September Medicare Must-Knows

By RetireMEDiQ

RetireMEDiQ strives to keep individuals informed about the latest Medicare news. Each month, we recap the top information consumers need to know about recent developments in the Medicare industry and how it may affect you.

New Short-Term Health Insurance Plan Options

There will be more new options for short-term health coverage for pre-65 retirees and their spouses, available in 2019. The Trump administration has removed the current three-month limit on short-term health plans that was enacted by the Obama administration. The plans will last up to a year, and individuals will be able to renew these plans for up to three years.

This coverage will be less expensive and less comprehensive than current short-term plans. Short-term plans are cheaper partially because carriers can choose not to cover individuals who have pre-existing conditions, and they also typically cap coverage.

Trump’s health department expects 600,000 will enroll in these plans in 2019, with a projected 1.6 million people to eventually enroll.

Medicare Approves Step Therapy for Medicare Advantage Plans

The Centers for Medicare and Medicaid Services (CMS) recently announced that Medicare Advantage (MA) plans will be permitted to use step therapy. Medicare Part D Prescription Plans are already able to use these programs.

The San Diego Tribune defines step therapy as “the term used when a health insurance company forces doctors to prescribe the cheapest medication first, providing access to more expensive alternatives only if the first option doesn’t get results.”

CMS’s proposal includes some protection for patients, including limiting step therapy to new medications. This means that MA plan members with a prescription that is not preferred in the step therapy program may not be required to switch to the newly preferred drug.

MA plans that choose to implement step therapy programs are required to notify their current members of the change. If you have questions about your current plan and how step therapy might affect you, please call RetireMEDiQ’s Client Services team at 1-877-222-1942.

New Medicare Cards Will Arrive Soon!

You may be aware that Medicare has issued new Medicare cards to enrollees. This card will include a unique Medicare number, instead of your Social Security number, in an effort to help protect your identity. Your new card will look like the sample below.New Medicare Card

If you reside in Indiana or Pennsylvania, your new Medicare card has been mailed, and you should already have received it. If you live in one of these states and have not received your new Medicare card, please call Medicare at 1-800-633-4227.

If you live in Ohio or Kentucky, your card will be mailed to you soon. If you are interested in receiving an email when you card has been mailed, visit Medicare’s website.

Please note that your new Medicare card is free. If someone calls you and tells you that you must pay in order to receive your new Medicare card, it is a scam. Medicare is asking that beneficiaries throw away your old card when you receive your new card.

2019 Social Security Cost-of-Living Adjustment Predicted to Top 3%

Next year’s cost-of-living adjustment (COLA) is expected to be the highest increase since 2012. The 2018 COLA was 2%. In 2017, it was 0.3%, and in 2016 there was no increase. The 2019 COLA will be announced in October.

According to Investment News, an increase of 3% “would boost the average Social Security benefit of $1,404 per month in 2018 by $42 per month next year and increase the maximum benefit of $2,788 per month for someone retiring at full retirement age in 2018 by about $85 per month in 2019.”

While this increase appears to be substantial, household expenses are growing significantly faster than 3%. A survey by The Senior Citizens League found that “total out-of-pocket medical expenses grew by about 10%. The price of typical grocery items such as potatoes, tomatoes, oranges and eggs all increased by 10% or more last year, and the cost of home heating oil soared by 22%.”

Retiree costs have consistently grown faster than the COLA for nearly a decade, and we expect this to continue in 2019.

Differences in Your Medicare Annual Notice of Change (ANOC)

While Annual Notices of Change included Evidence of Coverage in the past, the Centers for Medicare and Medicaid Services (CMS) announced that this year, you will still receive your ANOC in the mail, but it will no longer include the Evidence of Coverage. However, if you are interested in reviewing it, you can request it from your insurance carrier.

Medicare Limits Initial Opioid Prescriptions to Maximum of 7-Day Supply

CMS announced in its 2019 Call Letter that in order to reduce potential chronic opioid use or misuse, Medicare Part D carriers must “limit initial opioid prescription fills for the treatment of acute pain to no more than a 7 days’ supply.”

2019 Medicare Plans and Benefits to Be Released in October

Medicare plans for 2019 will be released to the public next month as the Annual Enrollment Period begins on October 15 and ends December 7. As we’ve mentioned in previous Medicare Monthly Must-Knows, these plans are predicted to be strong and as good, if not, better than in 2018. This means that the only reason for you to consider a different Medicare plan for 2019 is if your needs have changed. If you are enrolled in a Medicare plan and are happy with it, we recommend you stay on your current plan for 2019.

We’d Love to Hear from You!

If you have questions about anything covered in this post, please comment below, call our Client Services team at 1-877-222-1942 or email us at

If you are not yet a RetireMEDiQ client and have questions about what these changes may mean for you as you approach retirement, contact our team of licensed Benefit Advisors at 1-866-600-5638.

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