Aruba Archives

Greetings and may this note find you in great health with your Medicare coverage working properly. Today, I want to discuss changes to your Medicare Prescription Drug Plans for 2024. But first …

If you’re having problems, reach out to Gray or book a time on my calendar if it’s complicated.

Don’t you love the smile on this guy’s face? He’s enjoying the day tooling around the old town sharing his city with travelers in this classic car.

That’s the way I’d like to feel every day.

My reality is a little closer to this old tortoise who sleeps behind the planters in this old hotel.

Every morning, getting up and out is a little harder. I’m a little achier and often a little grumpier, but, a good cup of coffee makes all the difference in the world.

Once we get up and out, there are adventures waiting, especially when Quantz twists my arm and gets me to do something I’d enjoy but wouldn’t do on my own.

If it weren’t for her, I’d work more and enjoy less. Traveling with Q pushes my comfort zone.

This is an old German freighter off the coast of Aruba. Instead of letting it fall into Allied hands in 1942, the captain chose to sink her himself by flooding the boiler room and causing the engine to explode. I’m glad I wasn’t on board.

Our daughter Sus had to return to her home in Colorado because she had a burst pipe. As you can tell, Plato was happy to see her but he’s still mad at us for leaving him at home with her boyfriend.

Now Quantz, our Air Force son Nicholas, and I have moved on to explore Colombia.

Thanks to Tim in Firestone, Colorado for sharing an interesting article from the Wall Street Journal about drug trends for Medicare. Here’s the gist:

In 2024, Medicare Part D plans will have a ceiling of $8,000 for how much they and consumers (combined) will pay out of pocket.

Changes brought about by the 2022 Inflation Reduction Act mean that people on Part D plans will pay no more than roughly $3,300 on drugs annually (subject to variation based on brand or generic medications).

In 2025, the cap will change to a flat $2,000.

The 5% coinsurance that patients had to pay after reaching the “catastrophic” spending threshold has been eliminated. This change is expected to offer significant savings to approximately 1.5 million people.

The cap on drug costs will force insurers and drugmakers to cover a larger part of the cost.

Potential downsides for Medicare patients include higher premiums and more complicated paperwork.

The changes represent a significant makeover to the Part D prescription-drug benefit.

Cancer drugs in pill form can be costly for people on Part D plans, and these changes are expected to provide substantial savings for patients with expensive medications.

Despite all the good news, drug costs seems to be one of the biggest frustrations everyone has.

Remember the following strategies when filling a prescription:

Often, physicians will prescribe a brand name medication without taking into consideration a client’s financial situation. Check with the doctor’s office to see if they can provide you with a sample before you shell out your own money.

If you are a prescribed a brand name drug, check with your pharmacist and find out if there is a generic alternative.

A single medication is always easier but sometimes, a combination of drugs can be used successfully and perhaps keep down your costs. Every situation is different so do your homework.

Before filling the prescription through your drug plan, ask the pharmacist if they have a cash price that is lower than your copay.

If you get into the catastrophic phase every year (which means the total cost of your drugs {paid by you and the drug plan, $8,000 for 2024} then you may want to run all of your drugs through plan but…

If you barely reach the donut hole each year ($5,030 paid by you and the drug plan) or never reach the donut hole, paying the cash price or using a third party tool like GoodRx, Amazon, or Cost Plus Drugs might save you some serious coin.

Life continues to be filled with a million moving pieces but if you take thirty minutes and make a few calls and check a few websites, it might really save you some money.

Please know that even though we are traveling, I have slots open every week if you need me.

Keep squeezing the juice out of life and look for ways to help others!

Medicare questions or problems?

Book a time on my calendar or email Gray, Gray@theBig65.com.

If family or friends need help… referrals are the lifeblood of my business.

Let us know what’s going on and please send pictures :).

Karl Bruns-Kyler
(877) 850-0211
Book a time on my calendar here
Happy with my Service? Click Here to Leave a Review.

