Medicare & Individual

Employers who provide prescription drug coverage to those who are or may become eligible for Medicare Part D, must notify both plan members and CMS on whether the coverage provided is deemed “creditable” or “non-creditable” per the MMA Act of 2003. Creditable coverage means the prescription drug plan is at least as good as the Medicare drug benefit. Read more
On July 17, 2019 the IRS issued guidance expanding the preventive care benefits that can be provided by a high-deductible health plan (HDHP) and remain qualified for HSA eligibility. Ordinarily the HSA rules do not allow for preventive care for services or benefits intended to treat existing illnesses, injuries, or conditions. The new ruling allows for certain conditions to have coverage with no-deductible or below the HSA deductible limits. The Treasury Department and ... Read more
The government provides minimum coverage under original Medicare (Parts A & B).  Patients enrolled in Medicare alone are at risk for large medical bills with no maximum out-of-pocket protection for covered expenses.  One solution for protecting from these out-of-pocket expenses is to purchase additional insurance commonly referred to as “Medigap”, or a Medicare Supplement policy from a private carrier.  The chart below outlines the standard... Read more
President Trump signed an executive order on June 24, 2019 directing federal agencies to increase healthcare price and quality transparency. The order directs the Departments of Labor, Treasury and Health and Human Services to issue guidance and propose regulations that would disclose negotiated rates, cost-of-care and de-identified federal healthcare data, and to expand the availability of Health Savings Accounts.   The order includes the following five main provi... Read more
On June 13, the U.S. Departments of the Treasury, Labor, and Health and Human Services issued a final rule allowing employees to use the dollars in employer-funded Health Reimbursement Arrangements (HRAs, also called Health Reimbursement Accounts) to purchase individual coverage both on and off the public Marketplace (or Exchange). The rule also creates a new excepted benefit HRA (EBHRA) to enable employees to be reimbursed for excepted benefit costs. Individual Covera... Read more
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