Annual Medicare Enrollment Period has Arrived
Monday, 14 October 2019
EDITORIAL NOTE: This is so far from comprehensive as to be a joke but I hope it will give you an overview of the basics of Medicare and how they apply in the annual enrollment period.
Because this post is longer than usual, I've used bolding and lists to make it easier to navigate and get to the sections that interest you most.
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It's that time again – Medicare Annual Open Enrollment begins tomorrow, 15 October, and lasts through 7 December. During this period of 54 days you can:
⏺ Switch from traditional Medicare to Medicare Advantage (MA)
⏺ Switch from Medicare Advantage to original Medicare
⏺ Select a different Medicare Advantage plan if you have one now
⏺ Enroll in a Part D prescription drug plan
⏺ Change to a different Part D plan if you already have one
If you are new or newish to Medicare, it can be daunting. Medicare is a massive program and I'm pretty sure that even people who are certified to help the rest of us figure it out don't know all of it.
In that regard, there is a short list of links at the bottom of this post for more detailed or personalized information.
Here are the various Medicare parts:
Part A: Part of traditional Medicare, it covers hospital and hospice care along with some skilled nursing services after a hospital stay. There is no premium for Part A.
Part B: Part of traditional Medicare, it covers doctor visits and certain outpatient services. The Part B premium is deducted from your monthly Social Security payment and will be about $144.30 in 2020, up from $135.50 in 2019. The exact amount has not been announced yet.
Parts A and B constitute traditional Medicare. You may choose any doctors who accept Medicare.
Part C: Medicare Advantage (MA), issued by private insurance companies, is required to include traditional Medicare Parts A and B (at the same premium as traditional Medicare) and often includes Part D along with limited coverage for vision and dental care, for example.
MA takes the place of traditional Medicare. (Some companies charge no premium.) You are restricted to their network doctors.
Part D: Helps pay for prescription drugs. Part D is private coverage for which you pay a separate monthly premium if you have traditional Medicare.
Medigap: Also called Medicare Supplemental, is private coverage that helps pay for what Medicare does not, such as co-payments, co-insurance and deductibles. Restrictions apply as to who can buy Medigap coverage and when.
MEDICARE AND YOU HANDBOOK
The Medicare and You Handbook has many explanations and answers. You can download an electronic copy online. There is a wide choice of editions: PDF, large-print PDF, ebook for your Kindle, iPad, etc. You can also telephone to have a CD audio version, a Braille version or the paper edition mailed to you.
The telephone number is 800.633.4227 or visit the webpage.
This booklet is well organized, clearly written and as easy to use as anything related to Medicare can be.
The official Medicare website is at medicare.gov. Check the dropdown menus at the top of the page for many specific questions.
If you have not signed up for My Medicare which personalizes the Medicare website for you, you can do that on this page. It can help a lot.
When I signed in to My Medicare to check my Part D coverage a couple of days ago, all my current prescriptions were already listed for me – names, dosages, quantities for each refill, and frequency of refills. All of it was correct.
If any of my prescriptions had changed, this is were I could edit them or add and subtract drugs as needed.
In my state, there are 28 Part D plans available, most with a deductible. With just a mouse click, I could see details of each plan and select up to three-at-a-time to compare with one another and check that my drugs are still covered.
That's important. It can change from year to year and, of course, each company's formulary is unique to it.
A recent mailing from that plan advised me that if I wish to continue for 2020, I don't need to do anything. My plan will roll over to next year.
You can also check drug prices of plans at several pharmacies near you and at mail-order pharmacies.
It took me about two hours to work through all the information and make my choice. I use seven prescription drugs. If you have more, it will take longer but the interface makes it relatively easy with one caveat: the plan finder is newly updated and may contain some glitches.
The above applies only to Part D in connection with traditional Medicare. If you have Medicare Advantage or are switching to it, you're on your own. MA is a mystery to me but Medicare's MA Plan Finder works similarly to the Part D Plan Finder.
PERSONAL SUGGESTION NO. 1: If you do not use any prescription drugs, choose the least expensive plan. Since there is no way to predict what might go wrong and therefore what drugs you would need, nothing else makes sense.
