2020 Medicare Part A and Medicare Part B

by Kristin P. Sinclair   January 17, 2020

January 2020: It is a new Year and Medicare Cost Sharing has changed for the 2020 Annual Period.

Since Medicare has unlimited out of pocket exposure it is important that the Medicare beneficiary have coverage above and beyond that to the original Medicare. Supplemental coverage options can help pay for that additional out of pocket exposure and different plan designs off different levels of coverage. You can call Kristin at 803-329-0615 to discuss setting up an appoint to review coverage options than can help you protect your out of pocket exposure.

Medicare Part A in 2020 has a $1,408.00 deductible for Hospital Admission as an inpatient. That amount is applicable whether You are admitted for one day or up to 60 consecutive days. On days 61 through 90 the Medicare beneficiary would have a co-payment responsibility of $352.00 per day. On days 91 through 150 which are one time use life time reserve days the Medicare beneficiary would have a co-payment responsibility of $704.00 per day. At which point Medicare would have paid as much toward that admission as could be paid by the original Medicare.

It is possible for a Medicare beneficiary to have several admissions into the Hospital during an annual period, and have to a need to meet deductibles and co-payments on multiple occasions during the annual period.

After three days as an inpatient in the Hospital and having the need to be admitted to a Skilled Nursing Facility with in a 30 day period after the inpatient hosital stay of the 3 days or moreof inpatient care , for the reason associated with that inpatient hospital care. Hospitalization was a necessary Medicare care occurrence Medicare Part A would pay in full the first 20 days of Skilled Nursing Home services. For days 21 through 100 the Medicare Beneficiary would be responsible for the first $176.00 per day co-payment. Medicare would pay the amount above the $176.00 per day for the days of 21 through 100. After the 100th day of continuous Skilled Nursing Home care Medicare would not pay for any additional days. Medicare does not pay for Long Term Care.

Medicare Part A does not pay for the first three pints of blood, however, after the first three pints of blood Medicare would pay for Medically necessary additional pints while in the Hospital.

Medicare Part A pay for all but limited co-insurance and co-payments for outpatient drugs while in Hospice Care. As well as limited in-patient respite care. Note: the intention of Hospice Care is to provide quality of life care at the end of life, but it is not intended to extend life or help the patient recover from an illness. The Patient must meet Medicare requirement for admission to Hospice for end of life care.

Medicare Part B in 2020 has a deductible of $198.00 which is a one time annual deductible. Followed by 20% co-insurance for the Medicare negotiated rate. Which is the 20% of the Medicare approved rate. And it is possible for the Medicare beneficiary to also be responsible for any excess charges as well. The excess charges would be associated with a Medicare covered item being provided by a Medicare provider who does agree to see Medicare patients however, their charges could be up to 15% higher than Medicare approved rates. If the medical treatment is not a Medicare Part B approved service the Medicare beneficiary would be responsible for the total charges associated with that medical care being received.

Any time you are receiving medical care, the medicare beneficiary should inquire as to whether the medical care is a medicare covered service, so that the beneficiary can make decisions as to whether they want to assume any additional financial responsibility. Concierge services are an example of medical care that is not covered by Medicare.

Medicare Part B does not cover the cost associated with the first 3 pints of blood received on an out-patient basis but would cover the cost of blood over and above the 3 pints, based upon medical necessity and the patient paying for their cost sharing responsibly.

Medicare as a general rule will pay the charges associated with medically necessary Skilled care services received at home and medical supplies associated with the skilled care. This care is being considered medically necessary while recovering. While returning to an improved level of health. Medicare does not offer unlimited Skilled Care in the Home setting. After a period of care if improvement is not being realized the Skilled Level of Home Care would no longer be considered Medically necessary and would end. It is also important the Medicare Beneficiary is aware that, Medicare Part B does not covered other levels of non skilled care, associated with at home care. Medicare Part B has cost sharing associated with Durable Medical Equipment. Such as the Annual deductible of $198.00 if not already met as well as the 20% co-sharing co-insurance amount.

