New Medicare Cards – What You Need to Know

The new Medicare cards are coming! With the Equifax security breach in the news, as well as other recent hacks of personal and sensitive information, this news could not come soon enough. Medicare will begin mailing out the new Medicare cards in April 2018.

new Medicare cards

FIRST LOOK! The new Medicare cards will no longer contain your Social Security number. Instead, they will have a random, unique sequence of numbers and letters.

Currently, Medicare cards contain a Social Security number on them with a letter at the end. The letter, by the way, indicates whether you are drawing Social Security yet, and whether your Social Security is based on your work history or that of a spouse, former spouse or deceased spouse. Most Medicare cards contain the Social Security number of the insured person.

In 2015, Congress passed a law requiring Medicare to change the way they identify Medicare beneficiaries on their Medicare cards. It’s a bit of an undertaking with Medicare having to assign all Medicare beneficiaries a new unique number and recreate 60 million Medicare cards. The rollout of the new Medicare cards will take place over a 12-18 month period, and it will begin in April 2018.

“We want to make this process as easy as possible for everybody involved,” said Seema Verma, the administrator of the Centers for Medicare & Medicaid Services, on a conference call Thursday.

Medicare has set up a website specific to the transition, will also be sending out handbooks related to this and has a call center to handle questions specific to the new Medicare cards.

So, what do you, as a Medicare beneficiary, need to know about the new Medicare cards:

  1. First and foremost, you should not do anything with your current card until you receive the NEW Medicare card. Keep using the current card, then once you receive the new one, replace the “old” card (the one with a Social Security number on it) with the new card (the one with the unique set of random numbers and letters on it).
  2. Be patient. CMS Head Seema Verma stresses that the rollout will START in April 2018 but it will carry over into 2019. We would expect it will last until late 2019. There has been no indication yet on how they will decide who gets the new cards first or what order they will go in.
  3. The new cards will be paper, just like the current cards (we know, it doesn’t make sense to us either!). $242 million just doesn’t buy you what it used to, I guess.
  4. Do not give anyone your current Medicare card or any information from it. Just like everything else that pertains to seniors, there is certain to be scams related to the new Medicare card rollout. To repeat, Medicare will NOT be asking you for your old Medicare card back or any information from it.
  5. When you receive the new Medicare card, take care to appropriately and effectively destroy the old one. Remember, it has your Social Security number on it. Burning it up may be taking it too far (but it is paper, after all). Whatever you do – cut it, shred it, burn it, flush it – make sure you leave no trace since it has your personal information.
  6. The new Medicare cards do not affect anything about your actual Medicare coverage. Your benefits will stay the same.
  7. If you have a Medicare Advantage plan instead of “original” Medicare, you will still get a new Medicare card (even though you don’t have to actually use it). Make sure you keep it in case your Advantage plan cancels you or you decide to go back to regular Medicare in the future.
  8. If you have a Medicare Supplement (Medigap) plan, you will also receive the new Medicare card but should not need to contact your Medigap company with the new information.

If you have any questions about this transition, or anything else related to Medicare, we are here to help. Feel free to contact us online or call us at 877.506.3378.

Do You Need Supplemental Insurance with Medicare?

What does Medicare cover?

Medicare, administered by The Centers for Medicare & Medicaid Services (CMS), is the largest health insurance program in the U.S. Created as a result of the Social Security Act in 1965, its enrollees account for about 40 million people.  Original Medicare does not pay for everything. Even if you are covered by Medicare Parts A and B, there will be some out-of-pocket expenses you may have to incur, i.e. copayments, coinsurance and deductibles, as well as travel outside the U.S. Original Medicare pays for 80% of your Part B medical expenses; the remaining 20% (of the Medicare-approved amount of the service, if the doctor or other health care provider accepts assignment) is your responsibility. That 20% gap could place a significant financial burden on you, resulting in very high out-of-pocket expenses.  There are no limits to the Part B 20% copays.  That is the reason why it is necessary to have a Medicare supplemental insurance plan in place.  This insurance is commonly referred to as a Medigap policy, its name implying its purpose to fill in the gaps where Medsenior staying healthyicare coverage does not exist.

There is usually no premium to pay for Part A of Medicare upon turning age 65, if you or your spouse paid Medicare taxes while working.  That is why this is often called premium-free Part A.  Important! To qualify for Medicare Part A and/or Part B, you must be a U.S. citizen or be lawfully present in the U.S. (be a legal resident of the U.S. for the last five years).

