SHINE: Serving the Health Insurance Needs of Everyone
- Written by Lorraine York-Edberg, SHINE Regional Program Director
2022 Medicare Part B Premiums, Deductibles, and Coinsurance
The Centers for Medicare and Medicaid (CMS) released the 2022 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs on November 12, 2021.
The standard monthly premium for Medicare Part B in 2022 will be $170.10, up from $148.50 in 2021, an increase of $21.60. This larger than usual increase is due to the rising cost of healthcare utilization combined with several other factors. This premium is normally taken out of your Social Security direct deposit. If you are not collecting Social Security yet, you will be billed the additional amount starting in 2022.
The standard monthly premium for Medicare Part B in 2022 will be $170.10, up from $148.50 in 2021, an increase of $21.60.
Social Security benefits are increasing by 5.9% in 2022, which is about $59 for every thousand dollars received from Social Security. This is the largest cost of living increase in 39 years. However, the 15.9% increase in Medicare Part B will reduce the amount of increase you receive. Medicare beneficiaries whose individual income is above $91,000 annually or a couple’s joint income that is above $182,000 annually will pay an increased amount for their Part B and Part D, called an income-related monthly adjustment amount, also known as “IRMAA.” This affects 7% of people with Medicare Part B. The federal government bases the 2022 adjustments on the beneficiaries’ 2020 federal income taxes. If you believe your IRMAA is incorrect, you may request a new initial determination by contacting your local Social Security office. This is especially important if your income has changed after 2020 due to various reasons—for instance, you have retired.
The monthly Part B premium helps pay for doctors' services, x-rays and tests, outpatient hospital care, ambulance service, medical supplies, and other medical equipment. The 2022 Part B annual deductible will be $233 for all people with Medicare, an increase of $30 from 2021. The Part B deductible is annual; once you have incurred $233 of expenses for Medicare-covered services in any year, the Part B deductible does not apply to any further (covered) services you receive for the rest of the year.
Medicare Part A (Hospital Insurance) helps pay for hospital care, skilled nursing care, home health care, hospice care, and other services. The Part A deductible will increase from $1,484 to $1,556 for beneficiaries with Medicare only, the Part A deductible is the beneficiary’s only cost for up to 60 days of Medicare-covered inpatient hospital services. The 61st to the 90th day has increased from $371 to $389 a day, and beyond the 90th day, it has increased from $742 to $778 a day. For beneficiaries who have a Medigap Supplement 1 or 1 A plan, these costs are covered by that supplemental insurance coverage.
The skilled nursing facility coinsurance increased from $185.50 to $194.50 for the 21st to the 100th day. Medicare Part A covers the first 20 days in a skilled nursing facility, after a three-day-qualifying stay in a hospital.
Many Medicare beneficiaries purchase additional insurance to cover the gaps of Medicare to help reduce out-of-pocket expenses including Medicare Supplemental Plans or Medicare Advantage Plans.
Medicare Advantage Open Enrollment Period Starts January 1, 2022
Did you know that if you are unhappy with your Medicare Advantage Plan, you have options?
The Medicare Advantage Open Enrollment Period (MA OEP) occurs each year from January 1 through March 31. You can only use this enrollment period if you have a Medicare Advantage Plan on January 1. Changes made during this period take effect the first of the month following the month you enroll. For example, if you switch to a new Medicare Advantage Plan in February, your new coverage begins March 1. Unlike Fall Open Enrollment period, you can only make a single change during the MA OEP.
It’s important to understand and be confident in your Medicare coverage choices. If you have a Medicare Advantage Plan and want to change your plan, check out your options today. Remember, the MA OEP ends March 31.
Changes that can be made during this period include switching to:
- a different MA plan with drug coverage;
- a different MA plan without drug coverage;
- Original Medicare and a Part D plan; or
- Original Medicare without a Part D plan.
In Massachusetts you may also add Medigap coverage to your Original Medicare during this time.
People who want to leave their Medicare Advantage plan and enroll in Original Medicare, can access Medigap policies, also known as supplemental plans. We are fortunate in the state of Massachusetts, as our insurers in this state offer continuous open enrollment.
Medigap policies are health insurance policies that work with Original Medicare and pay part or all of certain remaining costs such as deductibles, coinsurance, and copayments after Original Medicare pays first.
