2017 Medicare Part A Hospital Inpatient Deductible & Coinsurance.
Part A Deductible $1,288.00 $1,316.00
61-90 Days $322.00 $329.00
91+ Days (Lifetime reserve days) $644.00 $658.00
SNF 21-100 Days $161.00 $164.50
Medicare Part B
Part B Deductible $166.00 $183.00
HDF Deductible $2,180.00 $2,200.00
OOP Limit Plan K $4,960.00 $5,120.00
OOP Limit Plan L $2,480.00 $2,560.00
Part B Premium
Standard monthly $121.80 $134.00
Receive Social Security Benefits $104.90 $109.00
Individuals will pay a different premium amount in 2017 if: They enroll in Part B for the first time. They don't get Social Security benefits. They have Medicaid, and Medicaid pays their premiums. Their modified adjusted gross income from 2 years ago is above certain amounts
1. What is the Medicare Access and CHIP Reauthorization Act of 2015? (MACRA)
MACRA has many components, one of which is a limit on first dollar coverage in certain Medicare supplement insurance plans for individuals considered “newly eligible” and a transition away from using Social Security numbers as identifiers. It also includes a change to the way Medicare pays healthcare professionals. Currently, healthcare professionals are paid based on the number of services they perform. MACRA allows for healthcare professionals to be compensated on quality of care as opposed to the number of services they perform.
2. Who is considered newly eligible?
“Newly eligible” is defined as anyone who is turning 65 on or after January 1, 2020 or anyone who is eligible for Medicare benefits due to age or disability as defined by the Centers for Medicare and Medicaid Services (CMS) on or after January 1, 2020.
3. What does MACRA require?
As of January 1, 2020 MACRA does the following:
4. How are enrollees in current Plans C and F affected?
No change. Plans C and F can still be sold after January 1, 2020 BUT only to Medicare beneficiaries who were age 65 PRIOR to 1/1/2020 or first became eligible for Medicare PRIOR to 1/1/2020 regardless of what plan they had previously.
5. What will the new Medicare card design be?
MACRA mandates the removal of Social Security Number (SSN) based Health Insurance Claim Number (HICN) from Medicare Cards to address the risk of beneficiary medical identity theft and fraud.
6. What do you need to do next?
Brokers and Agents do not have to do anything at this time except be aware of the new rules. If your customer gets a new card and number, you do not have to call Cigna Supplemental Benefits. The customer should give the new card to their health care provider on their next visit after receipt of the card.
New Medicare cards are coming
The Social Security Number Removal Initiative (SSNRI)
We’re removing Social Security Numbers from Medicare cards to prevent fraud, fight identity theft, and keep taxpayer dollars safe. Learn more about how we’re protecting the identities of people with Medicare and helping you put patients first.
Prepare for Upcoming Medicare Supplement Changes
Those who read the writing on the wall put themselves in a better position when changes arrive. We’re here to tell you that change is coming to Medicare Supplement coverage.
In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act, prohibiting Medicare Supplements from providing first-dollar coverage to those who become eligible for Medicare after January 1, 2020. As a result, Plans C and F, which cover the Part B deductible, will no longer be offered to new enrollees in 2020.
What’s It Mean for You?
You’re successful in this business because you adapt. We recommend you reposition your portfolio in advance of these changes.
Seek out strong carriers that offer Plan D and Plan G at competitive rates. Why? These two plans will be the next logical option for beneficiaries who might have been interested in Plan C or Plan F, respectively.
Plan D offers the same protection as Plan C, except for covering the Part B deductible ($183 in 2017). Similarly, Plan G mirrors Plan F, except for coverage of the Part B deductible.
In 2010, 53 percent of all beneficiaries enrolled in a Medicare Supplement had either Plan F or Plan C, according to the Kaiser Family Foundation. With the coming changes, you can expect Plans D and G to slip in as the most popular choices after 2020.
Comparing Plan D and Plan G
The only difference between these two plans is that Plan G covers excess charges while Plan D does not.
What’s an excess charge? When a beneficiary goes to a doctor that doesn’t accept Medicare assignment, the doctor can charge an amount that’s more than the cost Medicare has established for reimbursement. Only plans G and F cover the difference in cost — the excess charge. It goes without saying that this extra coverage typically drives the premium of Plan G higher than the that of Plan D.
If a beneficiary receives care only from doctors who accept Medicare assignment, he or she won’t incur excess charges. Some states don’t allow doctors to charge more than the Medicare-assigned rate, including CT, MA, MN, NY, OH, PA, RI, and VT.
Why Sell Plan D and Plan G?
Abolishing first-dollar coverage aims to encourage smarter use of health care services by consumers. The Congressional Budget Office estimates the elimination of Plans C and F will reduce federal spending by $400 million between 2020 and 2025.
For individuals turning 65 in 2020 and beyond, Plan G will offer the most comprehensive coverage in a Medicare Supplement. Additionally, neither Plan D nor Plan G are guaranteed issue, which means only those in their initial enrollment period or those healthy enough to pass underwriting can enroll in them. Generally, non-guaranteed-issue plans have a healthier book of business which typically means lower premiums.
Just as you’ve always done, understand your clients’ needs and financial situations before suggesting a plan. There are several Medicare Supplement options for a reason, and depending on a client’s circumstances, one plan may be a better fit than another. Help them choose wisely.