Archive for November, 2016

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Medicare Announces 2017 Premiums and Deductibles

The Centers for Medicare and Medicaid Services announced Thursday, new premiums and out of pocket costs for 2017. This information comes after some beneficiaries have already made plan choices for 2017 based upon 2016 figures for out of pocket costs and premiums. Medicare is notorious for announcing changes late in the game, well after the year’s OEP/AEP (Open Enrollment Period/ Annual Election Period) have already begun.

The annual Medicare Part B deductible for all Medicare beneficiaries for 2017 will increase to $183, up from $166 in 2016. This is the deductible that anyone with a Standard Medicare Supplement Plan G is responsible for before their supplement plan’s benefits are triggered. For those who have Medicare Supplement Plan F, the plan will continue to cover the Part B deductible in full for the member.

The Part B premium rates will increase for about 30 percent of beneficiaries. The new monthly Medicare Part B premium for 2017 will be $134, up from $121.80 in 2016; an increase of 10 percent. Most beneficiaries will be protected from the hold harmless provision which locks in their Part B rate. Those protected are beneficiaries are those already receiving Social Security, and dual eligible participants having their premiums paid by Medicaid. Seniors that are newly eligible for Medicare in 2017 and those that are not receiving Social Security and being billed directly for Medicare will have to pay the higher premium.

In addition to increased Part B premiums and Part B annual deductible, Medicare has also increased other out of pocket costs such as the Part A deductible and per day costs for skilled nursing and Part A coinsurance. People with Medicare Supplement plans typically have benefits to cover these costs. The agents at Texas Medical Plans can review your Medicare Supplement policy benefits to see if you are effected by some or all of these changes. A Licensed agent can help you make an informed decision about you supplement policy and review it regularly to help you stay ahead of Medicare changes for years to come.

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How will a Trump Presidency affect Obamacare and health insurance?

Donald Trump has promised that he will repeal and replace the Affordable Care Act, Obamacare, as the Unites States President. This change is possible, but to get a true repeal and replace he needs 60 votes in the Senate. It may be more plausible that he will implement the series of measures he proposed during his campaign through smaller legislative changes.

Even if Trump moves to change the Affordable Care Act and repeal Obamacare this will not happen overnight. The Affordable Care Act was written into law two years and three months after President Barak Obama took office. It took another four years for the Affordable Care Act to be implemented into individual health insurance and group health insurance.

In January 2011 pieces of the Affordable Care Act were implemented into new health insurance plans. Amongst the first of the changes we saw were adding preventative / wellness benefits, the elimination of coverage caps, and the ability to leave children on a parents individual health insurance or group health insurance policy until they are twenty-six years of age.

Other pieces of the Affordable Care Act that were implemented in 2014 were that individual health insurance plans and group health insurance plans removed waiting periods, they covered pre-existing conditions, and the medical loss ratio (MLR). Pieces of the Affordable Care Act are still not implemented today. More than seven years after the law was written we are still in the implementation phase.

People want to know; will President Donald Trump get rid of Obamacare and will insurance go back to the way it was. The simple answer is there is no way to know. Even if he does make changes to Obamacare we may not see those changes until years later.

The GOP has a replacement plan to Obamacare detailed out in their A Better Way – Health Care Policy Paper, By The Numbers, and Fact Sheet.

What we at Texas Medical Plans have seen is that for most people looking at individual health insurance plans have fewer health insurance companies to choose from, monthly health insurance premiums have increased, and the health care provider networks continue to change. We have worked hard in 2016 to explore all the available options for your health insurance needs in 2017. There are other options available outside of Obamacare. If you are healthy it may be better to pay the health insurance tax penalty and get medical insurance that covers less than Obamacare. A Healthcare sharing ministry or accident plan may be a better fit for you in 2017. If you are a small business owner or our self-employed then you might be able to set up health insurance through your business as a group health insurance plan. It is now simple to set up a group with one or two people. Group health insurance plans can offer you a PPO again and access to a Nationwide network at possibly a better price than individual health insurance.

We welcome the opportunity to review all your options and will make recommendations to fit your budget. Call us at (512)847-3164. See more on our YouTube, Facebook, or Instagram pages.

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Insurance and Health Plan Options Grid

  Cost Covers Pre Existing Covers Pregnancy Satisfies Insurance Mandate Can have Subsidized Premiums PPO HMO Details
Affordable Care Act Indivudal & Family $-$$$ check-markYes check-markYes check-markNo Penalty check-markMust Qualify x-markNo check-markYes ObamaCare
Qualified Health Plan (QHP)
Group Employer or Small Business $$$ check-markYes check-markYes check-markNo Penalty x-markNo, but may be deductible check-markYes check-markYes Qualified Health Plan (QHP)
Major Medical – Short Term $$ x-markNo x-markNo x-markPenalty x-markNo check-markYes x-markNo Covers Major Occurrences
NON-Qualified Health Plan
Limited Benefit $$ x-markNo x-markNo x-markPenalty x-markNo check-markYes x-markNo Covers Minor Occurrences
NON-Qualified Health Plan
Accident Only $ x-markNo x-markNo x-markPenalty x-markNo dollar-signCash dollar-signCash Covers Accidents Only
NON-Qualified Health Plan
Specified Disease
(Cancer/ Heart Attack/Stroke)
$ x-markNo x-markNo x-markPenalty x-markNo dollar-signCash dollar-signCash  Covers Specified Diseases Only
NON-Qualified Health Plan
Healthcare Sharing Ministry $$ x-markWaiting Period check-markRestrictions Apply check-markReligious Exemption x-markNo check-markYes x-markNo Must abide by religious principles
NON-Qualified Health Plan
Not Insurance, No Guarantees

 

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