The SHINE program, (Serving Health Information Needs of Everyone…on Medicare), provides free, confidential, and unbiased health insurance counseling for Medicare beneficiaries. This is a free service, though contributions are welcome and will go a long way to help support this vital program. For further assistance with any Medicare issue, you can make a SHINE appointment. To reach a trained, certified counselor in your area, please contact the Regional Office at 800-498-4232 or 413-773-5555, or contact your local Council on Aging.
This article is based on the November 12 news release from the Centers for Medicare and Medicaid Services.
- Written by Janis Merrell, Editor of The Good Life
This past July, seven people celebrated their graduation from the SHINE program while enjoying a luncheon at LifePath’s office in Greenfield. Each graduate received a bouquet along with their certificate of graduation. SHINE is an acronym for “Serving the Health Insurance Needs of Everyone.” As newly certified SHINE counselors, these volunteers will work in their own communities to provide free and unbiased health insurance information, education, and assistance services to Medicare beneficiaries and adults with disabilities.
As newly certified SHINE counselors, these volunteers will work in their own communities to provide free and unbiased health insurance information, education, and assistance services to Medicare beneficiaries and adults with disabilities.
According to SHINE graduate Amanda Joao, “It’s such important work” and “will make such a difference” for her to have this training in her position as Shelburne Senior Center Director.
Graduate Diana Soler, who will be offering SHINE counseling at the Amherst John P. Musante Health Center, says she is looking forward to “helping elders in the Latino community gain access to Medicare by overcoming any language barriers.”
Lorraine York-Edberg, SHINE Regional Program Director, provided the intensive 60-hour training. “This was a great group of dedicated and concerned SHINE trainees,” she said. “They will be very helpful to Medicare beneficiaries in our service area!”
- Written by Lorraine York-Edberg, Western Mass. Regional SHINE Program Director
Initial Enrollment Period (IEP) (the seven months surrounding your 65th birthday: 3 months before, the month of, and the 3 months following).Most people become eligible for Medicare when they turn 65. Your Medicare enrollment steps will differ depending on whether or not you are collecting retirement benefits when you enter your
- If you are receiving Social Security retirement benefits or Railroad Retirement benefits, you should be automatically enrolled in both Medicare Part A and Part B.
- If you are not receiving Social Security retirement benefits or Railroad Retirement benefits, you will need to actively enroll in Medicare by contacting the Social Security Administration.
If you are eligible for automatic enrollment, you should not have to contact anyone. You should receive a package in the mail three months before your coverage starts with your new Medicare card. There will also be a letter explaining how Medicare works and that you were automatically enrolled in both Parts A and B. If you get Social Security retirement benefits, your package and card will come from the Social Security Administration (SSA). If you get Railroad Retirement benefits, your package and card will come from the Railroad Retirement Board.
Typically, you should not turn down Part B unless you have insurance based on your or your spouse’s current work (job-based insurance).
Typically, you should not turn down Part B unless you have insurance based on your or your spouse’s current work (job-based insurance). If you do not have job-based insurance and you turn down Part B, you may incur a premium penalty if you need to sign up for Medicare coverage in the future. Also, if your job-based insurance will pay secondary after you become eligible for Medicare, you should consider enrolling in Medicare in order to have primary coverage and pay less for your care.
If you are 65 but are not receiving Social Security retirement benefits or Railroad Retirement benefits, you will need to actively enroll in Medicare.
Signing Up for Medicare
Follow the steps below if you need to actively enroll in Medicare.
If you decide to enroll in Medicare during your Initial Enrollment Period, you can sign up for Parts A and/or B by:
- Visiting your local Social Security office.
- Calling Social Security at 800-772-1213.
- Mailing a signed and dated letter to Social Security that includes your name, Social Security number, and the date you would like to be enrolled in Medicare.
- Or, by applying online.
If you are eligible for Railroad Retirement benefits, enroll in Medicare by calling the Railroad Retirement Board (RRB) or contacting your local RRB field office.
Keep proof of when you tried to enroll in Medicare, to protect yourself from incurring a Part B premium penalty if your application is lost.
- Take down the names of any representatives you speak to, along with the time and date of the conversation.
- If you enroll through the mail, use certified mail and request a return receipt.
- If you enroll at your local Social Security office, ask for a written receipt.
- If you apply online, print out and save your confirmation page.
This article is made available to you with permission from the Medicare Rights Center in Washington DC. The Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives.
The SHINE program (Serving Health Information Needs of Everyone . . . on Medicare) provides free, confidential and unbiased health insurance counseling for Medicare beneficiaries. To reach a trained and certified counselor in your area, contact the Regional Office at 1-800-498-4232 or 413-773-5555, or contact your local Council on Aging.
