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☆ Retirees can shop for health-care coverage during Medicare open enrollment. It's a great time to review costs, experts say
▼ + stars: | 2024-10-14 | by ( Lorie Konish | ) www.cnbc.com time to read: +4 min

Changes you can make during open enrollmentDuring Medicare open enrollment, retirees may select new health plans and prescription drug plans. They may switch from original Medicare, which is provided by the federal government, to Medicare Advantage plans that are privately managed. They may also switch from Medicare Advantage to Medicare original or change Medicare Advantage plans. Original Medicare includes Medicare Parts A and B. Medicare Part A covers care provided by hospitals, skilled nursing facilities and hospice, as well as some home health care. Retirees also should be on the lookout for changing Medicare Advantage coverage, Moeller said.

Persons: Tricia Neuman, Ryan Ramsey, Philip Moeller, Moeller, Harris, KFF's Neuman, Neuman Organizations: Getty, Medicare, National Council, Aging, Biden Locations: Connecticut, Maine, Massachusetts, New York

☆ Here's how to reduce your health-care costs during Medicare Advantage open enrollment
▼ + stars: | 2024-02-16 | by ( Lorie Konish | ) www.cnbc.com time to read: +2 min

Certain retirees can now change their health coverage during Medicare Advantage open enrollment, which runs until March 31. Medicare Advantage is health coverage provided through private companies that are paid by Medicare to cover your benefits. If you're already on a Medicare Advantage plan, you can take advantage of the open enrollment period to switch to another Medicare Advantage plan or drop your Medicare Advantage plan and switch to original Medicare and perhaps also a separate Medicare drug plan. However, those enrolled in Medicare Advantage may need lower savings targets, the research found. Medicare open enrollment periods can be an opportunity to identify potential ways to save.

Persons: Carolyn McClanahan, McClanahan Organizations: Medicare, Finance, Social Security, Research Institute, Planning Partners, CNBC FA Locations: Jacksonville , Florida

☆ Ozempic, Mounjaro and hundreds of other drugs become even more expensive in 2024
▼ + stars: | 2024-02-15 | by ( Tami Luhby | ) edition.cnn.com time to read: +8 min

Novo Nordisk boosted the list price of Ozempic by 3.5% to $969 for a four-week supply. Eli Lilly last month raised the list price of Mounjaro by 4.5% to $1,069 for a four-week supply. However, they may have to pay the list price if they are uninsured or have not yet hit their annual deductible. Former President Donald Trump, who is running for election again, also unveiled several proposals and issued executive orders aimed at lowering drug costs during his administration. Another factor is the recent policies that penalize pharmaceutical manufacturers for raising list prices faster than inflation.

Persons: Drugmakers, Eli Lilly, Eli Lilly’s Zepbound, Ozempic, Eli Lily, Marlene Foss, Foss, “, ”, Mark Rapp, Rapp, ’ ”, Mark Rapp's, grandkids, ” Rapp, Joe Biden’s, Donald Trump, We’ve, Antonio Ciaccia, we’ve Organizations: New, New York CNN, Ozempic, Novo Nordisk, CNN, Food and Drug Administration, Nordisk’s, Mounjaro, Medicare, ”, White House Locations: New York, Portugal, Doylestown , Pennsylvania, Italy, Mansfield , Ohio, Ohio, Idaho

☆ California healthcare provider's move shows pitfalls of Medicare Advantage
▼ + stars: | 2023-11-02 | by ( Mark Miller | ) www.reuters.com time to read: +6 min

But Part D prescription drug or Medicare Advantage coverage should be reviewed. Medicare Advantage enrollment has grown quickly over the past decade, partly due to its all-in-one features and lower upfront costs. Medicare Advantage plans can drop healthcare providers from their networks - and that happens when providers and insurers cannot agree on contract terms. The Scripps decision marks a new twist: healthcare systems deciding to drop out of Medicare Advantage. During the annual enrollment period, it is possible to drop Medicare Advantage in favor of traditional, fee-for-service Medicare.

Persons: Scripps, Chris Van Gorder, ”, “, Sophie Exdell, Medigap, Exdell, Mark Miller, Matthew Lewis Organizations: Scripps Health, Diego, Medicare, Scripps, Health Insurance, Program, Reuters, Thomson Locations: San Diego , California, Southern California, San Diego, Connecticut, Maine , Massachusetts, New York, In California

☆ Here are 4 ways health savings accounts can be used to pay insurance premiums
▼ + stars: | 2023-10-26 | by ( Greg Iacurci | ) www.cnbc.com time to read: +3 min

COBRA coverage typically allows consumers to keep the same health-care providers, but the coverage is often pricey. With COBRA coverage, however, individuals may have to cover the full premium, up to 102% of the cost to the plan. Premiums while on unemploymentHealth premiums paid by someone receiving unemployment compensation under federal or state law are also eligible. These might be premiums for COBRA or a health plan purchased over an Affordable Care Act marketplace, for example. Medicare beneficiaries don't have to pay their premiums directly with an HSA to get the benefit.