When I was diagnosed with cancer and began using prescription drugs, there was one not covered by my plan. Fortunately, it was not too expensive but in the next enrollment period, I chose a Part D plan that covered all my drugs.
(Yes, it is a stupid idea to make people choose a plan when they don't know what they will need it for. Complain to your representatives in Congress.)
PERSONAL SUGGESTION NO. 2: I was prescribed a new inhaler this year. When I was told my part of the price, I nearly passed out – about $500 per month. I told the pharmacist that was out of the question and prepared to see what else the doctor could recommend.
But the pharmacist told me that drug companies will reduce the price considerably in many circumstances, that I would need a declaration signed by my physician and that they, the pharmacy, would take care of all the paperwork.
In less than a week, the drug company approved me and the price dropped to just over $100. So if the price is high, ask what can be done. Pharmacists are well informed and helpful.
WHAT'S NEW IN MEDICARE FOR 2020
Medicare Advantage may now cover such items grab bars, rides to and from medical appointments, acupuncture, massage therapy and more. They are offered at the plan's discretion and only for certain health conditions. This applies only to Medicare Advantage and not to traditional Medicare.
At last, the Medicare Part D doughnut hole (coverage gap) goes away completely in 2020. However, the new limit for out-of-pocket expenses increases from $5100 in 2019 to $6,350 in 2020. Part D plan members will now pay 25 percent of the cost of generic and brand name drugs. Once you have reached that $6,350 threshold, you pay five percent of a drug's cost.
WHERE TO FIND PERSONALIZED MEDICARE HELP
You can get personalized help as you ponder your open enrollment decisions.
Medicare.gov has an online chat feature available during open enrollment, and the Medicare hotline, 800-MEDICARE (800-633-4227), is open 24 hours a day, seven days a week during the annual enrollment period.
SHIP (State Healthcare Insurance Assistance Program)
These state-based organizations offer help with Medicare questions, including your benefits, coverage, premiums, deductibles, and coinsurance along with help for joining or leaving a Medicare Advantage Plan, any other Medicare health plan, or Medicare Prescription Drug Plan (Part D).
Locate a SHIP representative in your state here.
Another SHIP list by state from Seniors Resource Guide. This list is up to date as of October 2019.
The wonderful Ronni Bennett put a great "intro to Medicare" guide on her blog "Time Goes By." Very helpful.
by Bridget Small
The Truth About Forced Arbitration -- the real story emerges from data from the arbitration companies themselves
Forced arbitration is a rigged system designed by corporations in which injured workers and consumers have no meaningful chance of finding justice.
Forced arbitration requires Americans to “agree” to surrender fundamental constitutional rights – often without ever realizing they’ve done so.
When corporations harm workers and consumers by cheating, stealing, or even breaking the law, cases that should be heard by a judge or jury are instead funneled into a secret system controlled by the wrongdoers in which there is no right to go to court, no right to a jury, no right to a written record, no right to discovery, no transparency, no legal precedents to follow, no opportunity for group actions when it would be too difficult or costly to file a claim alone, no guarantee of an adjudicator with legal expertise, no transparency, and no meaningful judicial review. Without such checks and balances, the deck is stacked heavily against workers, patients, and consumers, and systemic misconduct is allowed to continue in secret.
Forced arbitration’s proponents counter that the process is faster, fairer, and better for workers and consumers than going to court. However, this comprehensive analysis of the self-reported data provided by the arbitration organizations makes clear that forced arbitration is not an alternative judicial process, but instead eliminates claims, immunizes corporations, and allows abuse, discrimination, fraud, and essentially all other corporate wrongdoing to go unchecked.
Americans are more likely to be struck by lightning than they are to win a monetary award in forced arbitration.
Click on the image to get a copy of the full report or download it here.
Another good story explaining why YOU should submit your comments on the CFPB's new debt collection rules by 18 September
How Collectors Trick Consumers into Reviving Dead Debts
Source: The Washington Post
Debt collectors are not allowed to sue on old debts that have expired. These debts are so old that there is often little or no proof showing who owes the debt and how much is owed. The most common complaint about debt collectors is that they harass consumers for debts that the consumers do not owe. And debt collectors are finding new ways to exploit loopholes and trick consumers into reviving zombie debts.
