Author: Dan Hoelscher

Dan Hoelscher founded Seniormark in 2007 in an effort to help individuals make a successful transition into retirement. Dan is a Certified Financial Planner™ Practitioner and holds Certified Senior Advisor (CSA)© and Certified Kingdom Advisor™ certifications. Since founding Seniormark, Dan has helped thousands of retirees throughout Ohio.

Know The Drug Plan Lingo! 5 Terms to Get You Started

Posted on April 26, 2017 by - Employer, Medicare, Medicare Advantage, Medicare Drug Plan, Medicare Supplement

Know The Drug Plan Lingo! 5 Terms to Get You Started

Every field or discipline has its own language. And to the undiscerning ear, it can all run together into nonsensical jargon. Mumbo jumbo. Gibberish. Flim flam. Drivel. You get the idea. But if you want to walk the walk and get ahead, you must first talk the talk. To get you started, you’ve probably come across these 6 terms in your Part D Drug Plan research.

 

Formulary

I’ll start with an easy one. The formulary is simply the list of drugs a particular plan covers. There are 24 drug plans at your disposal. Not all of them will cover the same medications. This is why it is important to check a plan’s formulary to find out if it’s right for you.

 

Prior Authorization

If a drug plan requires prior authorization, it means that they will not cover certain drugs unless your doctor or prescriber proves that the medication is medically necessary.

 

Step Therapy

Drug companies do not want you on an expensive drug when a less expensive one will be just as effective. For this reason, they will often make their beneficiaries start on a generic or cheaper drug as a trial to see if it works just as well. If it doesn’t, then the beneficiary can “step” up to the more expensive (often name brand) medication. This is called step therapy.

 

Quantity Limit

Quantity limit is exactly what it sounds like: a limit on the quantity of a specific drug that a plan will cover. Drug companies limit quantity to reduce waste, curb drug costs, and prevent unsafe use. For example, if someone is on a pain medication with a standard dosage of 2 per day, the quantity limit for a month will likely be 60 pills. They don’t want people getting addicted or wasting them through misuse or carelessness.

 

Tiers

Drug plan companies often organize the medications they cover into levels or “tiers”. Drugs on a lower tier (often generic brands) have lower associated costs such as copayments or coinsurance. Drugs on a higher tier (such as name brand or specialty drugs) often have higher costs.

 

The Donut Hole

The donut hole is a gap is prescription drug coverage. After you reach $3,310 in total drug costs, you enter the donut hole (resulting in higher out-of-pocket costs). After you reach 4,850 in out-pocket costs, you leave the donut hole and enter into what is known as “catastrophic” coverage where the plan will cover 95% of your drug costs.

 

All done! If you finished reading this, your Medicare literacy just increased. But if you have run into any more difficult terms, leave a comment. We are more than willing to answer your questions. Or visit Medicare Interactive’s glossary for additional Medicare vocabulary.

 

Have other Medicare questions? Turning 65 soon and not sure what to do? Click here to sign up for our free Medicare workshop. No high-pressure sales pitches here, just in-depth discussion about the ins and outs of Medicare!

Is There an Advantage to Medicare Advantage?

Posted on April 21, 2017 by - Medicare, Medicare Advantage, Medicare Supplement

Is There an Advantage to Medicare Advantage?

According to Reader’s Digest, 1 in 4 retirees receive their health insurance coverage from a Medicare Advantage Plan.  And I can certainly understand the attraction.  Premiums as low as $0 a month.  Prescription drug plans often included.  What’s not to like?

 

But—as it goes for most purchases—you get what you pay for.  And when it comes to Medicare Advantage Plans, they definitely have a dark side.  Allow me to shed some light on the subject.

 

The Medicare (Dis)Advantage Plan

Networks

Medicare Advantage Plans contract with specific hospitals and doctors, usually within a relatively tight-knit geographic area.  If you don’t receive care from the ones with whom they’ve “networked”, you may be subject to higher copays or coinsurance at each visit. Depending on the plan, they may not even cover your expenses at all.

