additional opportunities for Americans to save for retirement.
The short video above some of the key highlights of this bill:
Expand Catch-Up Contributions
Delay Required Minimum Distributions (RMDs)
Mandatory/Automatic Enrollment in Retirement Plans for Employees
Authorize Student Loan Matching for Employers
Secure Act 2.0 provides some interesting incentives to improve retirement savings for individuals.
The Senate still needs to pass a companion bill and then it will need to be signed by the President to become law.
We still have some concerns with the lack of focus in Washington on the two large looming financial issues with Medicare (Hospital Trust Fund running out of money to cover expenses by 2026) and Social Security (not able to pay out full benefits by 2034). Hopefully, these important issues are addressed soon in Washington.
See bio here