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65Plus Is The Hottest Labor Market Demographic. Here Are Key 2019 Medicare Costs That Employees And Employers Should Know.

Some say it’s the hottest demographic in the labor market — men and women ditching traditional retirement age to work into their 70s, 80s and sometimes beyond.   According to the Bureau of Labor Statistics the 65 and over crowd will make up the fastest-growing segment of the workforce over the next decade.  With that in mind, over the next few months we’ll be providing key bits of information that employers and employees may find helpful as they navigate the best and most cost effective options for health coverage for the 65Plus workforce and their dependents.

First off, 2019 cost considerations for “traditional Medicare”:

2019 Medicare Costs + Coverage

PART A PREMIUM (Hospital Insurance)
Most people don’t pay a monthly premium for Part A (paid Medicare taxes for more than 39 quarters.  If 39 or fewer quarters worked they’ll pay a premium of up to $437).

PART A DEDUCTIBLE + COINSURANCE
– $1,364 deductible for each benefit period
– Days 1-60: $0 coinsurance for each benefit period
– Days 61-90: $341 coinsurance per day for each benefit period
– Days 91 and beyond: $682 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)
– Beyond lifetime reserve days: all costs

PART B PREMIUM (Medical Insurance)
The standard Part B amount is $135.50 (or higher depending on your income).

PART B DEDUCTIBLE + COINSURANCE
– $185 deductible per year
– After deductible is met, enrollees typically pay 20% of the Medicare-approved amount for most doctor services, outpatient therapy, and durable medical equipment (DME).

2019 PART B + PART D (Prescription drug coverage) INCOME-RELATED MONTHLY ADJUSTMENT AMOUNT (*IRMAA PREMIUMS)
An additional amount that some individuals whose modified adjusted gross income (MAGI) is above certain thresholds will pay for their monthly Part B and Part D premiums.

  • 2019 Medicare Part B (Medical Insurance) Income Related Adjustments
FILE INDIVIDUAL TAX RETURN FILE JOINT TAX RETURN FILE MARRIED + SEPARATE TAX RETURN MONTHLY PREMIUM IN 2019
$85,000 or less $170,000 or less $85,000 or less $135.50
above $85,000 up to $107,000 above $170,000 up to $214,000 Not applicable $189.60
above $107,000 up to $133,500 above $214,000 up to $267,000 Not applicable $270.90
above $133,500 up to $160,000 above $267,000 up to $320,000 Not applicable $352.20
above $160,000 and less than $500,000 above $320,00 and less than $750,000 above $85,000 and less than $415,000 $433.40
$500,000 or above $750,000 and above $415,000 and above $460.50
  • 2019 Medicare Part D (Prescription drug coverage) Income Related Adjustments
FILE INDIVIDUAL TAX RETURN FILE JOINT TAX RETURN FILE MARRIED + SEPARATE TAX RETURN MONTHLY PREMIUM IN 2019
$85,000 or less $170,000 or less $85,000 or less your plan premium
above $85,000 up to $107,000 above $170,000 up to $214,000 Not applicable $12.40 + your plan premium
above $107,000 up to $133,500 above $214,000 up to $267,000 Not applicable $31.90 + your plan premium
above $133,500 up to $160,000 above $267,000 up to $320,000 Not applicable $61.40 + your plan premium
above $160,000 and less than $500,000 above $320,00 and less than $750,000 above $85,000 and less than $415,000 $70.90 + your plan premium
$500,000 or above $750,000 and above $415,000 and above $77.40 + your plan premium

 

Next Up:  The eligible employee’s three main options when it comes to their employer-sponsored plan and/or Medicare coverage.

 

2019 Medicare_and_You_2019

 

Could 2018 End Up Being a Year of Improved Health Insurance Market Stability? Here are Five Reasons It Could Be the Case.

With healthcare seemingly out of the political crosshairs for the moment and any tectonic shifts emanating from a new Amazon/Berkshire Hathaway/J.P. Morgan Chase superpower health entity a ways down the road, employers may get to experience some at least temporary market stability in the way of more choices, more consistent rates, less volatile renewals, and more opportunities to innovate (e.g. SharedFunding).

Employers have grounds for hope, at least for the next year or so.

Here are five (5) reasons that may lead to at least some temporary stability and have positive impact on cost and selection in the group market:

  1. The total number of people insured is holding steady or possibly even increasing despite the repeal of the individual mandate.
  2. Interest and energy in employer sponsored plans is up. More employers are offering health coverage. Many are also trying to improve their health coverage in order to compete for and retain talent in a more robust job market and a stronger economy.
  3. Much of the market activity for both insurance carriers and healthcare providers is geared toward gaining scale while building a better mousetrap (eg. Aetna/CVS, Unitedhealthcare and other carriers acquiring providers, etc). Strategic M&A activity is expected to continue.
  4. More states are experimenting by exercising the state waiver option (more info here and here). While tinkering with the individual market and Medicaid will get most of the headlines, more control on the state level should spawn more innovation and new options in the group market especially for small and mid-size employers.
  5. Health systems are now focused on vertical integration and improving their overall value proposition. They’re jockeying for market position and attempting to win over patients and payors alike.

 

 

Health Coverage By the Numbers

Job-based health insurance is the largest single source of health care coverage in the U.S.

1.) Employer-sponsored insurance covers more than 157  million workers and their dependents.

2.) The next largest source of coverage, Medicaid, insures less than half as many, 63 million.

3.) Medicare enrolls 45 million;

4.) Individual market (on/off Marketplace) provides coverage for about 21 million.

Source: Kaiser Family Foundation (KFF.org)

 

Health FSA Limit Will Increase for 2018

The ACA imposes a maximum dollar limit on employee contributions to health flexible spending accounts (FSAs).  Although the ACA set this limit at $2,500, the limit is indexed for cost-of-living adjustments each year.  On Oct. 19, 2017, the IRS announced that, for taxable years beginning in 2018, the dollar limit on employees’ salary reduction contributions to a health FSA will increase to $2,650.


Employers may continue to impose their own dollar limits on employee contributions to health FSAs, as long as the employer’s limit does not exceed the ACA’s maximum limit in effect for the plan year.  For example, an employer may decide to continue limiting employee health FSA contributions for the 2018 plan year to $2,500.


Go here for more information.

Health FSA Limit Will Increase for 2018 10-19-17

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