Debbie Perlman Blog

Below is a warning issued by the Drug Enforcement Administration (DEA) on counterfeit prescription drugs coming into the States from Mexico that are causing fatalities. Beneficiaries who use pain medication should be especially aware of this warning. Also, we have a new fraud alert on Opioid Fraud and Abuse. Opioids have killed more than 47,000 people to date, and  2.1 million Medicare beneficiaries have an opioid disorder. This alert discusses what opioids are, what opioid fraud and abuse looks like and where to report it. DEA issues warning over counterfeit prescription pills from Mexico The Drug Enforcement Administration is alerting the public of dangerous counterfeit pills killing Americans. Mexican drug cartels are manufacturing mass quantities of counterfeit prescription pills containing fentanyl, a dangerous synthetic opioid that is lethal in minute doses, for distribution throughout North America. Based on a sampling of tablets seized nationwide between January and Mar...

Medicare is a valuable source of health insurance for people 65 and older, and making the transition from private health insurance involves some important decisions. These six steps can guide you through the process: 1. Enroll in Medicare Part B. Medicare’s Initial Enrollment Period lasts for seven months, beginning three months before you turn age 65. Most people automatically qualify for Medicare Part A (Hospital insurance) if they or their spouse paid Medicare taxes while working for ten years or more. However, Part B (Medical insurance) is voluntary and requires enrollment. Although there are special enrollment periods, delayed enrollment may result in a late fee with increased premiums and a gap in your health coverage. For 2016, the standard monthly premium for Part B is $121.80. While the “hold harmless rule” protects 70 percent of recipients from having their Social Security check lowered from one year to the next, Part B premium may increase to $149 in 2017 for weal...

Enrolling in a Medicare plan is a big decision. While you’re able to switch plans each year if you’re unhappy (in some situations more frequently) you still want to choose the best plan for your needs the first time. This means taking your out-of-pocket costs into consideration along with other factors. Medicare covers a wide range of medical services, but most are not free. Here’s what you should expect to pay out-of-pocket throughout the year if you’re enrolled in a Medicare Advantage/Part C plan. Premiums Premiums are the amount you pay each month out-of-pocket for your Medicare Advantage (MA) plan. The estimated average monthly MA plan premium for 2019 is $28, this cost may vary significantly. Some could be $0, while others could have premiums over $200. To join an MA plan, you must also be enrolled in Medicare Parts A & B. It’s important to remember that Part B has a separate premium that you are responsible for paying even if you enroll in a Medicare Advantag...

White House chief of staff Mick Mulvaney wants to see if the Medicare chief Seema Verma and the health secretary, Alex M. Azar II, can still work together. The acting White House chief of staff has summoned President Trump’s top two health policy officials to the White House on Thursday to assess whether the president’s health secretary and his Medicare chief can continue to work together, a senior administration official confirmed on Tuesday. White House aides said President Trump is still standing by his embattled administrator of the Centers for Medicare and Medicaid Services, Seema Verma, amid reports that she had requested that taxpayers reimburse her $47,000 for property stolen on a trip, including jewelry priced at more than $40,000.  But her feud with Alex M. Azar II, the health and human services secretary, has reached the president’s desk and the attention of the acting White House chief, Mick Mulvaney. For now, Mr. Trump is not expected to at...

A few years ago, my neighbors were in a car accident. Nothing too serious, thank goodness. They were, however, out of commission for a few weeks. As both were in their 80s and neither one able to drive during recovery, they needed home care – and a little extra help around the house. It’s important to plan for your health care needs, but sometimes life throws unexpected curve balls. And when that happens, you’ll need to know what’s covered.   Fortunately, there are ways you and your loved ones can get the necessary care at home. Here’s what you need to know. What’s home health care? It’s a range of health care services given in your home for an illness or injury. Things like: Covered by Medicare Skilled Nursing care (when given on a part-time or intermittent basis) Medical social services (counseling, help finding community resources) Medical supplies (wound dressings) Necessary durable medical equipment (walker, wheelchair, hospital bed) Physical, occup...

Like the first tree to turn color in the fall, the Annual Notice of Changes is the first sign of the season – open enrollment season, that is. Reviewing and understanding this important document is the first step in making sure you get the coverage you need from your Medicare plan next year. 1. What is it? If you have a Medicare Advantage, Cost or Drug plan, the Annual Notice of Changes (ANOC) tells you about changes to your current Medicare plan benefits and costs that will take effect Jan. 1. Not sure what plan you have? Check out the bottom of this post for resources. Changes to premiums, covered services and costs You should see a side-by-side before and after listing of services and costs. Depending on your Medicare plan, these may include: Premium (the amount you pay each month) Deductible (the amount you pay before your plan kicks in) Copay (a flat fee that you pay for each service) Coinsurance (as opposed to a flat ...

Recently, my mom fell and broke both her wrists. Between the trip to the ER, X-rays and follow-up visits, the cost of her health care really added up. Thankfully, her Medicare plan had a medical out-of-pocket maximum that limits the amount she has to spend each year.  Once she hits her out-of-pocket maximum, her plan covers all the costs for her medical care. She’s financially protected, even if she has another unexpected or expensive health care need. That’s why an out-of-pocket maximum is so important for people with a Medicare plan, especially those living on a fixed income. What is an out-of-pocket maximum? This is the limit on how much you might pay for medical care through copays and coinsurance in a year. Some people never get enough health care to hit their out-of-pocket maximum.  Think of your out-of-pocket maximum like a bucket. Every time you spend your own money on medical services or care, it goes into the bucket. Once the bucket is fu...