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Michael Bihari
Health Insurance Blog

By Michael Bihari, About.com Guide to Health Insurance

She’s Counting the Days to Medicare!

Thursday November 19, 2009

A close friend of mine is counting the days until she is eligible for Medicare. She turns 65 on April 17, 2010 and becomes eligible for Medicare on April 1. If my math is correct, she has 132 days to go.

No one wants to age, but the cost of her individual health insurance policy is a tremendous financial burden. Her husband is already on Medicare and my friend (who is self employed) has to purchase her own insurance.

Although she is perfectly healthy and takes no medications, her monthly cost is $978, or more than $11,700 per year. She has decided to join a Medicare Advantage plan that is being offered in her community. Her monthly premium will be $222 (125.60 for the advantage plan + $96.40 for the Medicare Part B premium) - an annual cost of $2664. She will save more than $9000 each year.

She has promised to throw one heck of a party with her first month savings!

Read the following article if you are too far away from Medicare eligibility to count the days:

Medicare Open Enrollment Starts This Week

Monday November 16, 2009

The Centers for Medicare and Medicaid Services (CMS), the federal agency responsible for Medicare, started open enrollment for 2010 on November 15.

The open enrollment period, which extends until December 31, allows you to go over your prescription drug and healthcare needs and change your Medicare coverage plans if necessary.

If you are currently enrolled in Medicare you should have received a Medicare handbook and a notice from your current health plan or drug plan about your options during open enrollment. If you are satisfied with your current plan, you do not need to take any action.

If you have a Medicare Part D prescription plan it is very important for you to be aware that many plans have changed what they offer for 2010. You may have to pay a higher premium and your medication may be cost more. Additionally, the drug plan's formulary may have changed and your medication may no longer be available.

Your 2010 handbook, Medicare & You, has a list of all the prescription drug plans in your state showing you the cost and quality ratings from members. You also can get detailed information on the Medicare website.

Americans Overestimate How Quickly Help Would Arrive if Health Reform Passes

Saturday November 14, 2009

Almost half (49%) of Americans believe that if health reform passes by the end of this year, people without health insurance will start to get financial assistance by the end of 2010.

Additionally, according to the October 2009 Kaiser Health Tracking Poll, 51% of the public also thinks that by the end of the coming year, health insurance companies will have to begin offering health insurance plans to people with pre-existing health conditions.

In reality, the changes envisioned in the current health reform legislation before Congress will not happen until at least 2013.

photo © iStockphoto

Halloween Surprise – Premiums Up 20%!

Friday October 30, 2009

The good news: My wife won't lose her health insurance.

The bad news: Her health insurance premium is going up 20%. And that is in addition to an increase in her medication copayments.

This wonderful news arrived in a letter from her health plan's Vice President of Customer Services to let her know that the premium change was due to increased medical costs and the fact that she is another year older and more of a health risk.

My wife buys her own health insurance and the premium increase will cost her an additional $170 each month. To save money she is looking at other health plan options that would eliminate the premium increase, but would have an annual deductable of $2000 instead of $500 and copayments for doctor's visits of $25.00 instead of $15.00. She's crunching the numbers.

Well, at least all of her prescription drugs are still on the formulary. Happy Halloween!

Check the Facts About Health Reform. What’s Myth and What’s Real?

Friday October 30, 2009

I recently attended a discussion about health reform that was held in my local library. I was amazed at the number of people, especially seniors, who believed that if health reform is passed their Medicare benefits would be "drastically cut" and they would have to get "clearance from the government" to be allowed to go to a health facility in a neighboring community.

Since this is absolutely not true, I asked the woman where she heard this. She claimed that she was not sure; perhaps "I read it in the paper or heard it from a bridge partner."

Since the debate about health reform heated up earlier this year, there have been numerous misstatements about specific parts of proposed health reform legislation. So many rumors have sped through the media that you may be confused and concerned about how health reform will impact you.