The Medicare Beneficiary should receive the Durable Medical Equipment from a Medicare approved preferred provider to save as much out of pocket exposure for any Durable Medical Equipment. The Medicare approved preferred provider will go over proper use of the durable medical equipment as well. You can research available preferred providers by referring to the Medicare.gov available resources.

Medicare pays nothing for Medical care received outside of the United States or the U.S. protectorates. For more on this topic the Medicare beneficiary should review the information available at Medicare.gov.

Original Medicare has preventative care services that are covered events and a list of those services provided will be covered in a separate article. You can also review these covered items by referring to the Medicare.gov publications available on line.

 

Updated in Rock Hill SC

by Kristin P Sinclair     A Accu Tax (803)329-0615

January 17, 2020

2020 Medicare Part A and Medicare Part B

by Kristin P. Sinclair   January 17, 2020

January 2020: It is a new Year and Medicare Cost Sharing has changed for the 2020 Annual Period.

Since Medicare has unlimited out of pocket exposure it is important that the Medicare beneficiary have coverage above and beyond that to the original Medicare. Supplemental coverage options can help pay for that additional out of pocket exposure and different plan designs off different levels of coverage. You can call Kristin at 803-329-0615 to discuss setting up an appoint to review coverage options than can help you protect your out of pocket exposure.

Medicare Part A in 2020 has a $1,408.00 deductible for Hospital Admission as an inpatient. That amount is applicable whether You are admitted for one day or up to 60 consecutive days. On days 61 through 90 the Medicare beneficiary would have a co-payment responsibility of $352.00 per day. On days 91 through 150 which are one time use life time reserve days the Medicare beneficiary would have a co-payment responsibility of $704.00 per day. At which point Medicare would have paid as much toward that admission as could be paid by the original Medicare.

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Medicare 2020 Parts A, B, C, and D

by Kristin P. Sinclair   January 12, 2020

Let’s talk Medicare, exercise, and cost sharing.

Original Medicare has several parts to it: Part A Hospital stays and Skilled Nursing events after Hospitalization. Hospice Care falls under Original Medicare Part A. If you need a blood transfusion while at the hospital that falls under the Original Medicare Part A .

Each of those above Mentioned items You as the Medicare Beneficiary have cost sharing responsibilities. With Medicare having no out of pocket limit on your cost sharing you need to find a way to limit your exposure to financial obligations.

Medicare Part D is the Drug coverage available to the Medicare Beneficiary. Medicare Part D is offered by Insurance companies that have plans designed to meet the guidelines established by the Government. Medicare Part D has a premium, each plan is going to have a premium unique to that plan and formulary. Plans are going to applicable to different geographic areas. That area might be a state or the area might be a multistate region. And different regions could have a carrier like one found in all other regions because they have a national presence. And in some areas you might see a carrier name that is not familiar to you.

Medicare Part C is the plan design that is chosen when the Medicare Beneficiary wants the Insurance Company to handle their Medicare Part A and Medicare Part B and often also their Medicare Part D all in one plan that the government has approved as a Medicare Part C plan design, called a Medicare Advantage Plan. Where You usually are going to be using a network of Doctor’s. If not using a network doctor plan on making a change of doctors or a change in plans. Your primary physician wants to be the anchor for your care with your specialists. Different plan are designed to more effectively address the care needs of select groups of people with certain health events, covered cost efficiently by the plan. When you choose an MAPD it quite often means you plan to pretty much stay near home most of the annual period and do not plan to do a lot of traveling.