Persons: they'd, Carolyn McClanahan, it's, —, — aren't, McClanahan, There's, isn't Organizations: IRS, Affordable, Bank, Getty, Social Security Locations: Jacksonville , Florida

Andreswd | E+ | Getty ImagesMedicare beneficiaries have until Dec. 7 to change their Medicare health and prescription drug coverage for the coming year through open annual enrollment. Starting in 2024, people who face high prescription drug costs will not have to pay anything out of pocket once they hit the catastrophic phase of their benefits, she noted, thanks to new prescription drug legislation. Notably, Medicare beneficiaries who take insulin currently do not have to pay more than $35 per month for covered prescriptions. There are other reasons why Medicare beneficiaries should pay attention to the annual enrollment period this year. Medicare open enrollment is when beneficiaries can shop around for health plans or prescription drug coverage that better meet their needs.

Persons: Meena Seshamani, Seshamani, Darren Hotton, Hotton, that's, Catherine, There's Organizations: Getty, Center, Medicare, Centers, Services, National Council, Aging, Insurance, State Health Insurance Locations: Catherine Falls, Medicare.gov, ShipHelp.org, Utah

☆ Big pharma's blockbuster obesity drug battle is just getting started, and it's headed for $100 billion
▼ + stars: | 2023-09-09 | by ( Bob Woods | ) www.cnbc.com time to read: +13 min

In this article LLYNOVO.B-DK Follow your favorite stocks CREATE FREE ACCOUNTOzempic drug to treat diabetes. Since Wegovy and Mounjaro have been on the market, "neither company can make the drug fast enough," she said. The Food and Drug Administration approved Ozempic in 2017 for diabetes and Wegovy in 2021 to treat obesity. Mounjaro, introduced in 2022 to treat diabetes, contains GLP-1, plus GIP, a similar appetite suppressor that can lead to weight loss. Coverage for Mounjaro ($1,023 per month) to treat diabetes varies based on an individual's insurance plan and drug benefits.

Persons: Eli Lilly, Novo's, Lilly's, Emily Field, Lilly, David Ricks, CNBC's Jim Cramer, Ozempic, Novo, Mounjaro, George Frey, Lars Fruergaard Jorgensen, Wajahat Mehal, Tom Carper, Bill Cassidy of, We've, Camilla Sylvest, there's, Sylvest, Cowen, What's, It's, Mike Mason, Amgen, Emmanuel Papadakis Organizations: Novo Nordisk, Pfizer, Amgen, Barclays, Nordisk, Drug Administration, Mounjaro, SVB Securities, Food and Drug Administration, Pharmacy, Reuters Novo, Novo, Wegovy, European Union, Medicare, Yale School, Metabolic, Congressional Black Caucus, CDC, pharma, American Medical Association, , Big Pharma, American Diabetes Association, Deutsche Bank Locations: Lilly, Denmark, Provo , Utah, U.S, European, Delaware, Bill Cassidy of Louisiana, Novo, Kalundborg, Hillerød, Boone County , Indiana

☆ Column: US Medicare drug negotiations a good start on bringing down healthcare costs
▼ + stars: | 2023-08-31 | by ( Mark Miller | ) www.reuters.com time to read: +6 min

And in 2025, a $2,000 annual cap on out-of-pocket costs for drugs under Medicare Part D takes effect. But drug costs are just one aspect of the healthcare cost problems confronting seniors. Inadequate protection from out-of-pocket costs across the Medicare program also poses a threat. Enrollees in fee-for-service Medicare can appeal direct to Medicare; in Medicare Advantage, the appeal process begins with your specific insurer. She also recommends that enrollees review their monthly statements that explain what healthcare services have been covered.

