Social Security Cost of Living Increase Announced

After two years without a cost-of-living adjustment (COLA), Social Security has announced that recipients will receive a 3.6% increase in their checks beginning in January of 2012. In January of 2009, recipients received a 5.8% increase (an uncommonly large adjustment) but did not see any adjustments in 2010 or 2011. In each of those years the rate of inflation was too low to trigger a COLA. Since an increase in Medicare Part B premiums cannot lower a Medicare beneficiary's Social Security amount, there has also been a corresponding postponement in the increase of Part B premiums for existing Medicare beneficiaries. The Centers of Medicare and Medicaid Services (CMS) has not yet released the Medicare Part B premiums for 2012.

For more information see the Social Security announcement by clicking here.

CLASS Act Eliminated

On Friday the CLASS (Community Living Assistance Services and Supports) Act, a part of the Health Care and Education Reconciliation Act of 2010 that created a voluntary long term care and disability insurance for working aged Americans, was scrapped by the Obama Administration.  Designed to be supported by member premiums collected via payroll deductions, the plan has come under significant scrutiny as its sustainability has been questioned.  The program was terminated indefinitely just before the weekend as it became increasingly clear that plan could not be self-supportive.  Removing this program from the law saves as estimated $86 billion over a decade.

See a full write-up of this story from The Hill by clicking here.

See a summary of the CLASS Act by clicking here.

2012 Baseline Prescription Drug Plan

CMS has recently released the 2012 advised structure for all prescription drug plans.  While each company may design their plan in any way they choose, they must be at least "actuarially equivalent" to this standard design.  That is, they cannot offer coverage that, all things considered, is less than the standard coverage. 

The changes of note from last year are...

• Deductible change from $310 to $320
• Donut Hole threshold change from $2,840 to $2,930
• Generic discount during the Donut Hole increased from 7% to 14%
• Catastrophic Coverage threshold change from $4,550 to $4,700

To see a full breakdown of the 2012 standard plan, click here.

Medicare Enrollment Periods for Plan Year 2012

This year changes have been made to the Medicare Enrollment Periods.  What is a Medicare Enrollment Period?  If you are enrolled in a Medicare Advantage Plan or a Prescription Drug Plan, there are only certain periods during the year in which you may make changes to your plans.  Baring any special circumstances these periods are as follow:

• Annual Election Period: Oct 15th - Dec 7th. During this period you may enroll or disenroll from a Medicare Advantage Plan or a Prescription Drug Plan. All changes during this time will be effective Jan 1st.


• Medicare Advantage Disenrollment Period: Jan 1st - Feb 14th. During this time period you may only disenroll from a Medicare Advantage Plan and return to Original Medicare. You may add a Prescription Drug Plan to replace the drug coverage that your Medicare Advantage Plan afforded.

There are small nuances to the above periods, as well as many other "Special Election Periods" If you feel that you may have a special circumstance that would allow you to enroll or disenroll from a Medicare Advantage Plan or Prescription Drug Plan and you would like to speak with us more about your potential options, please feel free to call (800-817-98223) or email (info@tweedyinsurancegroup.com) us anytime.

Happy Independence Day!

We here at Tweedy Insurance Group want to wish you a Happy Independence Day from our family to yours! For all our nation is and is not, we are extremely grateful to God for the country we live in. A county whose founding morality and sense of right was shaped by His principles. A country that has brought more freedom to the world than any other in the history of human civilization. In spite of all the mistakes she's made and the things we'd change, we would not choose to be citizens of any other nation. May God have mercy on America and in His goodness save us from ourselves.

Red Skelton: The Pledge of Allegiance (video)

The Declaration of Independence (pdf)

Can my doctor bill me up front?

There are two types of doctors who accept Original Medicare: those who accept assignment (participating providers) and those who don’t accept assignment (non-participating providers). Participating providers are doctors who take Medicare and agree to accept the Medicare-approved amount for a service as payment in full. Most of these providers will bill Medicare first, and then allow you to pay any difference between what Medicare approved and what Medicare paid.

Non-participating providers are doctors who take Medicare, but do not necessarily agree to accept the Medicare-approved amount for a service as payment in full. However, these doctors are only able to charge you 15 percent more than the Medicare-approved amount for a service. In many cases these doctors will require you to pay the entire bill up front. They will then submit the claim to Medicare and have Medicare reimburse you directly for the bill you paid.

In short the answer to this question is "yes", however, you are more likely be billed up front by a non-participating provider. This is one of the reasons we recommend using a participating provider whenever possible.

If you have coverage through a Medicare Advantage Plan, the above information does not apply to you. You will pay the coinsurance and/or copayments that your plan requires, and these will likely vary depending on whether or not they are a network provider. For more information on the difference between Original Medicare and Medicare Advantage Plans, please see the following information pages: Medicare Overview, Medicare Advantage.

Does Medicare cover bone mass measurements?

