NO SOCIAL SECURITY COST OF LIVING INCREASE FOR 2016

Low inflation in the US means people receiving Social Security payments won't be given a cost-of-living increase for 2016, the government said. Advocates said the news is of particular concern because of rising Medicare premiums and reduced buying power for health care. Also affected are federal retirees, disabled veterans and people getting help under the federal disability program for people with low incomes. The decision affects more than 70 million Americans.

MEDICARE PART B - 52% INCREASE JANUARY 1

$159.30 is the new normal for those ageing in to Medicare.
Medicare Part B prices impact everyone on Medicare, regardless, of whether they have a Medicare Supplement or Medicare Advantage, and Part B prices are going UP! Since there is a 'hold harmless' law, current members cannot be given an rate increase since there is NO Cost of Living increase for Social Security coming. That means the 52% increase in Part B will be felt by those who don't have their Part B taken from SS ( a weird loophole), those who will be aging into as of Jan.1, and those with higher incomes that didn't pay the standard $104.90.

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APP TELLS USERS WHAT THEIR DRUG COPAY WILL BE

 

With the current rise in prescription drug costs, several companies have popped up in recent years that promise to find consumers the lowest prices. The firms compare brand-name drugs with generic options and reveal the prices featured at local pharmacies.

Some commercial insurers offer their own price-comparison tools. OneRx, a mobile app launched nationally last week by New York health care analytics company Truveris, seeks to set itself apart by allowing a co-pay search based on the individual's insurer.

The app allows patients to enter their insurance information and find out what their co-pay will be for a prescription. To use OneRX, a picture is taken of the insurance card, and the information is available in a day. The information also can be entered manually.

At times, the app may reveal that a drug is more affordable without insurance because of step therapy requirements or other issues, said Bryan Birch, Truveris' chairman, president and chief executive.

The app takes into account manufacturer coupons, pharmacy discounts and other deals, independent of insurance coverage. Like competitor GoodRx, which also shows drug prices from different pharmacies, OneRx automates the process of searching for coupons so consumers don't have to ferret out savings on their own.

Ideally, patients will use the app while they're still in the doctors' office, which will boost their compliance with prescriptions, Mr. Birch said.

MEDICAL IDENTITY FRAUD INCREASES

 

Kathleen Meiners was puzzled when a note arrived last year thanking her son Bill for visiting Centerpoint Medical Center in Independence, Mo. Soon, bills arrived from the hospital for a leg-injury treatment. But her son had never been there.

Criminals are now getting medical treatment and prescriptions under stolen identities, and some hospitals are employing biometrics to verify patients' identities. "Criminals still go after retail and banks," said Ann Patterson, program director for the Medical Identity Fraud Alliance, "but the shift is into health care.

There has been over 20% growth in this crime since 2013. There were nearly 2.3 million victims in 2014 costing victims more than $20B out-of-pocket. Medical identity theft and fraud constitute a major societal problem exerting pressure on our healthcare and financial ecosystems.

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MEDICARE TRUSTEES REPORT HAS GOOD NEWS AND BAD NEWS

 

As Medicare approaches its 50th anniversary next week, the federal program got some welcome financial news Wednesday: Its giant hospital trust fund will be solvent until 2030, and its long-term outlook has improved, according to a report from the program’s trustees.

But the report warned that several million Medicare beneficiaries could see their Medicare Part B monthly premiums skyrocket by 52 percent in January — from $104.90 to $159.30. Medicare Part B, which is paid for by a combination of federal funds and beneficiary premiums, generally covers physician and outpatient costs.

The huge rate hike is predicted because of two factors: Medicare Part B costs increased more than expected last year, and Social Security is not expected to have a cost of living increase next year. By law, the cost of higher Medicare Part B premiums can’t be passed on to most Medicare beneficiaries when they don’t get a Social Security raise. As a result, the higher Medicare costs have to be covered by just 30 percent of Medicare beneficiaries. This includes the 2.8 million Medicare enrollees new to the program next year, 3.1 million Medicare beneficiaries with incomes higher than $85,000 a year and 1.6 million Medicare beneficiaries who pay their premium directly instead of having it deducted from Social Security. An additional 9 million people affected by the higher rates are so called “dual eligibles” — those on Medicare and Medicaid. States pay the Medicare Part B premium for duals.

HHS Secretary Sylvia M. Burwell said she will examine her options and make a final decision on rates in October. “Seventy percent of enrollees in Part B will have no change in premiums,” she said at a briefing with other program trustees.  (Kaiser Health News)

URGENT CARE CENTERS MAY NOT GIVE PATIENTS CLEAR INSURANCE INFORMATION

 

Patients who choose Urgent Care Centers instead of hospital emergency departments may face unexpected bills if the center is not clear about participation in insurance networks. Patients who call and ask whether a given Urgent Care Center accepts their coverage may misunderstand the response and expect an in-network co-pay, not balance billing. The New York State attorney general's office recently told some clinics their website insurance information may be deceptive. If you plan to use an Urgent Care Center make sure you tell them specific details about your health plan when asking what they accept.  Better yet, check with your health plan to see if the Urgent Care Center is “in-network.”