Information from Norm Sherman, Florida CSARC SE Florida Liaison & Outreach Coordinator, 

Council of School Supervisors and Administrators (11/15)

1.  Medicare Open Enrollment Period

 

Because we are in the Medicare open enrollment period (October 15, 2015 to December 2015), you have been deluged with literature and TV commercials touting various Medicare Health Plans. These companies are trying to get people on Medicare to switch to their plan. Several members have asked me if they should consider changing to another plan. While I cannot advise you what to do, you should be aware of the following:

 

----As a CSA member, you are on original Medicare. The plans that are advertising are Medicare Advantage plans.

----Part A costs “0”

----Part B has a deductible of $147 and a premium. Under the MLC agreement, you get back the premium.

----Part D – prescription drugs – has no deductible. You pay for the plan out of your high option rider. There are co-pays.

If you think you have found a better Medicare plan and are contemplating switching to it, my advice is to first check with the CSA Welfare Office. What you think is better, may not be.

 

2.  How do the costs for 2016 Medicare Part B compare to those for 2015?

 As you know, you pay a monthly premium for Medicare Part B.  The cost is taken out of your Social Security check unless you do not receive Social Security. In that case, you will get a “Notice of Medicare Premium Due” and pay by check or through your bank’s online bill payment service.

 

2015

 In 2015, the standard payment for Part B was $104.90. However, if your income reported on your 2013 IRS tax return exceeds a certain amount, you paid a surcharge called Income-Related Monthly Adjustment Amount (IRMAA). The amount of the surcharge will depend on how large your income was. The good news is that the Office of Labor Relations reimburses both the standard amount and IRMAA

 

2016

 In 2016, the standard payment for Part B will vary. If your 2014 IRS tax return is less than $85,000 (individual) or $170,000 (joint) and you are on Social Security, you will continue to pay $104.90. However, your standard amount will be $121.80, if you fall in either of the following categories:

----You enroll in Part B for the first time in 2016.

----You don’t get Social Security benefits.

----Your modified adjusted gross income as reported on your 2014 IRS tax return is greater than a certain amount.

 

There is also an increase in the IRMAA surcharges.

 

In 2015, the deductible was $147. This is going up to $166 in 2016. After you have met your deductible, Medicare pays about 80% of the Medicare-approved amount for most doctor services (including those while you may be in a hospital as an inpatient, outpatient therapy, and durable medical equipment) and your plan (most cases GHI) pays the other 20%.

 

3. Home Health Aide

In the November CSA News, Doug Hathaway explains what I consider one the most necessary, but underused, CSA benefits: the Home Health Aide. This benefit was revised in 2015 and, after a $100 annual deductible, covers 80% of any additional home health aide expense up to $8,000 annually, $24,000 lifetime. In addition, the CSA Retiree Chapter will reimburse you an additional 15% of the amount you receive from the Welfare Fund.

This benefit can be spread over many years if you decide to use less than the $8,000 in a given year. Whatever is left will be rolled over to the lifetime maximum. For example, if you use only $4,000 in a given year, the other $4,000 will be rolled over, leaving you with $20,000 lifetime.

This benefit can be used in a hospital or rehab center as well as the home. Just remember:

----You must have a doctor’s prescription showing the need for the aide.

----You must use a certified aide.

----You should also keep a log of when the aide comes and goes, and pay only by credit card or check.

 

To collect the benefit, just send a copy of the bill, proof of payment and the certification to the CSA Retiree Welfare Fund.

Have a Happy and Safe Day...

Norm Sherman
Florida Liaison & Outreach Coodinator Retiree Chapter 
Council of School Supervisors and Administrators
Tel #: 561-638-6439
email: nshermzie@aol.com