http://www.medi-solutions.org/Medicare/Tina

Tina Steward, Medisolutions, 54 Jerseyville Avenue, Freehold Township, NJ (2026)

05/16/2022

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04/21/2022

8 early signs of dementia:
• A decline in memory, thinking or attention.
• Decline in planning complex tasks.
• Changes in mood or behavior.
• Decline in functional abilities.
• An increase in confusion.
• Decline in social cognition.
• Repetition.
• Changes in language use.
• Dementia is common.
The World Health Organization reports that currently, more than 55 million people worldwide are living with dementia, and 10 million news cases are diagnosed every year.
Here in the United States, the Centers for Disease Control and Prevention estimates that 5 million adults over the age of 65 are living with dementia. That number is projected to rise to about 14 million by 2060.

What exactly is dementia?
“There are many conditions that result from brain diseases,” says Dr. Douglas Scharre, director of the division of cognitive neurology at the Ohio State University Wexner Medical Center in Columbus. If these conditions “are to such a degree that they lead to interference in day-to-day functioning, they’re called dementia conditions.”
Alzheimer’s disease, a condition in which certain proteins accumulate in the brain and disrupt normal functioning, account for about 60% to 70% of all dementia cases. But there are several types of dementia.
Across these various diseases, the resulting dementia doesn’t develop overnight, says Dr. William Nields, medical director of Cognitive Health Centers in Sarasota, Florida. “Dementia is a late stage in the process of cognitive decline and may be preceded by 20 years of pathological processes in the brain.”

Dementia symptoms can be hard to spot early on.
Symptoms may only surface after years of the changes taking place in the brain.
“In the case of Alzheimer’s Disease, beta amyloid plaques (misfolded proteins that interfere with normal brain functioning) may be building up in the brain 20 years before dementia, and years before symptoms are even present,” Nields says. Dementia is typically diagnosed after "significant cognitive decline has occurred and a person has difficulty caring for themselves."
In some cases, there’s a period when the individual notices their own decline before anyone else does. “This stage is called subjective cognitive impairment,” Nields says, “and we believe this is the time to intervene, even if screening tests aren’t sensitive enough to pick it up. A loved one may hide cognitive decline for a long time with vague responses, deflecting humor and avoidance of questions which they cannot answer.”

