confusion

Medicare Enrollment Form

UNEXPECTED MEDICARE PENALTIES AND INCOME-RELATED ADJUSTMENTS: CAN YOU APPEAL? HOW?

Medicare can be confusing and lead to unexpected costs. This is especially true if you’re not informed on the front end when you first become eligible for Medicare; or, if you delay enrollment, when you enroll that first time. The three most common surprise-cost culprits sprung on those new to Medicare include:

1.)   Medicare Income-Related Monthly Adjustment Amount (IRMAA)

2.)  Part B late enrollment penalty (LEP)

  • For each 12-month period you delay enrollment in Medicare Part B, you may have to pay a 10% Part B premium penalty, UNLESS you have other credible coverage that is compliant with Medicare rules (such as insurance based on your or your spouse’s job-based insurance).

3.)  Part D late enrollment penalty (LEP)

  • For each month you delay enrollment in Medicare Part D (Prescription Drug Plan), you may to pay a Part D late enrollment penalty unless you have creditable coverage that is as good or better than the basic Part D benefit or get “extra help” (Low Income Subsidy).

The good news, if you want to call it that, is if you get dinged for income adjustments or penalties – Yes, you can appeal.

In cases of IRMAA adjustments you can request a new initial determination right out of the chute if you have experienced a life-changing event that caused an income decrease, or if you think the income information Social Security used in making the initial determination is incorrect. If you don’t agree, you can also file for reconsideration or file an appeal.

You can also appeal your Part B and/or your Part D Late Enrollment Penalties (LEP) though the processes for doing so are different for Part B and Part D.

For Part B LEP, just follow the instructions on the notice that you received informing you of the penalty. You will need to prove that you were enrolled either in Part B or in coverage through current employment during the period of time for which you are being penalized.

For Part D LEP, you can appeal the penalty if you think you were continuously covered or if you think the amount of the penalty was calculated incorrectly. This appeal must be filed with Medicare’s contractor (MAXIMUS Federal Services) for handling appeals.

For more information on adjustments, penalties and how to file an appeal refer to this month’s Medicare Minute Newsletter courtesy of The Medicare Rights Center.

And go to:

Medicare Part B Premium Appeals | HHS.gov

Medicare IRMAA Life Changing Event Form

Late Enrollment Penalty (LEP) Appeals

If you have questions, we are happy to help:
Email: 65Plus@bbginc.net
Phone: 866-845-8600; Ext 130

bbg65Plus Certified To Facilitate National Medicare Educational Program

Medicare can be daunting and confusing and quite difficult to grasp.

This is true in the case of existing Medicare beneficiaries as well as their care givers.  And, it’s especially true for those prospective new enrollees who are about to turn 65 and have to deal with trying to understand their Medicare options for the very first time. 

The Medicare Minute was created and sponsored by the Medicare Rights Center to help address and alleviate some of the confusion surrounding Medicare. The program consists of an ongoing series of free monthly educational programs designed to equip people with the knowledge to more clearly understand their Medicare options, to make more informed decisions, and to ultimately utilize their Medicare coverage more effectively. 

Volunteers from across the country with experience in how health benefits work serve as facilitators for the Medicare Minute educational programs.  And, bbg65Plus is now certified and appointed to serve as a Facilitator of the Medicare Minute program. 

The Medicare Minute educational program is available free of charge to employers, organizations, and community groups interested in educating members on the ABC’s (and Part D) of Medicare. And now readers of our blog will be able to read a summary of some of highlights and key tips from those programs in this space each month. 

To learn more about the Medicare Minute educational programs and how you can schedule Medicare Minute presentations for your organization, contact Tom Barrett, Medicare Minute Facilitator for bbg65Plus at 866.845.8600 x130 or tbarrett@bbginc.net.

For more information — go here  1 Medicare Minute Overview and here 2 Medicare Minute FAQ

 

Medicare Minute

 

 

 

 

For Medicare Peace of Mind Turn To BBG65Plus

We have some very exciting news to share with you. Earlier this year, with great encouragement from our clients, we launched bbg65Plus.

Thinking about Medicare can be truly daunting. For years our clients have leaned on our knowledge, experience, and hallmark customer service for guidance on what to do and where to start when it comes to all things Medicare.

Now you can also turn to us to find the right coverage. We provide the full range of:

  • Medicare Advantage Plans,
  • Medicare Supplemental or Medigap Plans, and
  • Prescription Drug Plans

We match each person with the plan that’s right for them. And, we simplify the enrollment process making the transition to Medicare smooth and pain-free.

The age 65 and over demographic represents the fastest-growing segment of the U.S. workforce. Today, Medicare plays a much more significant role in the workplace.

Successfully transitioning to Medicare is a big deal that can also be a big cost and coverage win when done the right way. We can help.

Our goal centers on providing Medicare Peace of Mind. We remove the mystery and help you make the right decision about your Medicare coverage.

In launching bbg65Plus, we’re excited to serve the needs of our business clients as well as the Medicare needs of our families, friends, colleagues, and neighbors in the communities where we live and work.

So, for anyone needing assistance and hoping to experience Medicare Peace of Mind, please contact us. We’d love to help.

And, of course, we’d be very grateful if you’d help us spread the word.

(e) 65Plus@bbginc.net; (p) 866.845.8600 x130

The Wide Variation In The Price Of Diagnostic Tests Is Unrelated To Outcomes Or Quality Of The Provider: So Why Do We Pay More?

A study of spending on 12.5 million diagnostics tests by UnitedHealthcare once again revealed substantial variation in the prices patients pay for common diagnostic tests. The seven groups of common diagnostic tests included echocardiograms, mammograms and ultrasounds.

The price range for an echocardiogram — $210 to $1,830 – typifies and illustrates the wide variation in the price for common diagnostic tests. And, according to the report, the higher prices did not correspond to improved patient outcomes or to the quality of the provider.

So Why Do We Pay More?

“A more likely reason is that health care providers generally are incentivized to use their market power to increase prices, often resulting in overpriced services,” per the report.

A copy of the report can be found here.

We’ll write more in upcoming Two Minute Drill articles about what you can do to avoid the higher prices. You’ll learn how BBG paves the way for our clients via our SharedFunding program. They consistently experience lower costs without sacrificing quality of care.

  

“A more likely reason is that health care providers generally are incentivized to use their market power to increase prices, often resulting in overpriced services,”

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