Centers for Medicare and Medicaid Services

Posted October 15th, 2019 in Producers, Individuals
The Centers for Medicare & Medicaid Services (CMS) recently announced plans to pilot healthcontingent wellness programs in the individual market, a practice that has been previously prohibited. However, the Affordable Care Act (ACA) included a provision calling for health-contingent wellness programs to be tested in the individual market, and that time has now come.   
 
Posted April 23rd, 2019 in Producers, Employers, Individuals

Each year, the Centers for Medicare and Medicaid Services (CMS) adjusts the cost sharing limits for the standard Medicare Part D plan. Earlier this month, CMS announced the adjustments for 2020. Below is a summary of the adjustments for next year:

Posted October 17th, 2018 in Producers, Individuals

Each year, the Centers for Medicare and Medicaid Services (CMS) adjusts the premiums and out-of-pocket expenses for Medicare beneficiaries. Below is a summary of the 2019 costs.

Premiums

Part A: Most individuals don't have to pay a premium for Part A, however, those that do will generally have to pay $437 per month in 2019. This is an increase from $422 in 2018.
 

Posted October 9th, 2018 in Employers, Producers

Each year employers must provide a written notice to Medicare-eligible employees who are covered under their group health plan. The notice must include information about the creditable coverage status of the prescription drug benefit. In other words, the notice tells employees if the prescription drug benefit on the group health plan is at least as good as the standard Medicare Part D plan.

Posted February 13th, 2018 in Producers, Employers, Individuals

Happy Fat Tuesday! Much like the paczki, we will soon be without a "donut hole"- for Medicare Part D. The donut hole, also known as the gap in Medicare prescription drug coverage, will close a year earlier than expected as a result of a budget deal signed by President Donald Trump this past Friday. The donut hole will now close in 2019 instead of 2020.

Posted January 16th, 2018 in Producers, Employers, Individuals
In a letter sent to state Medicaid Directors on Thursday, the Trump Administration announced that it would allow states to impose work requirements to qualify for Medicaid. States will have the flexibility to design their work requirement eligibility structure, but they must submit details to the Centers for Medicare and Medicaid Services (CMS) for approval. 
 
Posted October 3rd, 2017 in Producers, Employers, Individuals
Each year employers must provide a written notice to Medicare-eligible employees who are covered under their group health plan. The notice must include information about the creditable coverage status of the prescription drug benefit. In other words, the notice tells employees if the prescription drug benefit on the group health plan is at least as good as the standard Medicare Part D plan. 
 
Posted September 19th, 2016 in Producers, Employers, Individuals
Employers must provide a written notice on an annual basis to any Medicare-eligible individuals who are covered under a group health plan that includes prescription drug coverage. The notice is required to include information as to whether the prescription drug coverage is considered to be creditable. In other words, is the prescription drug coverage at least as good as the standard Medicare Part D plan? 
 
Posted November 20th, 2015 in Producers, Employers, Individuals
The Centers for Medicare and Medicaid Services (CMS) has released premium and cost sharing information for Medicare beneficiaries in 2016.  Approximately 70% of individuals will pay $104.90 per month for Part B, however, the premium cost will be higher for the remaining 30% of individuals who:
 
  1. Enroll in Part B for the first time in 2016; or
  2. Those who don’t currently receive Social Security benefits; or
  3. People who have Medicare and Medicaid, and Medicaid pays the Part B premium; or
Posted October 14th, 2015 in Producers, Employers

The 2016 Medicare Part D annual enrollment period will begin on October 15, 2015 and run through December 7, 2015. Medicare beneficiaries can enroll in a Part D drug plan or make changes to existing coverage during this time period. Enrollment can be done through a stand-alone drug plan or a Medicare Advantage plan that integrates coverage for medical and drug expenses.      

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