Symptoms of dementia are different from typical aging.
“One of the things that’s really difficult with making an Alzheimer’s or dementia diagnosis is that in the very early stages, it’s very difficult to discern between just normal aging or forgetfulness and the signs of something much more serious happening,” says Lisa Skinner, a Napa, California-based behavioral expert in the field of Alzheimer’s disease and related dementias.
“The symptoms are very subtle in the beginning and almost unnoticeable. For that reason, most people are not diagnosed with Alzheimer’s or one of the other many brain diseases that cause dementia until they’ve already progressed into their mid-stage.”
However, there are some warning signs that may indicate it might be time to talk with your doctor.
1. A decline in memory, thinking or attention.
Perhaps the most recognizable sign of Alzheimer’s disease or dementia is a downturn in the ability to remember, make new memories or engage in more complex thought processes.
2. Decline in planning complex tasks.
Financial management, driving to a new location and other complex tasks that involve pre-planning or complex thinking also typically become very difficult for someone living with dementia as the disease progresses.
3. Changes in mood or behavior.
Dementia is “not just memory loss or confusion,” Skinner says. “This disease ravages a lot of the parts of the brain, and as a result of that, family members or caregivers will see behavioral changes or changes in mood.” For example, increased irritability is a hallmark of Alzheimer’s and some other forms of dementia.
In patients who have frontotemporal dementia, a disease that hits especially hard in the front of the brain where your personality and emotions are housed, aggressive outbursts and erratic or overly sexualized behaviors or mood changes may signal something is wrong.
4. Decline in functional abilities.
“Another obvious symptom is that thinking abilities become so impaired to actually interfere with daily functions,” Skinner says. More than just general forgetfulness, this shift affects the patient’s ability to complete daily tasks in ways that “don’t happen with normal aging.”
5. An increase in confusion.
Everyone experiences confusion from time to time, and garden variety forgetfulness, such as occurs when you’re preoccupied or under stress, is normal. But people experiencing cognitive decline related to dementia may begin to lose the ability to recognize common objects.
“That’s a sign of a more serious disease happening” rather than just general aging, Skinner says. She gives the example that forgetting where you’ve put your keys isn’t that big a deal – everyone does it sometimes. But if when you find them, you’re not able to remember what you’re supposed to do with them, “that’s a huge red flag.”
6. Decline in social cognition.
“Difficulty recognizing faces, names or responding to social cues” can also be early signs of dementia, Nields says.
“You’ll notice signs that the person’s social skills are changing, and they tend to avoid or withdraw from social situations or isolate themselves,” Skinner adds. This can lead some people to withdraw from social settings, which only further compounds the problem and could increase risk for loneliness and depression. Depression can exacerbate the situation, but it can also be a sign of dementia in its own right.
7. Repetition.
“This is a really common sign,” Skinner says. “A lot of people with dementia will repeat the same questions over and over and over again in the same conversation, or they’ll repeat the same story. They’ll tell it to you over and over and over again.
8. Changes in language use.
In addition to the typical word-finding difficulties, people experiencing cognitive decline may display, in more advanced cases and in folks who speak more than one language, there may be a reversion to the native language, Skinner says. In addition to typical word-finding difficulties, please experiencing cognitive decline may insert new words.
“Some people, when they’re experiencing damage to the brain due to brain disease, they actually will revert back to their first language. So, if your mother came from Italy and Italian was her first language, she might just all of a sudden start speaking in Italian without even realizing it.”

What to do if dementia symptoms arise.
If you notice any of the above symptoms, it’s worth talking with your primary care provider. Scharre says this clinician will “take a history, perform a pen and paper test, do a physical examination, order lab tests and order a brain scan to help identify what the cause may be.”

Early detection is important.
“If you notice these symptoms, you should come in and get evaluated immediately,” Nields says. “There is no benefit to waiting. Just like a person might undergo a colonoscopy for certain symptoms, we recommend a 'cognoscopy' to evaluate what is driving the problem.”
The good news is this “cognoscopy is much more pleasant than a colonoscopy. It includes a detailed interview and a panel of bloodwork initially, which may be followed by further specialized testing.”
When screening tests finally are able to pick up the cognitive changes, this stage is called mild cognitive impairment, or MCI, Nields explains. “MCI is actually a later stage in the process, and we believe ‘mild’ is a misnomer for this reason. MCI may eventually progress to dementia if the processes driving the neurodegeneration aren’t arrested.”
For that reason, he says it’s important to seek help early, before you get to that dementia stage. “We prefer to see people much earlier in the process when changes are just beginning to take place. We can do a thorough evaluation of factors that drive cognitive decline and address these biological processes before they cause the neurodegeneration that results in dementia.”
Scharre agrees that the longer you wait to address issues related to cognitive decline, the harder it becomes to slow the progression of the disease. “The earlier you detect cognitive decline the more beneficial are the treatments,” Scharre says. “Alzheimer's disease has a course of typically 8 to 12 years. Starting treatments earlier can probably slow the decline.”
Treatments are available.
Skinner notes that while there’s currently no cure for Alzheimer’s and other forms of dementia, there are treatments available that can “delay the progress of the disease.”
These medications aren’t effective for everyone, and there can be a lot of variability in how the disease progresses even after the patient begins treatment. But she says there's hope that early intervention can give you a better quality of life for longer.
A new, controversial drug called aducanumab (Aduhelm) was recently approved by the FDA and offers hope that treatment may offer a better quality of life. However, this medication has to be started as early as possible to be effective, and some providers aren’t using it because they don’t see the benefits as being worth the high price and potential downsides.

