If you live anywhere in the US, you have watched prices rise over the last year. In October 2021, the inflation rate was reported to be a whopping 6.2%, up year over year from just 1.2% in 2020. This impacts every facet of life, from the price of gas to grocery basics—and healthcare is no exception.
The Centers for Medicare and Medicaid announced on November 12, 2021, that Part B premiums will increase by 14.4% to a total of $170.10 per month; this translates to an additional $21.60 per month, and an additional $259.20 per year.
While Medicare beneficiaries who are receiving Social Security benefits will see a 5.9% cost of living adjustment in 2022, this Part B premium increase will take up a good part of that increase—and consumers, many living on fixed incomes in retirement, will feel the impact.
What is Part B?
Medicare Part B is sometimes called “Medical Insurance.” It helps cover services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services, including certain vaccines and cancer screenings.
Most people need to enroll in Part B, through Center for Medicare and Medicaid Services, when they turn 65. Only people who have health insurance from their (or their spouse’s) current employer may be able to delay.
Everyone pays a monthly premium for Part B. If you get Social Security or Railroad Retirement Board (RRB) benefits, your Part B premium is automatically deducted from your benefit payment. The premium varies depending on your income and when you enroll in Part B, but most people will pay the standard premium amount. In 2022, this amount will be $170.10 per month, as mentioned above.
Offsetting the premium increase
While there’s nothing you can do to change that Part B premium amount, you may be able to find a Medicare Advantage plan with a Part B premium credit that will offset a portion of this cost. That means the plan pays you back each month to help with the cost of your Part B premium.
If you’re looking for a Medicare Advantage plan with a Part B premium credit, research your options and corresponding monthly credit amounts; they vary by plan. But here are a few more things you may want to consider as you weigh your options:
PPO or HMO?
These plan types are both great options. But it’s helpful to know the difference.
A preferred provider organization (PPO) plan gives you a financial incentive to select providers within the PPO network. That’s because the health insurer has negotiated contracts with PPO network providers to provide health services at discounted costs. You can go outside of the network for care, but you’ll pay more.
- You don’t have to choose a PCP, although selecting one can help you coordinate care and help make sure your health care needs are taken care of.
- You don’t need a referral to see a specialist, but you’ll have to make your own appointments with specialists and other health care providers.
Health maintenance organizations (HMOs) of today aren’t like the HMOs of the past. Some HMOs have a point of service (HMO-POS) option as well.
Most HMOs provide care through a network of doctors, hospitals and other medical professionals that you must use to be covered for your care. With an HMO-POS you can go outside of the network for care, but you’ll pay more.
- You’ll need to choose a primary care physician (PCP) to coordinate all your care.
- You typically don’t need a referral to see a specialist, but your doctor can sometimes help you get in to see one more quickly.
Cost and network
$0 premium plans dominate the Medicare Advantage market. And many of those come with $0 copays for primary care provider visits, $0 virtual care, $0 labs and more. Look for plans that reduce your out-of-pocket costs with $0 copays for routine care.
Your “MOOP”—or maximum out-of-pocket cost—matters too. This is the most you’ll pay for medical services. Plans with low MOOPs give you some security and peace of mind, knowing that you won’t spend more than that fixed amount for medical services.
But low costs are only as good as your network. Before you jump to a super low-cost plan, make sure your doctors and preferred healthcare facilities are in network; this will help you avoid frustration and unexpected costs down the road.
Prescription drug coverage
Lastly, not all Medicare Advantage plans are created equal. Some include Part D (prescription drug) coverage, and some do not. Maintaining a consistent medication regiment, if you have one, is important to your health—especially if you’re managing a chronic condition.
If you have one or multiple prescriptions, consider choosing a Medicare Advantage plan with Part D coverage. And double-check to make sure your prescriptions are on the health plan’s Approved Drug List or formulary before enrolling.
Meet PriorityMedicare VitalSM
PriorityMedicare Vital is the only $0 premium Medicare Advantage PPO plan in Michigan with a Part B credit and prescription coverage. With PriorityMedicare Vital, members will get $360 back in 2022 ($30 monthly Part B premium credit) plus access to an open network, no referrals required, and a low $4,700 out-of-pocket maximum. Available in most of the lower peninsula, this plan also includes extras like a $40 quarterly over-the-counter allowance, dental, vision, hearing and robust travel benefits.
Learn more about PriorityMedicare Vital or other Priority Health plan options.
Need help? Give us a call at 888-481-1348 (TTY 711).We’re available from 8 a.m.– 8 p.m., seven days a week.
