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More Americans are working past 65 and continue to have employer-sponsored health insurance. However, the intersection of Medicare and employer coverage has a number of traps for the unwary and some of these traps come with real financial consequences. This makes it more important than ever that you (and your employer) understand the complex rules for starting coverage under Medicare. This blog post will identify some of the traps in these rules. Medicare Part A and HSAs. If you (or your spouse) has paid Medicare taxes for at least ten years, you do not pay monthly premiums for Medicare Part A (hospital) coverage. Because Part A does not require...

Health insurance is an empty promise if your doctor or hospital is not covered. Headlines keep on reminding us that insurance companies are restricting the doctors and hospitals covered by their plans. People covered by Medicare have their own separate rules and these Medicare-specific rules have both good news and bad news—but mostly good news. The good news—people covered by “original” Medicare have broad access to the doctor of their choice. Over 90% of doctors take Medicare[1]. The bad news: the Medicare rules are complicated and are filled with traps for the unwary....

There has been a lot in the media about the recent budget deal and changes to the Medicare Part B premium.  What just happened? Here is the bottom line (and its confusing): ·      If you are a current Medicare beneficiary and pay your Part B premium though a deduction to your Social Security check, your Part B premium will stay at $104.90/month for the time being. ·      If you are a Medicare beneficiary, but do not pay your Part B premium through a Social Security deduction—or are new to Medicare--your Part B premium will rise to about $123. But as is often the case, the reality is more complicated…. Medicare premiums are supposed to cover 25% of the cost of Medicare...

Both the popular press and the benefits/HR trade publications have been sounding the alarm—older workers are not adequately saving for their health care costs in retirement.  There are many reasons for this “retiree medical adequacy” gap—including limited resources and competing needs (e.g., housing, children’s’ education, and retirement income needs) and confusion over the best asset-accumulation vehicles (e.g., 401(k)/403(b), Roth, IRA, and HSA). Many of the challenges to retiree medical adequacy are based on financial constraints and filling these financial gaps will be difficult in an era of limited wage growth and increasing longevity....

On April 16 President Obama signed The Medicare and CHIP Reauthorization Act (“MACRA”). The focus of the law is to change how physicians are reimbursed under Medicare, but MACRA contains a number of provisions that may have far-reaching consequences for all of the “stakeholders” in Medicare—especially for consumers and their physicians. Most importantly, MACRA changes more than how much physicians are paid—it shifts how they are paid. Under MACRA, annual increases (and possible cuts) in physician reimbursements will be based on the physicians’ performance...

There is an ongoing controversy between hospitals and government regulators (The Centers for Medicare and Medicaid Services, or “CMS”)—with Medicare beneficiaries caught in the middle. Although the issue seems technical and bureaucratic, it raises some significant issues for those covered by Medicare. What is Going On? Hospitals can label a stay as an “admission” to the hospital—or as a stay for “observation.” In recent years the use of observation status has skyrocketed; as noted by the Kaiser News Network, the use of observation status rose 88% between 2006 and 2012 and the number of observation stays lasting...