Page 55 - November 2022 Issue.indd

SHIP assistance is free! One of our services is to perform your
annual “D” “checkup” to insure you are getting the best bang
for your buck each year, so call today! SHORE MEDICARE SOLUTIONS LLC
Speaking of bang for your buck, there is great news for Marti Wright • Owner

Medicare Benefi ciaries! The standard monthly premium for Independent Insurance Broker
Part “B” in 2023 is going down to $164.90, a decrease of $7
from the 2022 rate, for those whose Annual Individual Income Over 25 Years Experience with
is less than $97,000! This rate of $164.90 per person also Medicare Supplement Insurance

applies to those filing a joint tax return showing a household
income less than or equal to $194,000. Additionally, the Part Phone: (410) 443-1169
“B” deductible is also dropping $7 for all Medicare recipients Email: shoremedicaresolutions@gmail.com
to $226 for 2023!

The reason for this is twofold. The $170.10 2022 premium

included a “contingency margin” to cover “B” spending on
the Alzheimer’s drug Aduhelm. In a nutshell, this IV infusion
drug is limited to use on very early-stage patients with mild
dementia whose specified PET & MRI scans showed plaque

deposits in the brain. Aduhelm (generic is aducanumab) is Skilled Nursing Facility 520 Kerr Avenue
designed as anti-body to stimulate the immune system to We offer: Rehabilitation/Therapy, Respite, Denton, MD 21629
break down these protein plaques but is not considered a Dementia Care, Wound Care, IV Therapy, Phone: 410-479-2130
cure for Alzheimer’s. On January 11, 2022, CMS proposed Palliative Care, and so much more! Fax: 410-479-3057
that this medication would be covered by Medicare only
Call us today!
for patients enrolled in qualifying clinical studies. Clinical

trials showed most common side effects were brain swelling

in 35% of patients, with 20% reporting headaches related to pocket cost limit will benefit people with diabetes who rely
the brain swelling, while some experienced small spots of on more than just insulin to survive” (American Diabetes
bleeding on or in the brain. 15% reported falls, with 8-9% of Association).
participants experiencing delirium, confusion, vision changes,
Those who take insulin using a pump will not have to reach

and diarrhea. Some reported swelling allergic relations of the
their deductible to benefit from the $35 cap, since Pump
face(NCOA.org).
insulin is normally covered by “B”. However, benefi ciaries do

Therefore, lower than projected spending on Aduhelm and pay the 20% for the pump itself, which is considered Durable
other “B” items and services left larger than anticipated Medical Equipment (DME), unless they have supplemental
reserve bucks in the Supplementary Medical Insurance Trust insurance or are QMB.
Fund. Secondly, each year the “B” premium, deductible, and
For individuals under 65 and families who are insured by
coinsurance rates are determined by the Social Security Act,
private insurance through the Maryland Health Connection,
which addresses the costs passed onto Medicare benefi ciaries.
the American Rescue Plans IRA extends those pandemics
By law, those excess reserves in the SMI Trust Fund are getting
passed on to the folks who took a beating last year with the related premium subsidies known as tax credits through 2025.

major jump in “B” premiums and deductibles! Those premium subsidies will not end at the end of 2022, as
originally planned, but will continue for another three years.

Th e Inflation Reduction Act, (IRA) signed into law in August, Contact the Health Connection at 410-479-8004.
puts limits on what people could pay for prescription drugs
More good news: Beginning January 1, 2023, Medicare
every year. Starting July 1st of 2023, Medicare will cap the cost

beneficiaries who are 36 months post kidney transplant (and
of insulin at $35 per month for each insulin prescription for
therefore were not eligible for full Medicare coverage) can pay

all beneficiaries. Please note that is July not January, July 2023
is not a typo. This cap will occur whether the benefi ciary has an additional Part “B” annual premium of $97.10 for their

met their annual deductible or not. People who are charged immunosuppressive drug coverage to continue. “Th is option
is only for those who do not have Medicaid or any other
more than $35 per month in the first few months after the cap

public or private health insurance with an immunosuppressive
is enacted will be reimbursed by the plan for the diff erence
benefit. Anyone who had a transplant and whose Medicare

in cost. The IRA also addresses the high cost of prescription

eligibility expires before, on, or after January 1, 2023, can enroll
medications in part “D”. The law caps the total out of pocket

in Medicare Part B solely for immunosuppressive coverage if
costs to $2,000 per year starting in 2025.
they do not have other insurance for their immunosuppressive

“Considering the fact that $1 in every $3 spent on prescription drugs. The enrollment period begins October 1st for anyone
drugs in the US is spent on someone with diabetes, this out-of- whose Medicare coverage ends prior to January 1,2023.
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