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On New Year’s Day, 2011, the first baby boomers celebrated their 65th birthdays.
Baby boomers are the 77 million Americans born between the years, 1946 and 1964. Since that first day of 2011, baby boomers have been turning 65 at a rate of 10,000 per day, and that daily rate will continue until the year 2030.
What’s that got to do with Medicare premiums in the year 2017? The difference between the benefits promised and the taxes actually being paid into Medicare is already underfunded by at least $23 trillion, and if that trend continues, Medicare could go bankrupt as early as 2017.
According to David Walker, former U.S. comptroller general and CEO of the Comeback America Initiative, “The retirement of the baby boom generation will bring a tsunami of spending that will cause a severe problem for the federal government’s budget.”
The number of people eligible for Medicare will nearly double from 46 million to 80 million by the time all the boomers reach the age of 65.
It’s estimated the cost of Medicare, will grow from $500 billion a year, from the present year of 2015, to $929 billion over the next five years; and conversely, as the number of Medicare recipients increases, the number of workers supporting each recipient will decrease.
As stated by David Walker, “Ultimately we’re going to have to make tough choices about how much health care we can afford and sustain, and how we are going to change our payment systems to make sure that it doesn’t bankrupt the country.”
Before the passage of the Affordable Care Act (ACA), in 2010, the U.S. Congress had to approve any proposals that would affect Medicare payment rates and program rules. But that will change in 2017, as the Affordale Care Act created the Independent Payment Advisory Board (IPAB), a 15-member panel that would be empowered to propose changes if Medicare exceeds spending growth thresholds. The IPAB’s proposals are intended to extend the solvency of Medicare, slow Medicare cost growth, and improve the quality of care delivered to Medicare beneficiaries. Any recommendations would automatically go into effect, unless Congress took steps to override them. According to the, Medicare Trustees, a group that oversees the financial operations of the Hospital Insurance and Supplementary Medical Insurance trust funds, the Medicare per capita growth rate is projected to exceed the per capita target growth rate in 2017, triggering the IPAB for the first time. This means three in ten people will be hit with a 25% increase for Medicare Part B, and that 70% of people with Medicare will be exempt from paying. And, according to a recent report from the Medicare Trustees, because the law requires Medicare Part B premiums to cover 25% of program costs, the 30% of those with Medicare premiums will see an increase to at least $159.30 each month, and couples who earn $428,000 annually will pay a monthly premium of $509.80.
A notice was posted in the Federal Register on February 16 by the CMS. This stated that is comments about CMS-484 Attending Physicians’ Certification, Medical Necessity for Home Oxygen Therapy as well as supporting Regulations, MAC Durable Equipment Medicare Administrative Contractors, regional Carrier and Certificate of Medical Necessity and Supporting Documentation, Rate Increase Disclosure and Notices, as well as Record keeping Requirements all due by April 19, th.read more
CMS has withdrawn Transmittal 1483 which was dated Mrch 31, 2015. They replaced this with Transmittal 1625. This is to make it consistent with the direction given to CR 9215. More specifically this updates BR 8913.2. All additional info remains the same. Originally allowance provided a Recovery Audit specific, no documentation reason “code” for the MAC’s to attach to a prepayment claim denial.read more
Less and less time available for Congress to stop a 52% percent premium increase. This will affect about 30 percent of the enrollees next year for Medicare Part B. A sprawling 2 year budget deal is included as a partial fix. Suspending the debt limit according to a house source until March 17. Some are reporting a tentative budget deal. Part B participants facing a increase would pay about 14 percent more next year rather than 52 percent of the premium. A $3.00 per month premium surcharge would be paid over five years as a...read more
A fluke in the laws that are governing the Medicare and the Social Security will leave Americans open and vulnerable to a fifty % percent premium increase in the Medicare part that covers doctors’ bills, also known as Medicare Part B. If Congress doesn’t pass legislation protecting low and middle income people who will be unable to pay that much for the increase. Premium payments have to cover 25 percent of projected costs for Part B. The difference as this rise and fall of premiums happens will be deducted from Social Security payments each...read more
Insurers selling Medicare Advantage plans are ready for larger pay increases for 2017. This is a initial signal stark cuts on payments for the Affordable Care Act are almost over regarding the industry. A key metric for 2017 was released by CMS showing the Medicare fee for service base rate which is a measure of the traditional Medicare spending is going to increase by 3.1% in the year 2017. Back in December for 2016 rates, the CMS nailed the growth number at 2.02%. The formula is a mix of complex estimations and modifications for Medicare...read more
Medicare health insurers express satisfaction with the first announcement of the payment rate increases for the new 2017 Medicare Advantage Plan. The larger rates for enrollees mean larger payments for insurers, and is an indicator that payment cuts that had been enforced under the Affordable Care Act, also known as Obamacare, are a thing of the past. One of the main components used by the federal government to calculate the lump sum payments to Medicare Advantage Plan insurers, the “fee for service” rate, is...read more
More Savings, Through 2020, In The Drug Coverage Gap. The 55% discount a beneficiary receives on brand-name prescription drugs covered by Plan D, will be added to the coverage gap percentage savings (Medicare prescription drug coverage) and will gain through 2020. Note: You’ll pay 25%, in 2020, for covered generic drugs and also for brand-name drugs, during the gap, it will be the same percentage you will pay from the moment the deductible is met, (if your plan has one) until the out-of-pocket spending limit is realized. The...read more
16 million Medicare beneficiaries were facing a 52 percent increase next year in their premiums for Medicare Part B, but the Budget Deal worked out by the White House and Congress, held that to a 15 percent increase. Most beneficiaries have a “hold harmless” provision, which ensures that Social Security will not be reduced when Medicare Part B premiums increase. If inflation remains flat and the Social Security cost-of-living adjustment is zero, then we have a repeat of the fix in 2017 with most Medicare beneficiaries paying the...read more
New Congressional budget agreement will make it more difficult for American seniors to find physicians and other health care providers in 2017. The Congressional budget agreement of 2015 proposes that over a two year period, a $80 billion raise in spending, and an emergency war fund increase of $32 billion, would be offset by Medicare 2016, and Medicare 2017 spending cuts, and cuts in Social Security benefits extended over the same two years. The Medicare 2017 savings would come from payment cuts to health care providers and doctors, leaving...read more
As dictated by ObamaCare, (Patient Protection and Affordable Care Act), by 2017, Part B premiums, for seniors, will increase to $128.00, and there will be a rise in Part B deductibles to $180. There will be an increase to $1,336, in the Medicare hospital deductible for senior citizens, and at the same time, an increase to $334 for their daily hospital coinsurance. If senior citizens are hospitalized for more than 90 days, ObamaCare dictates an increase to $668 in their per diem coinsurance costs, during 2017 enrollment dates. These and other...read more