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Covering the Bases: 
Part B premiums vary according to income

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HomesInAnnapolis.com

Annapolis

Davidsonville
Published June 15, 2008

Q: In looking over my widowed aunt's financial records, I was surprised to find that she is paying a higher Medicare Part B premium than my wife and I. Should I check to see if this is an error?

A: Medicare premiums for Part B are now based on income reported on income tax returns. If your aunt's reported income is more than $82,000, she is paying a higher premium because the government is not subsidizing her premium as much as those whose income is less than that amount.

For those filing an individual tax return with incomes between $82,000 and less than $102,000, the monthly premium is $122.20. From $102,000 to less than $153,000, a person pays $160.90 per month. From $153,000 to less than $205,000, the premium is $199.70 per month, and with a reported income more than $205,000 annually, the monthly premium cost is $238.40.

It is also possible that your aunt is paying a penalty on her Part B premium each month due to having signed up for Medicare Part B later than normal. She can check with the Social Security Administration to find out why her premium is higher than the $96.40 that most individuals pay.


Q: We have recently come to the realization that my mother has short-term memory loss. Among the many issues we uncovered, we discovered that she didn't pay her Medicare Part D premium for six months, and the company that covered her has disenrolled her.

I contacted the plan and asked them to reinstate her, but they said they won't because they made a reasonable effort to contact her and then notified her in writing that they were going to discontinue her coverage. Is there anything I can do for her?

A: Unfortunately, the plan does have the right to disenroll your mother because it followed the regulations for those who are delinquent in paying their premiums. Your mother will have to wait until the next enrollment period for Medicare Part D plans, which is known as the Annual Coordinated Election Period, which runs between Nov. 15 and Dec. 31 of each year. She will be charged a penalty when she signs up at the end of this year and the effective date of her coverage will be Jan. 1, 2009.

Until then you should apply for the Department of Health's Prescription Discount Program. This is not an insurance policy, but it does provide discounts for prescriptions purchased from participating pharmacies, and there is no cost for applying for the card. Call Script Save at 800-700-3957 to apply. The group number for Anne Arundel County is 586. There is also a hearing and eye care benefit attached to this program, and anyone can apply.


Q: I am looking at Medigap plans as a new Medicare beneficiary. I think a high-deductible plan would be a good idea for me. The information I have is not current, so I don't know how much the deductible actually is. I am looking at a high-deductible Plan F.

A: The annual deductible amount for that plan is $1,900, which means that you would pay the first $1,900 of Medicare-covered expenses you incurred before your Medigap plan would pay anything.

The limited Foreign Travel Emergency coverage with Plan F carries a separate deductible of $250 per year, which you would have to meet before being reimbursed for any eligible expenses.


Susan Knight is a senior health insurance consultant. If you have questions about the information in this column, contact the county's Senior Health Insurance Program at the Department of Aging and Disabilities at 410-222-4464 or ship_program@aacounty.org.

 

Reader comments: ( Post )
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4 months 25 days 15 hours ago
Medi- Gap Plan F
By way of clarification. While A High Deductible Plan F, appears on the surface to save you money, it requires you to pay a deductible up front, it also does not pay the excess charges between what Medicare pays and actual costs. This means that If you have a $1000 doctor bill and Medicare approves only $650 - Medicare will then pay 80% of the $1000 or $520. Here is what happens to the balance of $480 due the doctor.... Your High Deductible plan will pick up the 20% or $130, you will have to pay the difference between what Medicare actual pays and what they actually approved - $130.00. Your out-of-pocket in this scenario would be $350 (the amount Medicare didn't approve) plus your deductible. Translate this into thousands of dollars which even a minor illness could cost you, and your share of the total bill would be the $1900 deductible (every year), plus the difference between what your doctor charges and what Medicare actually approves and pays. With a High Deductible Plan F you cannot budget accurately for future health care needs. On the other hand, a regular Plan F, costs a few dollars more, but you can budget for your premium payments if you know that is all it is going to cost you. And there is no deductible in a regular F Plan. If your funds are limited and you want the doctor to absorb the differences your choice of doctors is going to be very limited - since with all the cuts and difficulties there are fewer and fewer doctors willing to take
Faith St. Claire - Greenville, SC

 

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