Persons: Biden, ”, Hector Ortiz, Sarah Murdoch, Murdoch, ” Murdoch, Joe Biden, Mark Miller, Matthew Lewis Organizations: U.S, drugmakers, Medicare, Consumer Financial Protection Bureau, Seniors, Medicare Rights Center, Center, Reuters, Thomson

☆ Medicare will pay for Alzheimer's drug Leqembi. What patients and doctors should know
▼ + stars: | 2023-07-08 | by ( Spencer Kimball | ) www.cnbc.com time to read: +2 min

The Alzheimer's drug Leqembi is seen in this undated handout image obtained by Reuters on January 20, 2023. Medicare has agreed to pay for the Alzheimer's treatment Leqembi, a major turning point for patients who are diagnosed with the early stages of the disease. Medicare coverage is crucial for most patients to have any hope of being able to afford Leqembi. Eisai has priced Leqembi at $26,500 per year before insurance coverage, which is extraordinarily expensive for Medicare patients, who have a median income of about $30,000. Patients with traditional Medicare will pay 20% of the bill for Leqembi, according to the federal Centers for Medicare and Medicaid Services.

Persons: Leqembi, Biogen, Tricia Neuman, Neuman Organizations: Reuters, Medicare, Food and Drug Administration, Services Locations: Cambridge , Massachusetts

☆ As retirement confidence drops, experts say focusing on these 4 factors can help
▼ + stars: | 2023-05-31 | by ( Lorie Konish | ) www.cnbc.com time to read: +5 min

Decide where you will live in retirement— Key deadline to watch: The sooner, the better. While you may start your Social Security retirement benefits as early as age 62, eligibility for Medicare generally does not start until age 65. Choose when to claim Social Security benefits— Key deadline to watch: By age 60, you should go to the Social Security Administration website and review your statement, recommends Copeland. When to claim Social Security retirement benefits is one of the big questions retirees face. "The later you can file for Social Security, the better it is as far as the amount you're going to get," John said.

Persons: Craig Copeland, Copeland, Dann Tardif, Susan Reinhard, It's, Reinhard, Jane Sung, Sung, Rupp, John Organizations: AARP, Institute, Social, Medicare, Security, State Health Insurance, Social Security, Social Security Administration, Sporrer, Getty

☆ Heading into retirement? Here are 4 key tips for mapping out a game plan
▼ + stars: | 2023-04-28 | by ( Lorie Konish | ) www.cnbc.com time to read: +6 min

Claiming Social Security benefits• Key deadline to watch: By age 60, you should go to the Social Security Administration website and review your statement, recommends Craig Copeland, director of wealth benefits research at EBRI. When to claim Social Security retirement benefits is one of the big questions retirees face. At full retirement age — 66 or 67, depending on your date of birth — you will receive 100% of the benefits you earned. "The later you can file for Social Security, the better it is as far as the amount you're going to get," John said. While you may start your Social Security retirement benefits at age 62, eligibility for Medicare generally does not start until age 65.

☆ 75% of Medicare beneficiaries worry about affording costs beyond premiums. Here’s how high out-of-pocket costs can go
▼ + stars: | 2023-03-24 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +4 min

watch nowOther beneficiaries instead decide to pair Parts A and B with a standalone Part D plan and, often, a Medigap plan, which covers part of the out-of-pocket costs that come with Parts A and B. Basic Medicare has no out-of-pocket limitIf you have only basic Medicare, there is no cap on what you might spend in any given year. "If you can find a plan that has a lower out-of-pocket limit, such as $3,000 or $4,000, that is a benefit to you." "Both Medigap and Medicare Advantage Plans do a good job of this, since most Medigap plans cover the 20% [coinsurance] and Advantage Plans have caps on Parts A and B spending." Part D does come with catastrophic coverage that kicks in once out-of-pocket expenses reach $7,400 in a given year, Roberts said.

☆ Two key Medicare enrollment deadlines are approaching. Here's what you should know
▼ + stars: | 2023-03-23 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +3 min

If you missed your initial enrollment period, sign up nowYou become eligible for Medicare at age 65, and you get a seven-month window to sign up. This initial enrollment period starts three months before your birthday month and ends three months after it. If you don't qualify for a special enrollment period or an exception, you'd generally have to wait until Medicare's fall annual enrollment period to sign up for a Part D plan. "If there isn't a valid special enrollment period that a broker can help you with, it's still worth a call to 1-800-MEDICARE as they have broader ability to approve unusual special enrollment periods," Roberts said. Also, individuals who use the general enrollment period can sign up for a Medicare supplemental plan, or "Medigap."

☆ Most Medicare Advantage users are happy with their plan. What to do if you're not
▼ + stars: | 2023-03-02 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +4 min

momcilog | E+ | Getty ImagesFor the most part, Medicare beneficiaries in Advantage Plans are happy with their coverage, a new study suggests. However, if you're among those who are not thrilled about your 2023 Advantage Plan, you can do something about it. Or, they can drop the one they have altogether in favor of basic Medicare (Part A hospital coverage and Part B outpatient care coverage). Additionally, if you drop your Advantage Plan, don't assume that you'll be able to get a so-called Medigap policy, which many beneficiaries pair with basic Medicare. This means that once you move to a different Advantage Plan or drop it for basic Medicare, the change is generally locked in for the year.