A Medicare Supplement is an Insurance Plan offered by an Insurance company, and the plan design chosen is going to help fill the gaps in the original Medicare coverage. Once issued so long as you pay your premiums when due you can keep the policy, it is renewal for life. With a Medicare supplement added to the original Medicare Parts A and B you are free to seek your health care from any healthcare provider who accepts Original Medicare. You are free to self refer to a specialist even if that specialist is in a different region of the country. But it is always wise to have your primary physician aware of the folks who are on your care team. And aware of the reasons you are receiving treatment being sought.

Medicare has a Welcome to Medicare Visit that you should take advantage of in the first year you are on Medicare. And then you should have your annual preventative exams as well. If you need to go to the Doctor for a visit that is not considered Preventative that is when your deductible and cost sharing will be applicable.

Questions to ask yourself, do you exercise regularly, with intention to do what you can do to stay as healthy as possible. Since many of the health crisis events that folks can be forced to deal with, might be avoidable with Exercise, Diet, and Relaxation techniques. What are you doing or intend to do to begin minimizing un-necessary medical events. If you are active and enjoy walking and sports and relaxation techniques and as a result take few medications great job keep up those life style choices. There are plans designed for folks who have that world view.

Questions to ask yourself, do you intentional avoid exercise, and eat what you like knowing a consequence might surface as a result and decide that you are okay with the prospect that you might be a person who uses a high degree of health care at some point in time. Well there are plans designed for you as well.

Questions to ask yourself, do you want to begin to take a different approach to your health care now that, you have the time to make taking care of yourself a new focus in your life. Well there are plans designed for you as well.

My hope is of course that a goal for all of us, is to exercise, and practice deep breathing, and walk where the scenery is relaxing and calming. And lift light weights, even while sitting. Lift light weights while standing. And lift light weights even while exercising on the floor. And then get a realistic meal and then head out properly dressed for a walk after eating. And then get ready for your day. Roll up your attitude and take on the day ahead of you. And then do some more relaxing walking at the end of your busy day. Which will certainly help you get more relaxed and ready to enjoy a light meal and then a couple of hours later lay down and call it a great day well spent.

More to follow on more specific details.

Updated in Rock Hill SC and Charlotte NC

by Kristin P Sinclair     A Accu Tax (803)329-0615

January 12, 2020

Medicare 2020 Parts A, B, C, and D

by Kristin P. Sinclair   January 12, 2020

Let’s talk Medicare, exercise, and cost sharing.

Original Medicare has several parts to it: Part A Hospital stays and Skilled Nursing events after Hospitalization. Hospice Care falls under Original Medicare Part A. If you need a blood transfusion while at the hospital that falls under the Original Medicare Part A .

Each of those above Mentioned items You as the Medicare Beneficiary have cost sharing responsibilities. With Medicare having no out of pocket limit on your cost sharing you need to find a way to limit your exposure to financial obligations.

Learn More

Medicare 2020 Notes

by Kristin P. Sinclair   January 10, 2020

For those already receiving Social Security Benefits and also a Beneficiary of Medicare, You may have received; Your notification letter by now most likely that You are getting a cost of living increase.

You were also notified in the letter, that Your Medicare Premiums are going up, and Your cost of living increase will help to cover the additional cost associated with Medicare Premiums. So let’s look at some numbers:

$ 750.00 times 1.6% equals $12.00 add those two figures and you get $ 762.00

$ 1,000.00 times 1.6% equals $16.00 add those two figures and you get $ 1,016.00

$ 1,250.00 times 1.6% equals $20.00 add those two figures and you get $ 1,270.00

So when you are talking with folks and your friend shares information with you, and you hear of someone’s social security income increase amount and the numbers seem different for different people, yes it could happen.

In 2019 most people had a Medicare part B premium of $135.50, most people in 2020 will have a Medicare part B premium of $144.60 what is the increase to most peoples, Medicare part B premiums increase of $9.10. So for the person with an average social security check of $ 1461.00 before any deductions, with a cost of living increase of $23.38. Many Beneficiaries of Social Security and Medicare will feel like they got a bit of a raise.