The health care reform debate has become increasingly political, with liberal, moderate, and conservative members of Congress, along with their counterparts in the media, presenting numbers and anecdotes about the serious problems that would be caused if Congress passes (or doesn't pass) health reform.

Here are two websites that have emerged as reliable sources of information that will help you evaluate what's real and what's not:

  • Politifact, an independent, Pulitzer Prize-winning fact-checking site that evaluates claims made about the impact of health care reform
  • Factcheck.org, a project of the University of Pennsylvania's Annenberg Public Policy Center

The meeting at the library made me realize how important it is to have the facts!

Watch your MOOP! Significant Changes Coming to Medicare Advantage Plans

Friday October 30, 2009

On January 1, I will lose my Medicare Advantage Plan along with about half of the 11 million seniors enrolled in such plans.

My Medicare Advantage Plan combines Medicare Part A (hospital care), Medicare Part B (out-patient care and doctor's services), and Medicare Part D along with extra benefits such as free eyeglasses every two years and several other wellness perks. And I only have to send in a monthly premium check to one insurance company!

Seniors enrolled in a Medicare Advantage Plan that will continue to offer coverage in 2010 will most likely see their premiums increase along with their MOOP, or the plan's maximum out-of-pocket limit. Health insurance companies are dropping Medicare Advantage Plans because of lower payments from the government and increased oversight of how they operate. About 50% of the plans in the U.S. will close in 2010 - in Florida upwards of 90% of the plans are closing.

Watch your mailbox and make sure to open any mail from your plan and from Medicare. The Medicare open enrollment period starts on November 15 and you will have until December 31 to switch to a new plan.

I guess I won't have to watch my MOOP next year!

Preparing for Open Enrollment

Thursday September 17, 2009

If you or your spouse have health insurance through your employer, you may soon find yourself in "open enrollment," or the time of year when you can review your current benefits and decide if you'd like to change your plan.

As much of a pain as this can be -- it sounds about as exciting as taxes, right? -- picking the best health insurance plan for you and your family is critical. Planning to have a baby soon? Need new eyeglasses? Struggling to make ends meet? There are so many factors to consider when selecting health insurance. Make sure you do it right:

Open Enrollment in 5 Steps: How to Decide

Why Should You Care?

What Are Health Savings Accounts?


Special Interests Want To Shape Reform

Friday July 10, 2009
Special interest groups are going to great lengths for the chance to participate in health reform. According to the Associated Press, the pharmaceutical industry and hospitals have both agreed to give up billions of dollars now in order to protect their interests in the future. Providers are especially interested in ensuring that if healthcare reform includes a public plan option, payment rates are comparable to those provided by private insurance plans rather than Medicare rates.

However, these special interests cannot come close to footing the bill for health reform, which has been estimated at $1 trillion over the next 10 years. This means that their offer is a calculated risk - they hope that the President remembers their support when it comes time to sign a reform bill into law.

Health Coverage Is a Key Employee Benefit

Thursday July 9, 2009
A recent article in the Boston Globe highlights a disturbing but increasingly common trend - Americans who take or stay with a job strictly for the health insurance. In many cases, these individuals have tried to obtain coverage on their own but found it to be more expensive than the group coverage available through some part-time jobs. Even relatively low-wage jobs, such as those available through Starbucks or retail chains, become more attractive to Americans looking for affordable health coverage.

Health Reform Setback

Thursday July 9, 2009
A group of legislators who call themselves Blue Dog Democrats have put the brakes on a comprehensive health reform bill working its way through the House of Representatives. According to the Washington Post, this setback is especially troubling to President Obama, who has deemed health reform to be one of his top two priorities in 2009. However, the Blue Dog Democrats will not approve any legislation that fails to contain costs. They want to be sure that everything possible will be done to reduce costs within the system before resorting to taxation as a funding source. This faction is working on their own draft of legislation that will address their concerns. The President has asked Congress to present him with a reform bill by October, so time is running short - even if the House does reach an agreement, they must then reach an agreement with the Senate before delivering this key legislation.
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