Oklahoma social worker and mother of five Terrie Raymer was one victim of the collections industry's new tricks. A debt collector garnished 19 cents from Raymer's paycheck and later sued her, claiming that the 19 cent garnishment had brought the debt back to life.
Another collector fooled consumers with zombie debts by offering them new credit cards, but then enrolling them into a repayment program for their old debts without their permission.
The Consumer Financial Protection Bureau has proposed a new rule that would loosen the standards for debt collectors who sue on old debts by allowing them to argue they did not know the debt was expired. Read More.
YOU can help stop zombie debt collection
The Consumer Financial Protection Bureau has extended the comment period for its (terrible) proposed rule on debt collection to
September 18, 2019.
You can submit your comment through NACA's convenient portal to tell the CFPB that consumers need better protection from unfair zombie debt collection.
NACA is also collecting signatures on a petition that will be submitted to the CFPB. Sign and share the petition so we can show the CFPB that consumers want better protection from abusive debt collection tactics.
Wells Fargo tries to send Innocent Pastor to Jail, Then Insists Pastor Should be Forced to Arbitrate Claims Against Wells Fargo
If there was ever a case that showed exactly how forced arbitration encourages and promotes corporate misconduct and arrogance, this is it. A pastor wrongly accused of theft because of Wells Fargo's screwup simply asks for an explanation and for Wells to pay his legal fees, fees he was forced to incur solely because of Wells and its screwup.
Wells tells him to go fly a kite, "apologizing" but refusing to cover his legal bills. And now Wells is trying to hide the case behind the stone wall of forced arbitration, where the judge of the case (the private arbitrator) is literally on Wells Fargo's payroll.
Starting in the 1970s, a series of radical decisions by the US Supreme Court tossed out the 70 years of precedent barring forced arbitration in employment and consumer cases. Since then, we've seen the entire civil justice system in America has essentially been gutted by these forced arbitration clauses in consumer and employment cases. Corporations use these clauses to cover up when they lie, cheat and steal, and arbitration protects outrageous criminal conduct by corporations by keeping others harmed in the same ways of having any ability to even know that others are fighting the same fight.
Forced arbitration is the end of any concept of Equal Justice Under Law in America, and its use is a huge part of the reason that while most Americans are struggling to keep up, the richest of the rich are becoming even richer without bounds.
The Oregon Insurance Commissioner's office sent this around.
I say whether you meet with an insurance agent or not is up to you, but having a reasonably accurate home inventory in this day of cell phones is really, really easy and quite worthwhile. Just go through your house, take photos of every room from every angle with cupboards and drawers open.
And when you have any particularly valuable item, take several pictures of the item that shows its condition, and also take a picture of the purchase receipt or appraisal. Turn the date/time stamp on with your phone so that it's recorded on each photo.
Back up all these photos up to the cloud and to a thumb drive kept in your safe deposit box or at a friend's house (or in a fire safe).
Why should you do this? Because the insurance company will turn on you like a rabid dog when you suffer a significant loss -- you're no longer their valued policyholder at that point, you're a suspected thief whose word is absolutely not to be trusted (that's how they see it).
Normal people who haven't suffered a big loss are shocked when they find that their formerly oh-so-friendly insurance company (who has been happily taking their premiums all these years) turns sociopathic and paranoid and accuses them of inflating the losses and starts demanding documentation and proof of ownership for every item in the home. Insurers hire battalions of adjusters and train them on how to settle claims for less than they're worth.
Worse, the insurance companies are so rich and powerful that they make banks look like sandlot ballplayers, and most people who have not experienced the ordeal of trying to get fair treatment from an insurance company after a total loss are devastated by the second disaster (the first one is the fire or flooding, the second one is the way the insurers treat insureds if those insureds cannot prove every detail of every bit of every claim).
Essentially, the insurance companies win by shorting policyholders on damage payments, and the whole time while they do it, they are constantly issuing reminders that it's a crime to commit insurance fraud.
Meanwhile, they are all-but unregulated, as they bought themselves immunity from the Oregon Unlawful Trade Practices Act, the statute that lets consumers hold businesses responsible for misconduct in the marketplace. So their conduct isn't even illegal -- it's just what they do.