- Written by Lorraine York-Edberg, Western Mass. Regional SHINE Program Director
The Medicare Savings Programs, also known as the Massachusetts Buy-In Programs, are a set of benefits administered by our Massachusetts State Medicaid Agency.
The programs are divided into several categories called the:
- Qualified Medicare Beneficiary Program (QMB/Senior Buy-In)
- Specified Low Income Medicare Beneficiary (SLMB/Premium Assistance)
- Qualifying Individual (QI-1/Premium Assistance)
All of these programs assist beneficiaries with their Medicare Part B monthly Premium payment of $148.50 and offer assistance with a free Medicare Part D Drug Plan that offers reduced copays for your medications. In addition to those benefits, if you are eligible at the level of the Senior Buy-In Program/Qualified Medicare Beneficiary Program, the program pays your Part A and B deductibles and copays for Medicare services.
This program expanded its income eligibility levels by 30% thanks to the hard work of the Massachusetts Senior Action Council, Governor Baker, and our Legislators. In January of 2020 and in March of 2021, the state raised the eligibility levels in line with the current Federal Poverty Level.
See If You Qualify
If your income and assets are at or below the amounts listed here, you may qualify for help from one of these Medicare Savings Programs.
Income and Asset Limits Effective March 1, 2021
|Income / Month||Assets|
Prescription Drug Copayments with Extra Help Effective March 1, 2021
|Per 30-Day Supply|
Additionally, these programs are not subject to estate recovery since January of 2010, so the state will NOT place a lien on your property to recover benefits following your death.
To apply, it is an easy, one-page application that is simple to fill out, with no verifications. To get this application you can contact MassHealth at 1-800-841-2900 and request the Medicare Buy-In application and they can send it to you. Additionally applications are available online.
We also have applications available here at the regional SHINE office upon request. If you need an application sent to you, or assistance completing one, please call us at 413-773-5555. We are happy to help.
When does coverage begin? If you are eligible for MassHealth Senior Buy-In, your coverage begins in the month after MassHealth processes your application. If you are eligible for the Buy-In Program, in most cases the coverage begins as early as three months before your application month.
The SHINE program, Serving the Health Information Needs of Everyone, provides free, confidential, and unbiased health insurance counseling for Medicare beneficiaries. To reach a trained and certified counselor in your area, contact the regional office at 1-800-498-4232 or 413-773-5555.
- Written by Lorraine York-Edberg, Western Mass. Regional SHINE Program Director
If you’re interested in healthcare and looking for a volunteer opportunity, consider signing up to become a SHINE counselor with LifePath. The 2021 Spring Training is starting in April, and there is no better time to get started.
SHINE, Serving the Health Insurance Needs of Everyone, is a program that provides free, confidential, and unbiased health insurance counseling for all Medicare beneficiaries. Volunteers in the LifePath SHINE program serve communities in all of Franklin County as well as the North Quabbin region of Worcester County and parts of Hampden and Hampshire counties.
SHINE counselors work one-on-one with individuals in their own communities providing information, counseling, and assistance on Medicare, Medigap, Medicare Advantage Plans, Medicare Prescription Drug Coverage, Public Benefits, One Care Plans, and more.
SHINE counselors work one-on-one with individuals in their own communities providing information, counseling, and assistance on Medicare, Medigap, Medicare Advantage Plans, Medicare Prescription Drug Coverage, Public Benefits, One Care Plans, and more. Those interested in becoming counselors should be comfortable working with a population consisting primarily of elders and people with behavioral health challenges and physical disabilities.
SHINE Counselor Larry Bezio enjoys the volunteer work the program offers, adding that he finds “personal satisfaction to be able to help someone” and “good socialization” with other counselors.
Counselors benefit from ongoing monthly meetings, allowing them to stay up-to-date with new healthcare policies and programs, which “are always changing,” according to Lorraine York-Edberg, Western Regional SHINE Program Director. This year’s training is vast and comprehensive, and will address changes that have taken place in the past year.
The 2021 Spring Training is set to take place virtually via Zoom from 9:30 a.m. to 12 p.m. with a break for lunch, then back to the training from 1 p.m. to 3:30 p.m. beginning Thursday, April 29, 2021. Participants will meet virtually weekdays for 11 sessions. A graduation celebration will take place in July.