 

This can be a problem for anyone, but especially for those who travel frequently.  So for you snowbirds out there who fly south for the winter and leave us all to freeze, this serves you right (forgive my jealous outburst).  You may find yourself with less (or even no) coverage at your vacation home.  Although they will still cover you in emergencies, that doesn’t mean it won’t be an expensive hassle.

 

Inconsistency

Because Medicare Advantage Plans are funded by government subsidy, the cost and benefits can change drastically from year to year.  If the government decides to spend your tax dollars elsewhere, your plan may let prices creep (or even leap) up, while benefits wane.  This all depends on politics, which—as you already know—is rarely consistent.

 

Potentially High Out-of-Pocket Costs

Medicare Advantage Plans have more of a pay-as-you-go approach.  Although the premium is low, deductibles, coinsurance and copays are often much higher.  This is not a problem if you are healthy, but if you are struck with sudden illness, you might be stuck with astronomically high out-of-pockets: 3,500 to 6000 a year or more!  And if the diagnosis is bad enough, you may not qualify to switch to a Supplement plan.

 

Let’s take a real life example.

A client of ours came in with an Advantage Plan.  He was diagnosed with cancer in fall of 2012 and started chemotherapy immediately.  Since he was in charge of 20% of the costs due to his plan, he very speedily met his $7,500 annual out-of-pocket limit.  Then it was the New Year, and his out-of-pocket limit reset.  He continued chemo-treatments, which lead to another $7,500 expense.  That is $15,000 of spending in less than 6 months!

 

And since a cancer diagnosis prevented him from switching to a Supplement, he had to stay with his Advantage Plan.  He was stuck, and—needless to say—very unhappy about it.

 

So Here’s the Bottom Line…

Is there an advantage to a Medicare Advantage Plan?

If your doctors are in your plan’s network, you stay on top of changes, and—here’s a big one—you don’t get horribly ill (leading to high out-of-pocket costs), then yes!  The Medicare Advantage dark side has vanished.  The force is with you, and you’ve saved hundreds or even thousands in premium costs.

 

But you need to assess your situation.  You need to take the risk into consideration.  1 in 4 people might be on a Medicare Advantage Plan, but that doesn’t mean it is right for you!

 

Questions?

If you find yourself still searching for answers, one of our workshops might be for you!  Click here to sign up for one of our next workshops!

Looking to switch to or purchase a Medicare supplement, or Advantage plan? Call Seniormark at 937-492-8800 for a free consultation. We are here to help.

3 Questions You MUST Ask Yourself Before Enrolling in Medicare Part B

Posted on April 11, 2017 by - Employer, Medicare, Retirement Planning

3 Questions You MUST Ask Yourself Before Enrolling in Medicare Part B

When approaching 65, most people sign up for Part B, but not everyone. And for good reason, too—not just because they didn’t plan well and missed the deadline. If you are wondering if you are one of these few, stay tuned! The answer is dependent on these three questions:

 

Question 1: Will I (Or My Spouse) Continue Working?

You might be more than ready and able to clock out of that stuffy office or factory for the last time. If this is you, go ahead and enroll. Lack of active employment forfeits your right to delay Part B (even if you have retiree benefits from either your or your spouse’s employer).

However, you or your spouse might continue active employment past age 65 and have insurance coverage through your employer plan. In this case, move on to question #2.

 

Question #2: Who Pays First?

Medicare or the employer? This is an important question to ask because if Medicare pays first and you don’t get on part B, you could be stuck footing some pretty hefty bills on outpatient services. Your employer won’t pay for it because they expected you to get on Medicare. However, if the employer pays first, the decision to delay Part B and stick with your employer health insurance might save you cash on premiums.

The way it works is actually quite simple: Do you work for a company of 20 employees or more? Then the employer pays first. How about fewer than 20? Then Medicare pays first.

But don’t just assume. To be certain, ask your human resources department or employer. They might surprise you with their answer.