☆ Medicare expenses in retirement could top $383,000 for a couple with high drug costs, study finds
▼ + stars: | 2023-02-16 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +5 min

"You don't want to be shocked when you get to retirement and find this out, or discover that Medicare doesn't cover everything," Fronstin said. Representing an extreme case, a couple with high prescription drug expenses would need to have saved $383,000 to have a 90% chance of having enough to cover their health-care costs. Advantage Plan coverageThe second coverage scenario analyzed in the study involves a Medicare Advantage Plan, which delivers Parts A and B, and typically Part D, as well extras like dental and vision. Of Medicare's 64.5 million beneficiaries, 29.1 million are enrolled in Advantage Plans and that number is expected to continue growing. While many Advantage Plans have no premium, they do have their own deductibles, copays or coinsurance and out-of-pocket maximums that vary from plan to plan.

☆ Medicare users still have time to change, drop 2023 Advantage Plan coverage. What to know
▼ + stars: | 2023-01-30 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +2 min

This means that once you move to a different Advantage Plan or drop it for basic Medicare, the change is generally locked in for the year. "Call your doctor's office and ask what their favorite Medicare Advantage Plan is," said McClanahan, a member of CNBC's Financial Advisor Council. "They see a lot come through so they often do know which Advantage Plans cover your drug," McClanahan said. Assess drug coverage if dropping an Advantage PlanMeanwhile, dropping an Advantage Plan in favor of basic Medicare often means losing drug coverage — which means you would have to enroll in a standalone Part D plan. That charge is 1% of the national base premium ($32.74 for 2023) for each full month you go without drug coverage.

☆ Here are key things you need to know if you’re eyeing a Medigap policy alongside basic Medicare
▼ + stars: | 2023-01-06 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +7 min

For about 23% of Medicare's 65.1 million beneficiaries, the solution for covering those outlays is a so-called Medigap plan. The reasons that some beneficiaries instead choose Medigap alongside basic Medicare vary from person to person, according to Elizabeth Gavino, founder of Lewin & Gavino and an independent broker and general agent for Medicare plans. watch nowHere's what to know about Medigap policies if you're considering purchasing one. There's huge variation in costDespite Medigap policies' standardization, the premiums can vary greatly. The way a Medigap plan is 'rated' also mattersAnother difference in Medigap premiums can come from how the plans are "rated."

☆ Some Medicare costs are heading higher in 2023, while others are going down. Here's what you need to know
▼ + stars: | 2022-12-29 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +4 min

Part B premium and deductible will be lowerThe standard Part B premium will be lower in 2023 — $164.90, down from $170.10 in 2022. While most beneficiaries pay the standard premium, higher-income enrollees pay more due to income-related surcharges (see table below). However, "they are calculated based on income two years prior," said Elizabeth Gavino, founder of Lewin & Gavino and an independent broker and general agent for Medicare plans. And, some of those options either have no monthly charge or will pay your Part B premium. The maximum out-of-pocket limit for Advantage Plans will be $8,300 in 2023 for in-network services.

☆ Which to Choose: Medicare or Medicare Advantage?
▼ + stars: | 2022-11-20 | by ( Paula Span | ) www.nytimes.com time to read: +13 min

Which to Choose: Medicare or Medicare Advantage? Medicare Advantage plans, like traditional Medicare, are funded by the federal government, but they are offered though private insurance companies, which receive a set payment for each enrollee. The proportion of eligible Medicare beneficiaries enrolled in Medicare Advantage plans has hit 48 percent. Which is better: Medicare or Medicare Advantage? Credit... Kenny Holston for The New York Times Unlike most Medicare Advantage plans, traditional Medicare does not include drug coverage.

☆ Before dropping a Medicare Advantage plan altogether during open enrollment, compare these key costs
▼ + stars: | 2022-11-02 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +4 min

FatCamera | E+ | Getty ImagesFor some Medicare beneficiaries, an Advantage Plan ends up not being a good fit. Here's what to consider if you want to ditch an Advantage Plan altogether. Danielle Roberts co-founder of Boomer Benefits"There is not a guarantee that the underwriter will approve you for the Medigap policy," Roberts said. This means it may be wise to avoid dropping your Advantage Plan until you know you'd be able to get the Medigap policy. That 12-month trial period lets you drop an Advantage Plan and return to the Medigap plan you were previously enrolled in.

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