Part A covers the following:

  • inpatient hospital stays, including a semi-private room, meals, general nursing, drugs as part of your inpatient treatment and other hospital services and supplies.
  • physician’s fees
  • home health care – it covers medically necessary part time or intermittent skilled nursing care and/or physical therapy, speech language pathology services, and the need for continuing occupational therapy.  Your care must be ordered by a physician and it must be provided by a Medicare-certified home health agency
  • skilled nursing facilities,
  • hospice care – to qualify either a hospice doctor or your doctor must certify that you are terminally ill (life expectancy of 6 months or less).  After 6 months, you must be re-certified if you are still there.  Coverage includes pain management modalities, medical, nursing and social services, drugs, certain durable equipment, aide and homemaker services.  Hospice does not cover spiritual or grief counseling; stay in a facility (room & board) unless the hospice medical team deems it necessary for pain and symptom management; and the stay must be in a Medicare-approved facility.
  • critical access hospitals (small rural facilities)
  • inpatient care in a religious nonmedical health care institution.
  • blood – no charge except in cases where the hospital must buy the blood for you.  In that case, you must either pay the hospital for the first three units of blood you receive during the calendar year; or have blood donated by you or someone else.

Part B of Medicare is the medical insurance part.  It covers medically necessary physician’s services, i.e. x-rays, laboratory and diagnostic tests, flu and pneumonia vaccinations, blood transfusions, some ambulance transportation, and chemotherapy. In addition, outpatient care, physical and occupational therapy and some home health are also covered services.

Covered services also include the following:paying for medicare part b

  • Preventive screenings such as bone density tests, breast cancer screenings (mammograms), cardiovascular disease screenings and cervical and vaginal cancer screenings;
  • Clinical research studies
  • Mental health services
  • Surgical second opinions
  • Durable medical equipment (canes, walkers, wheelchairs, etc.), prosthetic and orthotics, surgical dressings, and therapeutic shoes and inserts.

According to the CMS website, coverage is equal to 80 percent of the lower of either the actual charge for the item or the fee schedule amount calculated for the item, less any unmet deductible. The beneficiary is responsible for 20 percent of the lower of either the actual charge for the item or the fee schedule amount calculated for the item, plus any unmet deductible.

What is not covered by Parts A and B of Medicare?

Medicare does not cover the cost of:

  • Routine dental care
  • Eyeglasses
  • Hearing aids and exams for fitting them
  • Acupuncture
  • Cosmetic surgery
  • Any type of custodial care for those who are unable to live independently.  That is provided you do not have an acute illness that would necessitate skilled nursing services.  For example, Medicare would not cover the medical expenses of someone in a nursing home who has Alzheimer’s or dementia, unless they suffered an acute illness, i.e. heart attack or pneumonia.
  • Long-term services
  • Concierge care (retainer-based medicine, boutique medicine, platinum practice or direct care).

In summary, supplemental insurance can help most people enrolled in Medicare pay for the things that are not covered by Medicare.  It covers the “gap” that Medicare Parts A and B do not cover.  The additional expenses can be quite substantial and become a financial burden to seniors.  Although Medigap plans have standardized benefits regulated by the Federal Government, it is very important to note that costs can vary from company to company, even though the insurance and the coverage is the same.  So, choose a plan wisely!

How Does PPACA (“Obamacare”) Affect Medicare Supplements?

How does PPACA, or “Obamacare”, affect Medicare supplement insurance. This is a good, and common, question. It’s one that we get asked frequently since the bill was passed into law a couple of years ago. The short answer is that PPACA does not directly impact Medicare Supplement insurance in any way.

The bill does not apply to supplemental, or secondary, policies in the same way that it applies to primary insurance or “under-65” insurance. So, for people on Medicare, there is minimal impact overall and no impact to their Medicare supplement coverage. Medigap plans (another name for Medicare Supplements) are still standardized into the ten plans that were established in June 2010. These plans are set forth by the government – private companies that offer Medigap plans must go by these coverage outlines, but they can set their prices however they want.