Activity and social engagement can help.
While medications offer some hope, other interventions can also help. Skinner recommends getting and staying as active as possible if you’re dealing with dementia.
“It’s very important for people with Alzheimer’s disease (and other dementias) to be provided with the right type of activities and stimulation and environment to delay the progression.”

She recommends finding activities that engage the body, mind and spirit “that will match the skill level that the person is at. You don’t want to overwhelm them with something that’s too difficult because that also causes agitation and frustration.”
From music therapy to gardening and gentle exercise, getting and staying engaged in ways that use all five senses can help stretch the brain and slow the progression of cognitive decline.
The brain is like any other muscle in the body, Skinner says. If it’s not kept active, it can atrophy and die. But, you can delay brain atrophy with physical and mental activities and social engagement.

Symptoms of dementia are different from typical aging.
“One of the things that’s really difficult with making an Alzheimer’s or dementia diagnosis is that in the very early stages, it’s very difficult to discern between just normal aging or forgetfulness and the signs of something much more serious happening,” says Lisa Skinner, a Napa, California-based behavioral expert in the field of Alzheimer’s disease and related dementias.
“The symptoms are very subtle in the beginning and almost unnoticeable. For that reason, most people are not diagnosed with Alzheimer’s or one of the other many brain diseases that cause dementia until they’ve already progressed into their mid-stage.”
However, there are some warning signs that may indicate it might be time to talk with your doctor.

“There are many conditions that result from brain diseases,” says Dr. Douglas Scharre, director of the division of cognitive neurology at the Ohio State University Wexner Medical Center in Columbus. If these conditions “are to such a degree that they lead to interference in day-to-day functioning, they’re called dementia conditions.”
Alzheimer’s disease, a condition in which certain proteins accumulate in the brain and disrupt normal functioning, account for about 60% to 70% of all dementia cases. But there are several types of dementia.
Across these various diseases, the resulting dementia doesn’t develop overnight, says Dr. William Nields, medical director of Cognitive Health Centers in Sarasota, Florida. “Dementia is a late stage in the process of cognitive decline and may be preceded by 20 years of pathological.

04/12/2022

Seniors on Social Security may get to keep more of their 2022 benefits for this reason...

There's a chance Medicare won't impose such a substantial hike for Part B this year.

Last October, seniors on Social Security got some pretty good news. That's when 2022's 5.9% cost-of-living adjustment (COLA) was announced, and it winds up being the biggest raise recipients have seen in decades. But that excitement was somewhat short-lived. That's because following the news of a big Social Security raise, seniors on Medicare learned that the standard Part B premium would be increasing from $148.50 in 2021 to $170.10 in 2022. That's an increase of $21.60, and one that now has the potential to eat away at seniors' most recent Social Security COLA.

Though Medicare Part A, which covers hospital care, is free for most enrollees, Part B, which covers outpatient services and diagnostics, costs money for coverage. There's a standard Part B premium that applies to low and moderate earners, while higher earners pay the standard premium plus a surcharge.

Seniors on Social Security have their Part B premiums deducted from their benefits directly. It's a convenient way to pay for Medicare, but it also means that seniors often don't get their Social Security COLA in full.

But now, there's a chance Medicare won't impose such a substantial hike for Part B this year. And if that happens, seniors will get to keep more of their much-needed Social Security raise.

A touch of hope
Many seniors depend on Social Security to provide the bulk of their retirement income. In recent years, those benefits have done a poor job of helping recipients maintain their buying power in the face of inflation. And a big part of the reason is that the cost of healthcare, including Medicare, has risen substantially through the years, and at a faster pace than Social Security COLAs.
But seniors may be in luck this year. On Jan. 10, Health and Human Services Secretary Xavier Becerra announced that he's instructing the Centers for Medicare & Medicaid Services to reassess this year's standard Part B premium hike.
A big reason for this year's giant increase stems from higher costs related to Aduhelm, a medication designed to treat Alzheimer's disease. But the drug's manufacturer has since cut its estimated per-patient cost in half from $56,000 to $28,000 a year. Because Medicare's Part B premium hike was based on that higher number, it's easy to make the argument that the cost of Medicare should not be increasing so drastically.