Refer to question 3 if you or your spouse is covered under a health plan that insures 20 or more employees.

For more information on the answer to this question, refer to this Kiplinger article entitled “Should You Enroll in Medicare If You Are Still Working?” The “Who Pays First” chart mid-page is especially helpful.

 

Question #3: Is Medicare Cheaper?

Some people have excellent employer plans that make sense to stay on. But for others, it is a toss up. And for a few, Medicare is clearly the cheaper option. The only way to find out is to perform a cost to benefits analysis to determine which is more cost effective. If the employer plan is more expensive, then sign up for Part B.

If this helped you come to a conclusion on enrolling in Part B coverage, I wish you sincere congratulations. You are one step closer to a smooth retirement transition. But—of course—you are not done yet. There are many more things to consider.

Turning 65 soon and not sure what to do? Click here to sign up for our free Medicare workshop. No high-pressure sales pitches here, just in-depth discussion about the ins and outs of Medicare!

If you would like our assistance to perform a cost/benefit analysis, or need more immediate answers to your questions, give our office a call at 937-492-8800 and we will see how we can help!

 

What Is the Fastest Way to Sign Up For Medicare?

Posted on April 3, 2017 by - Medicare, Medicare Advantage, Medicare Drug Plan, Medicare Supplement

What Is the Fastest Way to Sign Up For Medicare?

Once you’ve determined that it’s time to apply and have carefully considered all of your options, you are now ready to sign up for Medicare. You’ve got grandkids to get back to, family events to plan, and the world to explore, so you probably want to get this item off your to-do list as quickly as possible.

 

Fortunately, the federal government understands you in this respect. In response, they have designed a user-friendly website and an online enrollment process. It’s quick (taking only about 10 minutes). It’s easy (because you don’t have to leave the comfort of home). And the very fact that you are reading this blog proves you are tech-savvy enough to handle it.

 

To Apply Online, Just Follow These Few Simple Steps:

  1. Go to Social Security’s Website
  2. Click on the “Menu” Tab.
  3. In the “Benefits” section, choose “Medicare”.
  4. Scroll down and click the “Apply for Medicare Only” button.  (you will only be applying for medical coverage — not social security payments)
  5. In the “Apply and Complete” section, choose “Start a New Application”.
  6. The site will guide you from there.

 

Slow Down Partner!

But just wait! Before you start clicking away gung ho, I want you to consider how much thought you’ve put into your Medicare decisions. Not because I want to keep you from your grandkids, but because I know making mistakes in this process can result in unnecessary penalties and unexpected costs. If you haven’t sat down with a retirement expert in consultation, I strongly recommend doing so. It will take extra time, but—as the clichéd saying goes—sometimes slow and steady wins the race.

 

If you need someone to take this weight off your shoulders, give Seniormark a call at 937-492-8800. We make retirement decisions as quick and painless as possible!

 

Tax Penalty Alert: Mixing Medicare and HSAs

Posted on March 23, 2017 by - Employer, Medicare, Medicare Advantage, Medicare Supplement

Tax Penalty Alert: Mixing Medicare and HSAs

Medicare and Health Savings Accounts just don’t mix.

Like oil and water. Like toothpaste and orange juice. Like shopping with grandkids and fixed budgets.

 

This is very important to know. When you start Medicare, either Part A or Part B, you have to stop contributions to your HSA account. Otherwise, you could be on the hook for some tax penalties. According to IRS publication 969, the penalty is 6% of your contribution and its interest until you remove the funds from your HSA.

 

So if you want to continue contributing to your HSA (legally, at least), you will have to delay getting on Medicare. But here’s the catch: Very few people can delay Medicare without receiving—you guessed it—penalties (there seems to be a lot of these nowadays). In fact, the only people who can forgo Medicare benefits without consequences are those who have adequate coverage with their employer through active employment. I’m not talking retiree insurance. I am talking Monday through Friday, on-the-floor or in-the-office work. It’s the only way.