Bone mass measurements (sometimes called "bone density tests") are given to evaluate your bone’s health by assessing your bone quality, calculating your bone mass and detecting any bone loss. Bone mass measurements can help determine if you need medical treatment for osteoporosis, a condition that causes "brittle bones" in many older adults. Starting January 1, 2011, if you are in Original Medicare and meet certain criteria that put you at risk for osteoporosis, a bone mass measurement is covered as a preventive service. This means you will have no coinsurance or deductible if you see a doctor who takes assignment. Doctors who take assignment are doctors who cannot charge you more than the Medicare approved amount.

According to Medicare.gov, you have to meet one of the following criterions that put you at risk for osteoporosis for Medicare to cover the bone mass measurement test:

1. A woman whose doctor (or other health care professional) is treating her for estrogen-deficiency and is at risk for osteoporosis based on her medical history or other findings 
2. A person with vertebral (spinal) abnormalities as demonstrated by an x-ray 
3. A person getting (or expected to receive) steroid treatments for more than three months 
4. A person with hyperparathyroidism 
5. A person taking an osteoporosis drug  

This test is covered as a preventive service once every 24 months if you are at risk. Medicare will also cover follow-up measurements or more frequent screening if your doctor prescribes them and says that they are medically necessary. In this case, Medicare will cover the screenings but you will have to pay a 20 percent coinsurance.

*source: adapted from "Dear Marci." Medicare Rights Center Volume 10, Issue 11.  Online.  http://www.medicarerights.org/medicare-answers/dear-marci.php viewed on 5/31/2011.

The ABC's of Diabetes

Diabetes is a serious illness that affects almost every part of the body. Good diabetes management can relieve daily symptoms and even help prevent other health problems such as heart disease, stroke and nerve damage, along with vision and kidney problems.  Has your doctor diagnosed you with diabetes? Then ask your doctor about these three checks.

A1c: Diabetes is characterized by abnormally high blood glucose levels. An A1c test reveals your blood sugar levels over the past three months.  A score of 7 or less is typically an ideal level, but you’ll want to discuss your results with your doctor.  Your doctor can also tell you if you need regular A1c testing.

Blood Pressure: The goal for most people with diabetes is a blood pressure reading below 130 over 80.  Do you know yours?  It’s important to track your blood pressure closely because an increased number can lead to heart attack or stroke. Your doctor should check your blood pressure at every visit, or at least annually.

Cholesterol: Like high blood pressure, cholesterol build up can cause a heart attack or stroke. On average, your LDL, the bad cholesterol, should be less than 100.  Your HDL, the good cholesterol, should be more than 40.  Ask your doctor how often you should check your cholesterol levels.

* source: "The ABCs of Diabetes." Blue Cross of Idaho: One to One Spring 2011: 6. Print.

The Shrinking Donut Hole

Beginning this year, the Patient Protection and Affordable Care of 2010 has gone into effect that will begin to shrink the infamous Medicare Part D Coverage Gap - more commonly known as the "Donut Hole". Part D Prescription Drug Plans help pay cots for medications at different rates based on four different phases: the deductible, phase 1, the coverage gap, and catastrophic coverage. The deductible, which some plans do not have, is generally no more than $325 per year. After this deductible, the plan begins paying the bulk of the cost of your prescriptions, leaving you with a smaller copay or coinsurance. However, once the total retail cost of your medications reaches a certain level ($2,840 in 2011) you enter the Donut Hole begin paying 100% of your medications. The plan will begin helping with the cost of your medications again once you cross the Catastrophic out-of-pocket threshold level ($4,550 in 2011). That means that for approximately $3,600 per year, you are on your own.

Or, should we say, were on your own. Beginning this year Part D members will receive discounts on their medications when they enter the Donut Hole. In 2011, generics will be discounted by 7%, and brand-name medications will be discounted by 50%. These discounts are set to increase over the next nine years until there is a 75% discount on both generics and brand-name medications. To see a chart that depicts this Donut Hole phase-out click here.

Social Activity Correlated with Reduced Disability

Being active can help prevent disability, a recent study from Rush University Medical Center in Chicago shows. The study found that participating in social activities can help keep disabilities at bay.

Researchers studied 954 adults participating in the Rush Memory and Aging Project, with an average age of 82 years old.

When the study began, none of the participants had any disabilities. Each year, the participants had a physical exam and filled out a questionnaire about their social lives. The questionnaire asked how often they went out for meals, traveled, and saw friends and relatives. They were also asked if they could perform certain activities of daily living on their own.

The results showed that people who took part in a lot of social activities were twice as likely as people who did not participate in as many social activities to avoid disabilities that impacted their activities of daily living. They were also one and a half times as likely to avoid disabilities that impacted mobility. “The findings are exciting because social activity is potentially a risk factor that can be modified to help older adults avoid the burdens of disability,” said Bryan James, the lead researcher on the study, in a news release.

Read the full story here.

The above summary of the survey was provided by the Medicare Rights Center