If Medicare Part B premiums end up with a smaller increase, it could help a lot of seniors stay afloat financially in 2022. Though Social Security benefits are getting a sizable boost this year, the reason for that is because the general cost of living has gone way up over the past number of months. And so seniors getting a 5.9% COLA may not be banking that money so much as using it to cover higher food, gas, and utility costs, among others.
Though making retroactive changes to Part B increases isn't something Medicare normally does, this year, it's a move that could make a lot of sense -- and help a lot of seniors financially.

04/06/2022

Taking money from your IRA may seem like a simple matter, but it's a decision that must be timed right.

It sounds straightforward, but when you withdraw that money can make a big difference in how much you end up paying the government in taxes and fees.

Individual retirement accounts, commonly known as IRAs, are retirement fund staples for many people. Traditional IRAs let workers take a tax deduction when they deposit money into their account and then pay taxes when they make a withdrawal.

It sounds straightforward, but exactly when you withdraw that money can make a big difference in how much you end up paying the government in taxes and fees.
Here are five things you should know before pulling money from your traditional IRA:
• You could pay a penalty if you withdraw money too early.
• You could miss a window for tax savings if you withdraw too late.
• You are required to make minimum withdrawals from traditional IRAs once you reach age 72.
• Your IRA withdrawals could affect your Medicare premiums.
• You may be able to avoid an early withdraw penalty in certain circumstances.

You Could Pay a Penalty if You Withdraw Money Too Early
The trade-off for the tax deduction on traditional IRA contributions is a restriction on when you can withdraw money from the account. To discourage people from tapping into their account before retirement, the government imposes a 10% tax penalty on money withdrawn before age 59 1/2.

"IRAs are designed for retirement, and the government wants to ensure the money is used for that," says Stuart Chamberlin, president of Chamberlin Financial Inc. in Boca Raton, Florida.
The early withdrawal penalty is on top of income taxes that need to be paid. For someone in the 12% tax bracket, the added penalty could mean nearly a quarter of the amount withdrawn will be eaten up by taxes and the penalty.

You Could Miss a Window for Tax Savings if You Withdraw Too Late
While you don't want to pull money from your IRA too early, waiting too long to start disbursements can be a mistake as well.
"When you retire, often people have what I call this 'window of opportunity' where they have low income years," says Mike Piershale, president of Piershale Financial Group in Barrington, Illinois.

Piershale says those first years of retirement can be the perfect time to convert money from a traditional IRA to a Roth IRA. You will pay taxes on the money you convert, but a Roth IRA will allow the fund to continue growing tax-free. "In most cases, it may make sense to convert just enough to keep you in the same tax bracket," he says, noting you don't want to inadvertently bump yourself into a higher tax bracket. Another reason to withdraw money from an IRA earlier rather than later is to delay claiming Social Security benefits. You get an 8% increase in benefits for every year you wait to claim from your full retirement age until age 70. By withdrawing money from an IRA before age 70, you could delay the start of Social Security and maximize those benefits.

