Kevin Knauss: Health, History, Travel, Insurance
Posts focusing on Medicare Parts A, B, C and D, Medicare Advantage, Supplements, changes in benefits, enrollment.
When we extrapolate the savings to an annual basis, Plan N rates are $214 lower than Plan G by age 68. This means that at age 68, an individual could incur ten $20 office visit copayments during the year and still pay less than Plan G (annual premiums plus copayments.) The individual could also have two emergency visits at $50 and five office visits at $20 and still pay less money.
Under the leadership of Dr. Oz, Medicare is rushing to implement Artificial Intelligence (AI) to review, authorize, or deny health care services received by Original Medicare beneficiaries. The primary goal is to save money not necessarily improve patient outcomes. CMS calls the new AI health care initiative “Wasteful and Inappropriate Service Reduction (WISeR) Model.
The monthly insurance premium for Part B of Medicare is $185 for individuals who had earned less than $106,000 or $212,000 for a married couple filing a joint federal income tax return. As the household income increases, the insurance premium for Part B increases. For individuals who earned over $500,000, the Part B premium is $628.90 per month for 2025. Remember that the monthly premiums are per person. If a married coupled earned over $750,000 and are eligible for Medicare, each person will pay $628.90 for Part B.
Regardless of the error, Medi-Cal updates the Covered California income section denying the non-Medicare spouse their private health insurance with the subsidy. The spouse is determined Medi-Cal eligible and their health plan is terminated.
Social Security recipients who have a Part D drug plan need to review their 2025 monthly premium rate. The changes to the Part D drug plans with a lower maximum out-of-pocket amount has forced many Part D plan sponsors to raise their monthly premiums. Rate increases of $30 to $50 per month is not uncommon.
The impacts of so many Medicare plans not paying an agent commission will suppress the number agents who are willing to assist enrollments for no compensation. In other words, some Medicare beneficiaries may have a tough time finding local agent help to evaluate their Medicare plan options.
Other plans may have an out-of-network deductible of $500 to $750+. The out-of-network deductible must be satisfied before the plan begins to share in the cost of the health care services or out-of-network services.
The 2025 Medicare Part D standard benefit structure will have a $590 deductible. After the drug deductible is met the plan member goes into the initial coverage phase. During the initial coverage phase, the plan member is responsible for 25 percent of the drug costs.
Not all the below options may be available to you because some are contingent on your age, employment, or income. Those health insurance alternatives available to you are worth investigating and considering if they meet your budget or adequately address health care challenges you may be facing.
Medi-Cal breaks up the income into unearned income, earned income, in kind income, and exempt income. Finally, there are certain expenses that will reduce the final countable income for eligibility in the Medicare Savings Program.