For others they might get assistance from the federal Government to help them live a bit more comfortably. And receive a Low Income Subsidy making it possible the person living on a very low amount of social security income to more easily pay for medications.

And yet others could actually pay more than the $144.60 monthly for their Medicare Part B, why would that be, they had an income amount two years ago that they have what is called income related monthly adjustment amount.

So things can seem puzzling at times when folks share information with each other. But one thing that does not need to be puzzling. When you work for more than 40 quarters and pay into the social security system and the Medicare system at minimum required levels you get to have a level of confidence that you also worked to pay into the Medicare Part A in advance while you worked. And when you begin to receive Medicare Part B you will pay a premium for that portion of Medicare when you receive the benefits.

When you have paid into the Social Security System for 35 or more years you will have a greater amount of Social Security benefit than if you paid into the system less than 35 years. If you paid into the system for 10 or more years, let’s say for 10 or more years or 40 quarters at a minimum. Some people’s benefits could be very different than another person’s benefit amount.

For the person who paid social security taxes on income which topped at $100,000.00 annually for many of their working years, and the person who paid social security tax on income which topped at $50,000.00 for many of their working years, and the person who paid social security tax on income which topped at $25,000.00 for many of their working years, each of those people will have contributed into the system at different levels and their benefits will vary based upon their earnings history. And then add to your consideration the person who worked paying into the social security system for the 35 years or more, and the person who worked 20 years and the person who worked 15 years. Each of those people also contributed into the system at different levels as well. So paying into the Social Security trust fund while challenging at a young age, it has a reward which can be benefited from later in life when working a full time schedule is much less realistic for many people when they need and want to have a chance to slow done a bit more and enjoy more leisure time and the opportunity to volunteer your precious time to causes important to so many.

Not every person pays the same exact amount of Medicare Part Premiums as every other person receiving Medicare benefits, but most people do indeed pay the same amount. Some folks who have a much lower income are receiving a premium increase as well. And if their Social Security income is at a low enough level they might actually pay less than most Medicare Beneficiaries.

Well the same holds true for those who have a significantly larger income over all, They will pay an additional adjusted premium based upon Their income from two years prior.

So things can seem complicated, Life is complicated, We all need to do our best to plan for our tomorrows and take care of our todays as well. When We are able to plan for tomorrow it can make tomorrow a bit easier to enjoy.

So let’s consider a more comfortable future. If one worked for 35 years and most of Americans in their early working years made very little earned income, but contributed to Social Security every year and as the years past your earnings grew and job changes were made and your earnings grew more. And now it is time to be playing more, work less. You enjoy working through part of the year but no desire to work as much as you once did.

Social Security income for some maybe $1400.00 for another, will be $1900.00 per month and for someone else they are looking at $2700.00 per month. Since you still enjoy working, it would be wise to have some taxes withheld from your Social Security earnings. Since you enjoy working portions of the year you want to have adequate taxes with held from your earnings. With that additional planning you likely have made certain that you will have few tax obligation surprises when it comes time to file your tax return.

Life is a series of choices and planning for retirement years can involve choices as well.

 

Updated in Rock Hill SC and Charlotte NC

by Kristin P Sinclair     A Accu Tax (803)329-0615

January 10, 2020

Medicare 2020 Notes

by Kristin P. Sinclair   January 10, 2020

For those already receiving Social Security Benefits and also a Beneficiary of Medicare, You may have received; Your notification letter by now most likely that You are getting a cost of living increase.

You were also notified in the letter, that Your Medicare Premiums are going up, and Your cost of living increase will help to cover the additional cost associated with Medicare Premiums. So let’s look at some numbers:

$ 750.00 times 1.6% equals $12.00 add those two figures and you get $ 762.00

$ 1,000.00 times 1.6% equals $16.00 add those two figures and you get $ 1,016.00

$ 1,250.00 times 1.6% equals $20.00 add those two figures and you get $ 1,270.00

So when you are talking with folks and your friend shares information with you, and you hear of someone’s social security income increase amount and the numbers seem different for different people, yes it could happen.