Minimum Withdrawals From Traditional IRAs Required at 72
Regardless of whether you withdrew money from your IRA earlier, everyone with a traditional IRA must begin taking required minimum distributions, or RMDs, at age 72. The year 2020 is the one exception to this rule with the CARES Act, passed in response to the COVID-19 pandemic, waiving the requirement for this year.
In any other year, failure to take these annual distributions results in a tax penalty equal to 50% of the required distribution amount. Piershale notes a person with a $700,000 retirement account may have an RMD around $27,000. That means missing the deadline to withdraw the RMD would cost that person $13,500 in penalties.
"The money in these accounts hasn't yet been taxed," says John Mantia, co-founder and director of finance for PARCO, a firm based in Washington, D.C., that specializes in helping federal employees navigate their retirement benefits. By requiring RMDs, the government ensures that this cash is not tax-deferred indefinitely.
The RMD is also why it makes sense to convert or withdraw money from a traditional IRA during a low-income period early in retirement. The more money converted or withdrawn prior to age 72, the lower RMDs will be later in life. That lower RMD could then translate to reduced taxes. "If you don't need the money, plan out how much to move over to a Roth account," Mantia advises. However, be aware that money converted to a Roth account cannot be considered an RMD once you reach age 72.
IRA Withdrawals Could Affect Your Medicare Premiums
In addition to taxes, the RMD and other IRA withdrawals can affect Medicare payments. While the standard Part B premium for 2020 is $144.60 a month, those with higher incomes could pay significantly more.

In 2020, people who have modified gross incomes greater than $87,000 start paying additional premiums for Medicare Part B and prescription drug coverage. Married couples filing jointly with modified gross incomes of $174,000 or more will also have additional premiums. The government goes back two years when determining your income level. For example, in 2020, data from tax year 2018 is used for calculating Medicare premium payments.
These higher premiums start at $202.40 per month and go to as much as $491.60 a month for single taxpayers with incomes of $500,000 or more.

You May Be Able to Avoid an Early Withdraw Penalty
Although money in a traditional IRA is meant to be preserved for retirement, the government does allow workers to tap into the fund without penalty for certain purposes.
"On a traditional IRA, generally you can't withdraw until 59 1/2, although there are all sorts of exceptions," Piershale says. Those exceptions include the following:
• A disability leaving you unable to work indefinitely.
• Terminal illness.
• Medical expenses.
• Tax payments.
• Higher education expenses.
• Home purchases for first-time buyers.
• Health insurance during periods of unemployment.

What's more, the CARES Act allows those affected by COVID-19 to withdraw up to $100,000 in 2020 and not pay a penalty. This option is available to those who have been diagnosed with COVID-19 or who have a spouse or dependent who was diagnosed using a CDC-approved test. A penalty-free withdrawal can also be taken by those experiencing a wide range of adverse effects from the pandemic, including a lost job or reduction in hours.
Although money used for an eligible purpose is not subject to a penalty, income taxes still apply. For withdrawals related to COVID-19, the IRS allows people to spread their income tax payments over a three-year period.

Another option to avoiding the early withdrawal penalty is to take at least five substantially equal periodic payments as allowed under IRS rule 72(t). "Very few people use that," Chamberlin says. Since modifying a payment plan after its start can result in retroactive penalties, it is best to attempt 72(t) distributions only under the guidance of a finance professional.
The decision to raid a retirement fund should not to be taken lightly. A financial advisor can help you understand if you're eligible to withdraw money without penalty and, if so, how that may affect your ability to retire comfortably in the years ahead.

02/02/2022

Possible Price Increase
It’s important for Medicare customers to know there may be price increases for their coverage. These changes can impact your coverage and what you’re paying for health insurance. According to Yahoo, the following changes for 2022 prices are:
• Part A deductible increases 3.2 percent from $1,364 to $1,408;
• Part B premium increases 6.7 percent from $135.50 to $144.60, and;
• Part B deductible increases seven percent from $185 to $198.5
Another increase to be mindful of involves Medicare Part D. This coverage is expected to rise 4.9 percent from $31.47 to approximately $33. Healthcare Finance News says this is calculated based on plan expectations of per capita drug spending in 2022.6
Customers can expect these added costs and changes to appear during open enrollment.

