Kevin Knauss: Health, History, Travel, Insurance
Post related to Medicare health insurance, Part A, Part B, Part C, and Part D prescription Drug Plans, Medicare Advantage and Medicare Supplement plans.
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 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.
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.
Pat and Don are a married couple. Pat is age 67 and Don is age 64. Pat retires from work and leaves the employer group plan. Pat activates Part B of Medicare. For the last filed tax year, the modified adjusted gross income for Pat and Don was $350,000. Pat will be subject to an Income Related Monthly Adjustment Amount for the Part B and Part D.
Once you leave your job and the health plan, you must enroll in Part B in order to enroll in a Medicare Supplement or Medicare Advantage plan. In this situation, enrollment can be a little confusing.
The California Department of Health Care Services will now participate in a Part A Buy-In program with Centers for Medicare and Medicaid Services (CMS) and cover the premiums for Part A. Medicare beneficiaries eligible to have their Part A premiums covered are:
Of all the Medicare plans, the Part D Prescription (PDP) plans are the most confusing. The confusion arises because Medicare allows the Part D plans to offer alternate plans that differ from the standard plan. The alternate plans must be as good as the standard plan for the average Medicare beneficiary. Cost Sharing of the […]