Although Medigap plans are not directly affected, the PPACA does affect Medicare in some ways, primarily in the areas of Medicare Advantage (the private plans that replace Medicare) and Medicare Part D (Rx coverage for people on Medicare). For Medicare Advantage plans, the bill took some money away from the plans in the form of reimbursement rates. This is where part of the money to pay for the under-65 portion of the plan comes from. Medicare reimburses the private Medicare Advantage companies a certain amount per person for those who elect Medicare Advantage instead of Medicare itself. Decreasing this amount will obviously decrease the level of coverage (or added benefits) that these plans can offer.

For Part D, the biggest change is the reduction and eventual elimination of the Part D donut hole. This is the portion of Part D coverage during which the insured must pay the largest portion of their cost. In the past, the individual was responsible for paying the full retail costs of medications during this coverage “gap”. Because of the PPACA, this gap is being reduced each year up until 2020, at which time consumers will pay 25% of the retail costs of medications during the coverage gap (instead of the 100% that they were responsible for in 2010 before the bill).

For Medicare Supplements, many people believe “Obamacare” will have a “trickle-down” effect on Medigap insurance companies, particularly those who also are involved in the under-65 insurance market. There have been several companies that have pulled out, or reduced, their service areas for under-65 insurance, and some feel that this will affect their profit needs/motives in the Medicare supplement market.

If you have questions about this information or wish to discuss this further, you can contact me at 877.506.3378 or online at Secure Medicare Solutions.

Health Care Reform – How Will It Affect Medicare?

Even if you wanted to, you cannot escape the talk of health care reform these days. It is everywhere in printed, online and television media. As a leading, independent resource for Medicare and Medicare insurance news, Secure Medicare Solutions has closely examined both sides of how the proposed bill will affect those on Medicare. Our goal is to give you an unbiased look at how some of the proposed changes will affect you and your Medicare and/or Medicare insurance.  

Proposed Reform: Better Pricing for Part D Drugs
How it Affects You: This is a proposed change to assist in regulating the pharmaceutical industry and controlling drug prices. Medicare Part D aims to do this by negotiating better overall prices for Part D drugs, which should, over time, reduce the Part D premiums and co-pays that Medicare-eligible individuals have to pay. Some headway has been made on this already, with the pharmaceutical industry agreeing to a 50% cut for those that reach the dreaded “donut hole” (details for this are still pending).

Proposed Reform: Reduce Medicare Payments to Private Insurers (Medicare Advantage)
How it Affects You: If you have been paying much attention to the health care debate, you have heard the Medicare Advantage program mentioned numerous times. The projected change is to base the payments to these private insurers on an average of the plans’ bids, rather than the system now which is a standardized government-set amount. For those on Medicare Advantage, this reduced funding will, most likely, lead to an increase in premium and/or reduced benefits. For everyone on Medicare, it should lead to the ability to reduce the Medicare Part B premium.

Proposed Reform: Link Payments to Hospitals to Hospital Performance
How it Affects You: The idea to link hospital payments for Medicare patients to hospital performance has been around for a while, and it is a major part of the proposed health care reform. It’s intention is to increase overall hospital efficiency and give hospitals an economic incentive to “do right” by the patient. Some feel that this will lead to greater efficiency at hospitals, while others believe it will lead to greater dishonesty and fraud within the system. If it is a part of any legislation that is passed, we’ll find out for sure!

Proposed Reform: Standardization of Payments to Skilled Nursing Facilities/Long-term Care Facilities
How it Affects You: This provision of proposed legislation is intended to cut waste in the current Medicare system by measuring actual costs to come up with a more uniform system for reimbursing these facilities through Medicare. It remains to be seen if this will affect the quality of care received if in one of these facilities; however, the overall goal is to reduce waste in this part of the system and reduce the cost of Medicare to all Medicare-eligible individuals.

Proposed Reform: Reduce/Regulate Fraud, Waste and Abuse in the Medicare System
How it Affects You: This is the proposed reform that most everyone can agree upon. There have been many ideas tossed around as to how to do this. One of the primary ways that this is projected to be accomplished is higher scrutiny of health care providers and hospitals. Additional pre-payment reviews will be implemented, particularly on doctors/hospitals that order a significant amount of high-risk or high-cost procedures. Over time, this is intended to reduce the cost of Medicare (Part B premium, etc) to the individual.

Regardless of which side of the debate you come down on, it is obviously important to keep an eye on how it will all play out and how it will affect you. At Secure Medicare Solutions, we will do our part to keep you updated on any changes. You can always get updated information and follow along with us at Secure Medicare Solutions: An informative Medicare Insurance and Medicare Supplement Blog.