01/28/2022

Coverage of Blood-Based Biomarker Test for Colorectal Cancer
Medicare is offering some new coverage in relation to colorectal cancer screenings. The goal is to help customers get diagnosed early when treatment is more effective.
Now, you have the option of doing a blood-based biomarker test. This test is covered in certain cases once every three years. If your doctor or other health care provider deem you eligible, then you pay nothing.
In order to qualify, you must:
• Be between the age of 60 and 85;
• Show no symptoms of colorectal disease, and;
• Carry average risk for developing colorectal cancer

01/19/2022

Coverage of Cognitive Assessment and Care Plan Services
The next time you visit the doctor for a wellness check, they may also perform a cognitive assessment that’s covered by Medicare. These assessments are performed by doctors and specialists to look for signs of diseases such as dementia and Alzheimer’s.
With Medicare, you can now receive coverage for a full review of your cognitive function. This appointment can be used to establish or confirm a diagnosis and develop a care plan. You may be referred to a specialist or community resources depending on the status of your condition.
Doctors must evaluate potential symptoms and rule them out against other conditions like depression or anxiety. There are several symptoms they look for that are related to cognitive impairment. Some of them include having trouble:
• Remembering things;
• Learning new things;
• Concentrating;
• Managing finances, and;
• Making decisions about everyday life.

01/14/2022

Coverage of COVID-19 Items and Services
Since many Medicare customers are at high risk for contracting a serious case of COVID-19, there are more coverage options related to this illness. You can receive coverage on preventative measures, testing, and some treatments for this virus.
Medicare will cover FDA-authorized vaccines that significantly reduce your risk of coronavirus. You pay nothing for the vaccine as long as you carry your Medicare card to the doctor’s office or pharmacy where you get the shot. The vaccine works with the body’s natural defenses to help provide immunity to the virus.
If you suspect that you have COVID-19, Medicare will also pay for FDA-authorized tests. These tests can be taken in your local area. You will pay nothing to find out if your test comes back positive or negative.
Lastly, Medicare may pay for monoclonal antibody treatments if you’re sick with COVID-19. This is aimed at people who test positive with mild to moderate symptoms. There are certain qualifications to receive this treatment, so you will have to discuss with your doctor if the treatment is right for you.

01/06/2022

CMS Announces 2022 Medicare Part B Premiums
The Centers for Medicare & Medicaid Services (CMS) released the 2022 Medicare Parts A and B premiums, deductibles, and coinsurance amounts, and the 2022 Part D income-related monthly adjustment amounts. Most people with Medicare will see a 5.9 percent cost-of-living adjustment (COLA) in their 2022 Social Security benefits—the largest COLA in 30 years. This significant COLA increase will more than cover the increase in the Medicare Part B monthly premium.
Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A. The increase in the standard monthly premium—from $148.50 in 2021 to $170.10 in 2022—is based in part on the statutory requirement to prepare for expenses, such as spending trends driven by COVID-19, and prior Congressional action in the Continuing Appropriations Act, 2021 that limited the 2021 Medicare Part B monthly premium increase during the COVID-19 pandemic. It also reflects the need to maintain a contingency reserve for unanticipated increases in health care spending, particularly certain drug costs. There is significant uncertainty regarding the potential for future coverage of clinician-administered Alzheimer’s drugs (i.e., Aduhelm™), requiring additional contingency reserves. Potential Medicare drug coverage is currently the subject of a Medicare National Coverage Determination (NCD) analysis, which, if covered, could increase Medicare spending. The proposed NCD on Aduhelm (as well as any drugs in this category) is still to be determined.
Most people with Medicare will see a significant net increase in Social Security benefits. For example, a retired worker who currently receives $1,565 per month from Social Security can expect to receive a net increase of $70.40 more per month after the Medicare Part B premium is deducted.
“CMS is committed to ensuring high quality care and affordable coverage for those who rely on Medicare today, while protecting Medicare’s sustainability for future generations," said CMS Administrator Chiquita Brooks-LaSure. “The increase in the Part B premium for 2022 is continued evidence that rising drug costs threaten the affordability and sustainability of the Medicare program. The Biden-Harris Administration is working to make drug prices more affordable and equitable for all Americans, and to advance drug pricing reform through competition, innovation, and transparency.”
By law, the Medicare Part B monthly premium must equal 25 percent of the estimated total Part B costs for enrollees age 65 and over. CMS has a responsibility to establish an annual Part B premium that will adequately fund projected Medicare spending and maintain an adequate reserve in case actual costs are higher than estimated.
The annual deductible for Medicare Part B beneficiaries grows with the Part B financing and is increasing from $203 in 2021 to $233 in 2022.
The Administration is taking action to address the rapidly increasing drug costs that are posing a threat to the future of the Medicare program and that place a burden on people with Medicare. President Biden has proposed to lower prescription drug costs for Americans by letting Medicare negotiate drug prices as part of his Build Back Better agenda. In addition, Department of Health and Human Services Secretary Xavier Becerra released a comprehensive plan to lower drug prices as part of President Biden’s Executive Order on Promoting Competition in the American Economy. The plan includes legislative and administrative proposals to reduce drug costs in Medicare Parts B and D.