Karl Bruns-Kyler is a Medicare insurance broker and independent Medicare agent licensed to help Medicare recipients in thirty states around the country, including:

Alabama
Arizona
Arkansas
California
Colorado
Connecticut
Florida
Georgia
Idaho
Indiana
Iowa
Kansas
Louisiana
Maryland
Michigan
Minnesota
Missouri
Nevada
New Hampshire
New Jersey
New York
North Carolina
Ohio
Oklahoma
Pennsylvania
South Carolina
Tennessee
Texas
Virginia
Washington
Wisconsin

The Big 65 Medicare Insurance Services does not offer every plan available in your area. Currently, we represent 10 organizations that offer 50 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Greetings and may this blog post find you in great health with your Medicare coverage working properly.

If you changed plans in the fall, you should have received your new ID cards by now.

If you haven’t, or if you’re having a carrier issue (and you’ve already spoken to the carrier), reach out to Gray and he’ll get you squared away.

In talking with clients this week, I’m hearing a lot about issues with billing.

According to this article, up to 80% of all medical bills have at least one error.

Client Stan tells me he’s pulled out most of his hair trying to get a shingles vaccine bill properly coded and submitted. He received incorrect information from the doctor and from Medicare ☹. Stan is a retired engineer so if someone as logical as he is can’t get the right answer, it sure is frustrating.

I wish I could tell you there was a single step you could take to avoid billing issues, but complicated problems are never solved that easily.

However, if you have a Medicare Supplement, Plan G, your only out-of-pocket for Medicare approved services (excluding drugs, dental, and vision) is $240.

If you have a Medicare Advantage plan, the summary of benefits should you provide you with exact costs for deductibles, copays and the maximum out of pocket each year.

Nevertheless, here are some suggestions to help you avoid over paying:

Check Your Information:

Billing errors can happen due to small mistakes on your insurance claim form.
Even a single missing digit in your insurance ID or a misspelled name can lead to denied claims and premature billing.
Verify that your insurance details on the bill are accurate and have been processed by your insurance company.

Compare to EOB:

After your health insurance processes claims, you’ll receive an Explanation of Benefits (EOB).
Compare your medical bill to the EOB to ensure the amount on the invoice matches what your insurance says you owe.

Beware of Aggressive Billing:

Some providers may send bills while your insurance is still processing your claim.
Don’t pay these bills without checking with your insurance company.
Look for phrases like “Due Now,” “Estimated Amount Due,” or “Amount You May Owe.”

Request an Itemized Statement:

Medical bills often lack a detailed breakdown of charges.
Ask for an itemized statement to ensure you’re only paying for services and items you received.

Check Billing Codes:

Each medical procedure has a billing code (HCPS/CPT), and there are diagnosis codes (ICD-10) for medical conditions.
Review these codes to ensure they’re correct.
Mistakes in codes can lead to claim denials or unjustified procedures.
Research codes independently and take action if there’s an issue.

Negotiate a Reduction:

If your bill is more than you can afford, negotiate with the provider.
Find resources online to determine fair service costs.
Make your financial constraints known and ask for a discount or a payment plan.
Paying a lump sum may increase your chances of getting a discount.
Ask for zero interest on a payment plan.

Act Quickly:

Address your medical bills promptly to avoid collection agency involvement.
Hospitals must wait six months before reporting to credit bureaus, but late reporting can affect your credit for years.
Taking quick action can prevent future financial issues like higher interest rates or difficulty securing loans.

The bottom line: be slow and extra careful BEFORE you remit any payment to healthcare providers and call the insurance company for help as well. This process will not eliminate the number of mistakes, but hopefully it will reduce them.

In case you couldn’t tell, the Bruns-Kyler family is celebrating their first vacation as a family together in almost three years. We finally got our Air Force son together with the rest of the family at the same time. We are giving thanks for warm weather and this time together in Aruba. Can you tell Q was happy to see our son?

Remember, life is short. Don’t take anything or anyone for granted!