 

And if you started receiving Social Security early and were signed up for Medicare automatically, I’m sorry to say you are stuck. You cannot contribute to your HSA, and it will be very difficult to get around it. This is because you are not allowed to opt out of Part A. Although you can drop Part B, being enrolled in Medicare Part A will still prevent you from contributing to your HSA.

 

However, it is important to note that you can still use the money in your HSA. There is no penalty for that. As a matter of fact, I would strongly encourage you to use your money. You’ve spent a lot of time building up that robust HSA; you might as well take advantage of it! You can use the funds for

  • Your Part B Premium
  • Your Drug Plan Premium
  • Your Advantage Plan Premium
  • Doctor’s Appointments
  • Copays

And this is just the beginning. There are many other qualified medical expenses you can use it for.

 

So don’t get too upset. You’re Health Savings Account is not obsolete. It’s just not going to grow much anymore. But that is just the way it is with a lot of things in retirement. Think of your nest egg. Your 401k. IRAs. It is just that time in your life when you stop working to save and start putting those hard-earned savings to work for you! When you look at it that way, it doesn’t seem too bad.

 

Have more questions about Medicare and your employer insurance?  Click here to receive your free copy of our handout:  “The top 4 questions Medicare-aged employees ask about their employer health insurance.“

 

If you still have questions — give our office a call at 937-492-8800.

 

Photo:  http://lifeandmyfinances.com/wp-content/uploads/2014/06/20140630-hsa.jpg

Turning 65 and Work For a Small Employer? Sign Up For Medicare Part B!

Posted on March 8, 2017 by - Employer, Medicare, Medicare Advantage, Medicare Supplement, Retirement Planning

Turning 65 and Work For a Small Employer? Sign Up For Medicare Part B!

The general rule of thumb is if you have employer insurance through active employment, you can delay Part B of Medicare without penalty.

 

But that certainly doesn’t mean you should! There are cases, of course, when your employer plan is the better value, and it works out for you to opt out of part B. However, in other situations, it may be very costly.

 

For example, consider the woman who came into our office earlier this year with an $8000 bill for her outpatient surgery. She opted out of Part B, but she had insurance through active employment. Shouldn’t her employer plan cover it?

 

Well, not always. You see, her insurance was provided through a company that employed less than 20 people. This made Medicare the primary payer of her insurance. And when she didn’t have Medicare? Well…it wasn’t good.

 

The costly mistake had to do with how coordination of benefits works between employer insurance and Medicare. Let’s take an employer health insurance plan that covers 80/20 as an example (insurance pays 80%, you pay 20%)

 

When an employer plan covers 20 or more employees, the employer plan is the primary payer of your claims. Therefore, your employer insurance pays 80% of the bill and Medicare (if you have it) pays the remaining 20%. In this case, it is not necessary to have Part B; you can opt out. You’ll have to pay the remaining 20%, but it saves you the $134.00 a month Part B premium.

 

But if your employer plan covers less than 20 employees, Medicare pays first. The whole thing is flipped. So what if you get the previously mentioned expensive surgery and don’t have Medicare? It will not just carry over to your employer plan. They won’t pay the 80% that was supposed to be covered by Medicare. Instead, you will be lucky to get them to pay the 20%, leaving you on the hook…80% or more on the hook, which might just be $8000 in uncovered surgery procedures.

 

This is why it is so important to ensure that you are signing up for Medicare at the right time. Just because your neighbor can opt out of part B doesn’t mean you can. They might work for a Honda or a Copeland, a company with thousands of employees. You might work for a small business of 15 people.

 

So check with your boss or human resources department. Ask and make sure. It could save you from an unexpected, expensive, and potentially crippling bill.

 

Confused about Medicare and not sure what to do next? Download our free E-book here, and let us walk you through it!  Still have questions?  Call our office at 937-492-8800 to schedule a free, no obligation appointment!

 

Is Signing Up For Medicare Automatic?