10/06/2021

CMS Releases 2022 Premiums and Cost-Sharing Information for Medicare Advantage and Prescription Drug Plans

The Centers for Medicare & Medicaid Services (CMS) released the 2022 premiums, deductibles and other key information for Medicare Advantage and Part D prescription drug plans in advance of the annual Medicare Open Enrollment to help Medicare enrollees decide on coverage that fits their needs. The average premium for Medicare Advantage plans will be lower in 2022 at $19 per month, compared to $21.22 in 2021, while projected enrollment continues to increase. As previously announced, the average 2022 premium for Part D coverage will be $33 per month, compared to $31.47 in 2021.
“We are committed to ensuring that the health system and Medicare work for people, their families and their providers,” said CMS Administrator Chiquita Brooks-LaSure. “Open Enrollment is the one time each year when more than 63 million people with Medicare can review their health care coverage to find new plans or change existing plans, discover extra benefits and help them save money.”
Enrollment in Medicare Advantage in 2022 is projected to reach 29.5 million people compared to 26.9 million enrolled in a Medicare Advantage plan in 2021. Medicare Advantage plans will continue to offer a wide range of supplemental benefits in 2022, including eyewear, hearing aids, both preventive and comprehensive dental benefits, access to meals (for a limited duration), over-the-counter items, fitness benefits and worldwide emergency/urgent coverage. In addition, the percentage of plans offering special supplemental benefits for chronically ill individuals will increase from 19% to 25%.
An increasing number of Medicare Advantage dual eligible special needs plans cover both Medicare and Medicaid services for people who are dually eligible. In 2022, 295 plans (compared to 256 in 2021), will cover all Medicare services, plus Medicaid-covered behavioral health treatment or long term services and supports, through a single organization.
CMS will continue to test the Part D Senior Savings Model in more than 2,100 plans in 2022, increasing access and affordability to select insulins for seniors. Over 500 new Medicare Advantage and Part D prescription drug plans, and two new pharmaceutical manufacturers of insulin, are joining the model this year to provide even more opportunities for eligible seniors to reduce their out-of-pocket spending on insulin.
Additionally, more than 1,000 Medicare Advantage plans will participate in the CMS Innovation Center’s Medicare Advantage Value-Based Insurance Design (VBID) Model in 2022, which tests the effect of offering a projected 3.7 million people customized benefits that are designed to better manage their disease(s) and meet a wide range of social needs, from food insecurity to social isolation. The VBID Model’s Hospice Benefit Component, now in its second year, will also be offered by 115 Medicare Advantage plans in portions of 22 states and U.S. territories and provides enrollees increased access to palliative and integrated hospice care.
Medicare Open Enrollment begins on October 15, 2021, and ends on December 7, 2021. During this time, people eligible for Medicare can compare 2022 coverage options between Original Medicare, and Medicare Advantage and Part D prescription drug plans. Medicare health and drug plan costs and covered benefits can change from year to year, so people with Medicare should look at their coverage choices annually and decide on the options that best meet their health needs.

Tina Steward, Medisolutions

05/16/2022

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