It's kind of like the situation with campaign finances -- the scandal isn't what's done that's illegal, the scandal is what they do that's perfectly legal. And that you have no very little recourse. The only solution I know of is to hire a lawyer so that you do not have to deal with an insurance company yourself if you have any kind of serious loss -- it's like being fed into a meat grinder if you don't have someone to advocate for you and make the insurance company do what it's supposed to under the contract and the the laws.
I'm not trying to drum up business here, I don't do that kind of work. But that's the advice I would give any family member in any state who suffers a substantial loss. In other words, the best way to prevent disputes with your insurance company after a loss is to first call a good lawyer who is experienced in insurance claims disputes before you call your insurance company.
What is the Military Lending Act and what are my rights?
The Military Lending Act (MLA) is a Federal law that provides special protections for active duty servicemembers like capping interest rates on many loan products.
What are my rights under the MLA?
Answer: The MLA applies to active duty servicemembers (including those on active Guard or active Reserve duty), spouses, and certain dependents. It limits the interest rates that may be charged on many types of consumer loans to no more than 36% and provides other important protections.
Go to the CFPB website for the full Military Lending Act flyer
Or click below to download the flyer so you can share it with others.
If any business seller tries to make you sign something where you agree not to post a negative review, make sure you get a copy of the agreement (then call me)
REMEMBER: Federal law prevents businesses from sticking fine print into their contracts that prohibits you from writing or posting a negative review of the business! (The Consumer Review Fairness Act (“CRFA”) became law in March 2017.)
The Federal Trade Commission recently slapped three companies who had form contracts that said the consumers could not post negative reviews about the products or services from the businesses. Worse, these form contract also had confidentiality clauses -- those said that the consumers would PAY money damages to the businesses if the consumers disclosed information they got while using the products or services was confidential.
Good Washington Post Article on How Car Dealers Rip You Off with Financing
Ian Ayres is the William K. Townsend professor at Yale Law School.
As websites such as Cars.com and TrueCar have made car pricing more transparent, auto dealers have turned to boosting their profits with hidden fees on loans.
When a consumer chooses in-house financing with an auto dealer, the dealer sends the customer’s financial information to a lender and is told the rate that the customer qualifies for. But it’s legal for the dealer to turn around and charge the customer a higher interest rate. You might qualify for a 5.9 percent interest rate, but if the dealer can get you to agree to a loan at 11 percent, the lender will kick back more than $1,000 to the dealership as pure profit. This discretionary markup of the interest rate allows auto dealers to arbitrarily increase their fees.
An analysis by the independent online auto-loan marketplace Outside Financial has found that dealers are charging an average markup of $1,791 per loan. By contrast, in 2003, Vanderbilt University economist Mark Cohen estimated that 10 percent of loans to Nissan’s borrowers were marked up more than $1,600. Now the average loan is boosted more than that.
. . .
Economists have had evidence for decades that car dealers tend to charge minorities higher prices. A series of studies I authored and co-authored in the 1990s found that auto dealers consistently charge black consumers prices that are hundreds or thousands of dollars more than their offers to white shoppers. These inflated prices can more than double the dealer’s profits compared with selling the same vehicle to a similar white customer.
. . .
The CFPB and other government agencies should be on the lookout for ways to better curtail dealership lending abuses. Yet instead of stepping up enforcement and protecting customers, the CFPB has rolled back rules on discriminatory lending practices and decreased enforcement of existing protections. Just last year, the Senate used the Congressional Review Act to overturn a CFPB rule that explicitly banned auto lenders from charging discriminatory fees on the basis of race. . . .
Groups like the US Chamber of Commerce spend extraordinary sums of money on hired hack "scholars" whose mission is to produce propaganda that paints class action lawsuits in a bad light. Their goal is to destroy the class action form of lawsuit, so that their corporate backers can rip people off by the thousands and tens of thousands and not have to pay a price for it.
A recently concluded (after 8 years) huge Oregon class action shows the truth, which is 180 out from the Chamber propaganda.
The truth is this:
July 16, 2019 In Blog
John Gear is a Salem attorney in solo practice