Posted on March 1, 2017 by - Uncategorized

Sample Medicare Card

Is Signing Up For Medicare Automatic?

It might be. A lot of things are nowadays. You can now set up your bank account to automatically pay for your bills. And do you remember the last time you turned on your computer, and it took 20 min doing automatic updates?

 

But Medicare enrollment? Most of the time—no. You usually have to call or go online or visit your local security office to enroll…unless…

 

Did you sign up for social security prior to age 65?

If you did, signing up for Medicare is, in fact, automatic. You will receive your Medicare card in the mail 3 months before you turn 65. As pictured above, it will have the dates your Medicare Part A and B will go into effect and your Medicare number (which you should protect very carefully). As long as you can’t think of a reason why you should delay Part B of Medicare, you are finished with this phase of the Medicare planning process.

 

But before you exit this window, I do have some bad news: you’re not done yet. You still have some major decisions to make. Do you want a Medicare Advantage Plan? Or a Medicare Supplement? What about Drug plans?

 

And—quite unfortunately—these decisions are not automatic.  But, the good news is that we can help you make those decisions.  Just call our office at 937-492-8800 to set up your free, no obligation consultation and we will put your mind at ease.

 

Turning 65 soon and not sure what to do? Click here to sign up for our free Medicare workshop. No high-pressure sales pitches here, just in-depth discussion about the ins and outs of Medicare!

Will I Be Able to Afford Medicare?

Posted on February 16, 2017 by - Medicare, Medicare Advantage, Medicare Drug Plan, Medicare Supplement, Retirement Planning, Social Security

Will I Be Able to Afford Medicare?

The shortest and most honest answer is “I don’t know”. But I know this doesn’t help you answer the most pressing questions weighing on your mind as you approach retirement age. Am I ready? Or Should I delay my retirement? And most of all—how am I going to afford health care without my employer insurance?

 

So here’s what I am going to do. Using my 20 years of experience working with retirees, I am going to lay out a framework for what to expect when it comes to Medicare expenses. These will just be “in-the-ballpark” figures, but I believe they will help you come to a decision. You just might find that Medicare falls squarely into your budget.

 

So let’s get started with some good news.

 

Medicare Part A (Inpatient Care) Is Free

As long as you’ve paid into Social Security for at least 10 years, social security will return the favor with no associated Part A premium.

 

The Associated Part B (Outpatient Care) Monthly Premium is $134.00

This figure is adjusted for high income, but most people don’t fall into the high-income category. $134.00 will be your monthly premium unless you make $85,000 per year or more as an individual or $170,000 filing jointly.

 

From this point, the cost of Medicare is heavily affected by which path you take. You can boil down all the madness into two basic choices: Medicare Advantage or Original (traditional) Medicare.

 

The Traditional Medicare Route

If you choose the Traditional Medicare route, you will want Medicare Supplement Insurance to fill in the gaps of what Medicare doesn’t cover. Otherwise, there will be no limit to your out-of-pocket spending. The premiums for a Medicare Supplement range from $45-146 per month. However, we often recommend a plan G, which typically costs $110 per month. This is a fairly standard premium. It puts into perspective what you can expect a Medicare Supplement Plan to cost.

 

To cover your medications, you will also need a Part D prescription drug plan, which will cost in additional premium anywhere between $15 to $128 monthly. The average cost for a drug plan is $35.63 in 2017. The out-of-pocket costs associated with Part D vary greatly depending on your medications. It is impossible to estimate without knowing your specific situation.

 

The Medicare Advantage Route

Offered as an alternative to Traditional Medicare, Medicare Advantage is often the cheaper option when it comes to premiums. They are offered for prices within the range of $0-163 monthly with the average premium being approximately $60 per month. The Part D prescription drug plan is almost always rolled into the plan.

