Medicare Part D and MedAdvantage Plans

[NWBenefitProvider]

I hope this is a quick question.

Client I inherited from a group plan has just become Medicare eligible. He signed up for part A & B and we found him a local Medicare Advantage plan which includes part D coverage.

He just got a bill from Medicare for part A, B and D.

Does he really have to pay a part D premium to both the government and with his Medicare Advantage plan? I thought you could opt out and not pay part D premium to the gov. if your Medicare Advantage plan covered it instead. Please help!

 

[WCMason]

Sounds like it's IRMAA. Adjustment portion is paid to Feds. Premium portion to carrier. Adjustment still due even if premium is zero.

 

[Chazm]

He could pay more for his part D based on his income

 

[NWBenefitProvider]

If your income is high enough then you have to pay the higher amount to Medicare even if your part D coverage is covered under a Medicare advantage plan? Essentially pay for it twice?

Thanks.

 

[WCMason]

If your income is high enough then you have to pay the higher amount to Medicare even if your part D coverage is covered under a Medicare advantage plan? Essentially pay for it twice?

Thanks.

Yes. IRMAA--CMS-- doesn't care whether a Medicare beneficiary pays nothing for a drug plan that comes with an MAPD or a stand alone PDP. The IRMAA adjustment applies.

 

[NWBenefitProvider]

Ok, that answers it for me.

Thank you.

 

[DS4]

.
He just got a bill from Medicare for part A, B and D.

Probably just for Part B & D.
Very few people pay a premium for Part A.

 

[G.Gordon]

Good thread, most of us, including me, forget about income adjustments to part D.

 

[WCMason]

Just one of many little gifts in ObamaCare. ACA also removed the inflation adjustment to the IRMAA for Part B, ensuring that more people will be affected by it every year.

 

[DS4]

I had a senior(T65) last week with the following. He doesn't take any Rx's. Because he is still working(self) and making over 214k/year, his adjustment for Part D was going to be $66.40/month.
He declined to enroll in Part D. He understands the LEP.