2016 Benefit Changes

There are several 2016 benefit changes of which you should be aware.

Increased Out of Pocket Expenses

Medicare D (the prescription portion of the Medicare program) anticipates that individuals will be paying approximately 13% more out of pocket for their prescriptions than they did in 2015. I recommend using one of the drug calculators to get an approximate cost to you for your prescriptions in 2016.  Both Medicare and AARP have calculators which are fairly easy to use.

Other health insurance plans are increasing their patient deductibles.  The shift in paying for health care is definitely focusing on the patient being responsible for larger portions of their medical bills. Become familiar with your premium obligation, co-pay, and deductibles in advance of having to utilize your health insurance benefit.

2016 Benefit Changes in Federal Programs

There are 2016 Benefit Changes in both Medicare and Social Security.

Medicare: The previously anticipated 52% premium increases for Medicare B in 2016 has been adjusted to approximately 15%, effective January, 2016. This increase will continue to apply only to those not covered by the “hold harmless” provision for those currently enrolled in Social Security and Medicare.

Social Security:

The good news: additional funding has been allocated for Social Security disability claims.

The most significant change in Social Security benefits is with eligibility for the “file and suspend” option and for restricted application to collect only a spousal benefit. The “file & suspend” option allows an individual who has reached full retirement age to file for  Social Security benefits and then suspend them up to age 70. This results in an 8% additional benefit for every year of the suspension. The individual’s spouse and dependent children are also entitled to benefits based on his/her work record.

If you reach full retirement age by the end of 2015 you may file & suspend with spousal benefits until April 20, 2016. If you turn 62 in 2016 or later, you will be eligible for either a spousal benefit or a benefit based on your work record: whichever is higher.

I recommend that you contact your local Social Security office or discuss your personal situation with your financial planner or accountant.

Understand your 2015 Benefit Changes

I am not aware of any health insurance plan which doesn’t have some changes for 2016: premium increases, changes in prescription drug coverage, limitations on providers in the network, additional out of pocket responsibilities.  Make sure you find some time to review your health insurance and Social Security benefit options before the end of the year, so that you are aware of your specific coverage options.

Still not sure what to do next? Please contact me to discuss your specific questions in greater detail.

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