 

Caution: Check For Possible Out-of-pocket Costs

At first glance, it looks like the Medicare Advantage route is the obvious choice. But this fails to take into account the risk of out-of-pocket costs. With a Medicare Supplement (only available with Original Medicare), the maximum out-of-pocket is only $166-366 annually for Plan G. However, in an advantage plan, it is more of a pay-as-you-go approach. There are less monthly premiums; but copays, coinsurance, and deductibles are much higher. The potential out-of-pocket for an advantage plan can be as a high as $3500-6000 per year or more!

 

The Costs At a Glance


So there you have it! This should give you a good idea of what Medicare costs for the average 65-year old. But—as I said before—the cost of Medicare is different for every person. If you are still concerned about being able to afford Medicare, contact us for a free consultation. We will assess your financial and health situation to find an overall plan that meets your needs, concerns, and pocketbook. Ensuring you a successful and secure transition into retirement is our number one priority.

 

There are a lot circumstances that may prevent you from retiring. But I believe that the affordability of health insurance shouldn’t be one.

 

Disclaimer: Numbers are based on Ohio 45365.

 

Turning 65 soon and not sure what to do? Click here to sign up for our free Medicare workshop. No high-pressure sales pitches here, just in-depth discussion about the ins and outs of Medicare!

photo credit:  http://www.espace.cool/prudence-how-much-can-we-afford/

4 Ways to Make Exercise Fun and Get Healthy in Retirement

Posted on January 31, 2017 by - Health and wellbeing, Uncategorized

4 Ways to Make Exercise Fun and Get Healthy in Retirement

If you are concerned about your health as you approach retirement, you are definitely not alone. According to a Merill Lynch Retirement Study, 81% of respondents reported that health is one of the most important ingredients for a happy retirement.

 

Sure, an excellent way to take charge of your health is to exercise, but sometimes the last thing you want to do is set foot on the treadmill or in the gym. Exercise doesn’t seem like much fun…

 

Which is why you need to make it fun! This is my recommendation: instead of grudgingly conjuring up the will power to do exercises you hate, instead of dragging your feet to the gym, muttering the adage “it’s good for me”, why not craft a regiment that you actually look forward to each and every day?

 

Don’t believe it’s possible? Here are 5 ideas that might change your mind!

1.  Tie Exercise to a Goal—and Not a Goal Weight Either

And for you older men out there, I am not referring to your blood pressure or cholesterol settling in on the magic numbers either. No, I’m talking about a life goal. Instead of making exercise merely about getting healthy, make it about accomplishing something you’ve always wanted to accomplish. For instance, have you ever wanted to…

  • Hike in all 59 National Parks?
  • Take a week to bike across your state?
  • Finally clean out that attic or shed?

You can even sign up for a Relay for Life or another exercise-related fundraiser to help a good cause reach their goals!

Whether it gives you a sense of personal satisfaction, curbs your appetite for adventure, or helps someone in need, don’t make your goal about how many calories you’re burning; make it about the life you’re leading!

2.  Join The Right Crowd…

Unlike most high school peer pressure, peer pressure as you age can be a wonderful encouragement. And it can certainly help you keep active. Think sports leagues. Think hiking groups. Think dance classes. Check online or at a fitness center near you. And if you can’t find one, take a lesson from Jake Chesson, and start one! Being a part of a group will help you stay consistent in your exercise routine, of course. But as you develop friendships and a community, I bet you’ll find yourself enjoying it as well!

3.  …Or Just The Right Person

Don’t like crowds? Then use your exercise time to reconnect with just one person you love. Take your spouse out for a long walk by the lake or—if you are lucky enough to live near one—the beach. Exercise with your sister or your brother or a friend you haven’t seen in ages. You can even choose to play a game with a grandkid like kickball, tag, or even old school hopscotch. The Lord knows it takes a lot of energy to keep up with them!

4.  Incorporate Exercise into a Hobby!

Do you have a knack for building things? Then stop by Lowe’s and get started! Have you ever tried golf? Why not try 9 holes without a golf cart? Want fresh fruits and vegetables to complement your healthy lifestyle of exercising? Work up a sweat while planting a garden.