Learn More

Let’s Talk Medicare 2020

by Kristin P. Sinclair   January 13, 2019

We know that Medicare has several different parts. Today We will focus on some basics.

Medicare Part A and Medicare Part B.  In another article We will look at things in more depth. For today the basics.

In the Original Medicare Part A there is a deductible and cost sharing for covered services.  The hospital deductible is $1408.00 for 2020 per benefit period.  The benefit period in a continuous or unbroken number of days within a calendar year.  So a person in the hospital on different occasions during the annual period could actually have multiple deductibles.  And multiple cost sharing co-pays.  Medicare does not cover all costs so it is important to have coverage above and beyond Medicare Part A.   Whether a Nursing Home visit is in order after a hospital visit or you head home to recover, health care has costs associated with utilization of health care. More on that later.

Learn More

Let’s Talk Medicare 2020

by Kristin P. Sinclair   January 13, 2020

We know that Medicare has several different parts. Today We will focus on some basics.

Medicare Part A and Medicare Part B.  In another article We will look at things in more depth. For today the basics.

In the Original Medicare Part A there is a deductible and cost sharing for covered services.  The hospital deductible is $1408.00 for 2020 per benefit period.  The benefit period in a continuous or unbroken number of days within a calendar year.  So a person in the hospital on different occasions during the annual period could actually have multiple deductibles.  And multiple cost sharing co-pays.  Medicare does not cover all costs so it is important to have coverage above and beyond Medicare Part A.   Whether a Nursing Home visit is in order after a hospital visit or you head home to recover, health care has costs associated with utilization of health care. More on that later.

Medicare Part B is the outpatient portion of your Medicare coverage, and it too has cost sharing in the form of a deductible in 2020. That deductible is $198.60 for the annual period for health care sought and received, and then cost sharing in the form of co-insurance of 20% of the Medicare approved amount. With that being said, coverage above the original Medicare part B is also important. When durable medical equipment is in order with your doctor’s written order that too is a Medicare part B covered event with cost sharing.   More on that later.

Medicare has no annual cap on your financial responsibility for cost sharing.  Once again additional coverage is needed to limit the potential financial obligations that could be faced by a person who utilizes their Medicare Part A and Their Medicare Part B benefits.

In an article to follow, We will review things in more detail and We will look at the various options that you can take to help keep financial obligations manageable.  You worked hard to earn Your Medicare and now some thoughtful research to utilize Your Medicare benefits efficiently.

 

Updated in Rock Hill SC and Charlotte NC

by Kristin P Sinclair     A Accu Tax (803)329-0615

January 13, 2020

What is a Fixed Annuity?

By Donn J. Sinclair, MBA November 12, 2019

Insurance Professional Donn Sinclair

Fixed annuities pay guaranteed rates of interest and in many cases higher interest rates than those available from other financial institutions. Fixed annuities are the issued by insurance companies and are essentially fixed rate savings/investments from an insurance company.

You can select either a deferred or immediate fixed annuity. The deferred fixed annuity normally allows your savings to grow tax-deferred while accumulating regular rates of interest. The immediate annuity usually provides you with regular fixed payments which are partially determined by your age, the size of your annuity purchase, the payment schedule selected, and the interest rate for your annuity.

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Index and Exchange Trade Funds (ETFs)

by Donn J. Sinclair, MBA   January 15, 2020

An Index Fund is made up of a basket of securities designed to track and match the performance of a benchmark or index.  The Index Fund is also frequently called a Passively Managed Fund.  The Index Fund may be designed to track or match a stock or bond index.  Some of the most popular stock Index Funds attempt to track the S&P500 and the NASDAQ100, and some of the most popular bond Index Funds are designed to match the Total Bond Index and the International Bond Index.

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CURRENT ETF INFORMATION

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