In 1999 President Bill Clinton proposed that prescription drug benefits be added to Medicare and this was accepted and added President Bush with the Medicare Modernization Act of 2003. Initially this was supposed to be optional coverage, however, if you do not get a Part D (drug) plan when you are initially eligible but decide to later, you may be subject to a Part D Late Enrollment Penalty. This LEP is based on a percentage of the national average for drug plans and imposed for the rest of your life. Exceptions may apply if you’ve had creditable drug coverage through an employer/group plan. Many people who don’t take prescription drugs at the time they sign up for Medicare A and/or B, will decline to get a Part D plan feeling it is money wasted. However, when their health changes and they are prescribed any type of maintenance drugs (blood pressure, cholesterol, etc.) they are surprised to find they are subject to this penalty. This is why it is important to speak to a local, licensed Health Insurance agent to help you navigate your options.
There are two ways to get a Part D drug plan: Purchase an individual / stand-alone plan in conjunction with your traditional Medicare coverage, Medicare Supplement OR join a Medicare Advantage plan that includes prescription coverage (MAPD). There are four stages to Medicare Part D: Deductible Stage where the insured is responsible for up to $445 depending on the individual plan. Many companies impose this deductible on Tier 3-5 drugs in lieu of Tiers 1 & 2 which are normally the cheapest prescriptions one would take. Initial Coverage Stage comes into play once the deductible is met. The insured and insurance company (combined) pay the full cost for prescriptions up to $4130 after which the insured falls into the coverage gap otherwise knows and the “donut hole.” In the Coverage Gap Stage or donut hole, the insured pays 25% of the cost of the drugs until his/her MOOP (maximum out of pocket) reaches $6550 after which the insured falls into the Catastrophic Stage. While in the Gap Stage, only your out-of-pocket costs contribute toward the catastrophic stage. During the Catastrophic Stage of your Part D Medicare coverage, you will pay $3.70 for generic and $9.50 for brand name drugs. The Part D coverage is based on an annual/calendar year. If you are new to Medicare, you may be wondering what the Tiers are. T1 are Preferred Generic Drugs, T2 Generic drugs, T3 are Preferred Brand name drugs, T4 are Non-Preferred Drugs and T5 are Specialty drugs. Again, this is where a licensed Health Insurance agent is your best friend! For more information on Medicare in general, check out our FAQ and get up to date on Medicare changes for 2021 HERE. If you’re in need of a licensed Health Insurance, give us a call: 337-439-7730 Until next time, we here at Curtis Insurance / Curtis & Associates wish you and yours a Merry Christmas, Happy Holidays and Blessed New Year. Tommy Curtis and Staff Disclaimers: Medicare has neither endorsed nor reviewed this information. Not connected or affiliated with any United States Government or State agency *Guidelines vary by company/plan Life and Medicare Products marketed through Curtis & Associates Financial Services, Inc. {A Life and Health Agency} Happy Veterans Day _ We salute all Service men and women. With Covid-19 and two hurricanes, most of SW LA residents have more on their mind than Medicare. Trust me, we understand. However, each year during AEP we strive to give you a heads-up on the changes to Medicare. Let's look at the upcoming changes for 2021. One of the biggest and most beneficial points to discuss for the 2021 Medicare plans it that patients with ESRD (End Stage Renal Disease) can now qualify for a Medicare Advantage plan! Up until now, this was the one question that stopped a Medicare beneficiary from joining most advantage plans, but for 2021 that is no longer a *determining factor. Other changes are as follows: *For those who pay Part A premiums, there is an increase from $252 to $263 OR $478 (in lieu of $458) *Medicare Part A Deductible is $1452 (per benefit period) and up from $1364 *Part A Coinsurance for days 61-90 is now $353 per day (increase of $1) and lifetime reserve days the insured's responsibility is $726 per day instead of $704 *Fees for Skilled Nursing Facility have risen from $176 per day (days 21-100) to $181.50 *Medicare Part B Premium is $153.00 (up from $144.60) *Medicare Part B Deductible is $203, a $5 increase from 2020's amount of $198. Your Part D (prescription drug) Medicare benefits and coinsurance costs have changed also. *Part D deductible is $445 in lieu of $435 *Part D initial coverage amount increased from $4020 to $4130 *MOP (maximum out of pocket) is $6550 annually - up from $6350 *Your cost in the coverage gap/donut hole is a flat 25% of the cost of the drug in lieu of 31% *Cost of drugs in the catastrophic category is $3.70 for generic (up from $3.50) and $9.50 for brand (up from $8.30) Another remarkable change in the 2021 Medicare benefits is that select insulin medications will be available at the flat rate of $35 per month. This is great news for many diabetics! If you have questions about your current Medicare plan or need help navigating the Medicare maze for 2021, give one of our licensed professional agents a call: 337-439-7730 Meanwhile, we appreciate your patronage and honor our Veterans! Tommy Curtis and Staff Disclaimers:
*Guidelines vary by company/plan Life and Medicare Products marketed through Curtis & Associates Financial Services, Inc. {A Life and Health Agency} .We received a phone call here at the office informing us that our Medicare number will "expire." Yes, the scammers are out and busy so Medicare recipients, PLEASE BEWARE! Your Medicare number NEVER expires - Do NOT give your Medicare number out to anyone! For more information on Medicare Scams read our previous post or THIS Article. Meanwhile be safe and beware. If you think you've already been scammed call Medicare immediately at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. Tommy Curtis and Staff Disclaimers:
Life and Medicare Products marketed through Curtis & Associates Financial Services, Inc. {A Life and Health Agency} We've hardly had a chance to catch our breath after Hurricane Laura and here we are, facing Delta. We've shared with you tips on Hurricane Preparedness, travelling and moving but here are a few more tips we've learned since evacuating August 26th..... Even if you were lucky enough to not have a claim due to Laura, take your home and flood insurance policies with you should you evacuate for Delta! Many folks were left unprepared to file their claim because they didn't think to grab that insurance policy when packing to evacuate. Your policy gives important details about your coverage as well as phone numbers you need in the instance of a claim. Make sure your auto policy is with you also, especially if you have Comprehensive and Collision coverage and be sure you have a current ID card on hand. If you evacuate and end up in the hospital - Do NOT allow anyone to change your Medicare plan! We've had this happen and the results are not always what is best for you. Your Medicare Supplement travels with you and your Medicare Advantage plan pays for emergency services whether you are in your network or not. Only in the instance of a permanent move outside your network area should you change your plan. Please be careful allowing someone to "help" you by changing "part" of your Medicare plan. A Medicare Advantage plan usually includes RX so someone changing "only the drug portion" - changes your entire plan! You may end up with only basic Medicare and a drug plan leaving YOU to pay the 20% Medicare does not pay on covered charges and perhaps even more. This is especially important if you're on Medicare AND Medicaid! Hope these tips help. Take care of your health and protect home as well as possible from further damage. I know, this isn't always easy, especially now, but do your best. We are praying with and for you. Tommy Curtis and Staff Life and Medicare Products marketed through Curtis & Associates Financial Services, Inc. {A Life and Health Agency} Well, August is half over and it’s hot, hot, hot! To say it’s been quite a year, is an understatement, yet, here we are… Summer is drawing to an end and kids are returning to school so, please be careful of those young drivers out there! There’s still plenty of fun in the sun to be had though, so check out our safety tips. Hurricane season is nearly half over but we’re not out of the woods yet. If you haven’t reviewed your Home Insurance policy, now would be a good time to do so. Now is also a good time to get that Flood policy in place. There is a standard 30 day wait on flood insurance, so don’t put it off any longer – give us a call today! **Curtis insurance No Longer Offers Mobile Home Insurance ~ This Post for Informational Purposes Only** We’re in our second month of Hurricane season and I am forever amazed at some of the phone calls we receive for home insurance. Although we have discussed understanding home insurance in detail, binding restrictions, riders and endorsements, have FAQ’s and have covered policy discounts, many people aren’t aware of the guidelines and regulations regarding a home insurance policy. Here are a few things to consider before calling us, or anyone, for a home insurance quote…. Due to the stay-home orders which have been in place for months now, insurance companies are receiving several claims from not unusual, but uncommon, damages. This led to some important information you need to know to help keep your home safe. Although Fire Safety was covered in our Jan. 2018 blog post, we need to reiterate some of that information here, mainly, keeping the batteries changed in your smoke detectors. One of the biggest sources of fires outside of winter months are candles. Therefore, it is imperative you do not leave candles burning unattended! Also, keep candles away from drapes, towels, rugs, and other flammable items. Another cause of fire claims lately – Dryer Vents. Dust and Lint are fire hazards so keeping your dryer vent clean and clog-free will help alleviate heat build-up which could result in a fire. In this time of national upset, our lives have been disrupted to say the least. Even though we are beginning to see businesses reopen with limited capacity, every day and each news report can send us into fits of despair and uncertainty. What can we do? Take Precautions: Remember it is YOUR choice whether to go out more or stay home. Whichever you choose, protect yourself and your family. If you are sick (even if you feel it’s ‘just’ a “summer cold”) Stay HOME especially if you are running a fever! Have to get out? Wear a mask! Go where you must but try to avoid large crowds. |
Tommy Curtis
Is an insurance agent with integrity and your best interest in mind. Call to speak directly to him. Contact us Phone: 337-433-1683 Address: 509 7th Street Lake Charles, LA 70601 Office Hours: M-F 9a - 5p (CST) Follow Us
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