 

The point is you shouldn’t make exercise about exercise. Instead, you should infuse physical activity into your lifestyle, your goals, your hobbies, and the people you love most. It may take a bit of thought and creativity to find physical activities that you are passionate about intrinsically, but once you find them, exercise will cease to be drudgery. Your exercise will make your heart thump in more ways than one.

 

Turning 65 soon and not sure what to do? Click here to sign up for our free Medicare workshop. No high-pressure sales pitches here, just in-depth discussion about the ins and outs of Medicare!

 

Photo:  http://newbridgespine.com/exercise-and-pain/

Medicare Part B and D: Make More = Pay More

Posted on January 17, 2017 by - Medicare, Medicare Drug Plan, Medicare Supplement, News

Medicare Part B and D: Make More= Pay More

It’s true. The premiums for your Part B and D coverage for Medicare are adjusted for income.

 

I get it. It’s a little infuriating. You’ve spent all of these working years paying more in Social Security than everyone else, and now you find out they might come back for seconds.

 

But before any public pickets or private fist-shaking takes place, I want to grant you a little bit of comfort: according to Social Security, less than 5% of Medicare beneficiaries pay higher premiums due to income. And out of our clients, we’ve only come across a handful of affected people.

 

But to make sure, I recommend checking out the following chart. NOTE: There are separate numbers for filing individually, jointly, and filing individually when married, so make sure you are looking at the right one.

 

If your yearly income (modified adjusted gross income) in 2015 (for what you pay in 2017) was
File individual tax return File joint tax return File married & separate tax return You pay each month in 2017 for Part B  

You pay each month in 2017 for Part D

 
$85,000 or less $170,000 or less $85,000 or less $134  

Your plan premium

 
Above $85,000 up to $107,000 Above $170,000 up to $214,000 Not applicable $187.50  

$13.30 + your plan premium

 
Above $107,000 up to $160,000 Above $214,000 up to $320,000 Not applicable $267.90  

$34.20 + your plan premium

 
Above $160,000 up to $214,000 Above $320,000 up to $428,000 Above $85,000 and up to $129,000 $348.30  

$55.20 + your plan premium

 
Above $214,000 Above $428,000 Above $129,000 $428.60  

$76.20 + your plan premium

 

 

So there you have it. Did you make the cut? And now…

 

4 Things You Need To Know

  1. Premium increases are based on your MAGI

MAGI (Modified Adjusted Gross Income) is the magic number. It is calculated by taking your Adjusted Gross Income (all the income you’ve earned minus deductions) and adding some of those deductions back in such as IRA contributions. It is a little hairy, but for most people their Adjusted Gross Income is so similar to their MAGI, it is irrelevant.

 

  1. It is based on the tax return you filed last year

So, in 2017, whether or not you are cursed with higher premiums is determined by the tax return you filed in 2016 based on your 2015 income.

 

  1. Being married but filing separately can have costly effects

Pay close attention to those numbers. You’ll notice that the premium increases are much higher for comparable amounts of income. So file jointly unless you have a really good reason for doing otherwise.

 

  1. You can appeal to have the increase removed

This is a big one. The government has been known to make mistakes. So, if you notice that you were wrongly charged, you can fill out an appeal, and they will double check (I’ll keep my fingers crossed for you). This is especially helpful in the case of a “life changing” event that drops your income. The Medicare approved “life changing” events include but are not limited to:

  • Divorce
  • Marriage
  • Death of spouse
  • Work Stoppage
  • Loss of Pension

If you believe your IRMAA is incorrect, you can request that the Social Security Administration make a new decision.  You can contact them on the national helpline at 800-772-1213.

 

For those of higher income, it does seem like the government is doing a double dip. But I sincerely hope that you are not one of those affected individuals. Thankfully, the measure excludes most!

 

Confused about Medicare and not sure what to do next? Download our free E-book to get you started.   If you still have questions, call our office at 937-492-8800.

 

Photo:  www.affordablemedicareplan.com