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Keep in mind the you are not required to enroll in any Advantage, Medicare Supplement or Prescription plan.  However, if you elect not to enroll in a prescription plan when eligible and you do not have another credible prescription plan, you will have to pay a 1% penalty for each month that you wait to enroll in a prescription plan in the future.  The 1% penalty is figured on the cost of a base plan.  Also be aware that the penalty is payable for the rest of your life.

The following is very important for those concerned about their access to affordable Health Insurance and the most appropriate health insurance.  If you elect to get an Advantage Plan instead of a supplement plan, you may not be able to change your mind and go back to a supplement plan if you develop a medical condition.  In this case, the only thing that will let you go to a supplement plan, is if your Advantage plan is canceled or eliminated for some reason (other than something that was your fault) or if you move out of the area for your current Advantage plan.  This is very important to keep in mind as an Advantage plan may become a lot more expensive and limit some of you health insurance options.  It is my recommendation to go with a supplement plan instead of an Advantage plan if at all possible.  Remember that supplement plans do not include prescription coverage.

For those that just don’t have the funds for a supplement plan, there are plans available in most areas now that offer zero cost HMO plans.  I am not a big fan of HMO plans, but if you just don’t have the funds it’s better than nothing.  Just be aware of the limits of your HMO Health Insurance plan and when you are allowed to go outside your network of doctors and hospitals.

For those of you over age 65 in Michigan and looking to make a change in your Health Insurance plan this year may be a good time to go back to a supplement plan, as many of the private fee for service plans in Michigan have been eliminated this year.  Most insurance companies have moved away from an Advantage plan with no network of doctors or hospitals to HMO and PPO  plans.  If your plan has been eliminated for any reason you are able to go back to a supplement health insurance plan.

The two major reasons to go with a supplement plans instead of an Advantage plan is the freedom to choose your doctor and hospital, also many of the supplement plans pick-up all the costs that Medicare does not pay.  When you choose a supplement plan check out which ones pay your Hospital deductible and which ones pay your deductible for things other than the Hospital.  Remember you will have to enroll separately in a prescription plan too.  If you don’t take many medications now you can go with a basic plan for now.  Each year you can change your prescription plan.

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Health Insurance

• Effective June 2010: A new program called a “high risk pool” will provide affordable health insurance coverage for uninsured who have a pre-existing condition
• Effective September 2010: New health insurance plans will be required to provide certain preventive care services with no co-pay or deductible.
• Effective the first plan year after Sept. 2010: Health insurance carriers will not be able to cancel policies except for cases of fraud.  Health insurers will not be able to set lifetime dollar limits on benefits and annual dollar limits will be eliminated for the most part.  Children up to age 26 will be allowed to stay on parent’s health insurance plan.  Health insurance will no longer be able to refuse or limit coverage for children with pre-existing conditions.
• Year 2011: Individual will be able to buy into a national voluntary insurance program for long-term in-home nursing home care.
• Year 2013: Those looking to buy health insurance will have the option of purchasing it from newly created state based nonprofit health insurance co-ops.
• Year 2014: Health Insurance companies will not be able to deny or limit coverage, or refuse renewal, to anyone based on medical conditions.  Also, their ability to charge higher rates due to health status, gender, or other factors will be limited.  U.S. citizens and legal residents will have to purchase health insurance or pay a penalty fee to the federal government.  Those with incomes from 133% to 400% of the federal poverty level ( the FPL in 2010 for a family of 4 is $22,050) will receive a tax break or government subsidies to help them pay for their health insurance.  Individuals without employer coverage and small businesses will be able to purchase health insurance through state based health exchanges, offering potentially lower costs.  Insures will no longer be able to set an annual dollar limit on the benefits an individual may receive.  Business with more than 50 employees will have to offer health insurance or pay a penalty to the government.
• Year 2016: Health Insurance carriers will be able to sell their policies in multiple  states that participate in special compacts, providing more options for individuals in those states.
• Year 2018: All health care plans will be required to provide certain preventive services with no co-pay or deductible.

If you have any questions or need help with any of your Michigan Affordable Health Insurance needs you can contact a qualified agent through the following web site: www.MyAffordableHealth.com

Medicare Time-Line

• Year 2010: Medicare insured beneficiaries will get a $250 government rebate to help close the prescription coverage gap, also know as the “donut hole”.  The “donut hole” will be phased out by 2020.
• Year 2011: Medicare recipients with prescription coverage and in their coverage gap, will receive a 50% discount on brand-name drugs.  Health insurance coverage will be extended to provide beneficiaries a free wellness visit, a personalized prevention plan from their doctors and preventive services.

Taxes

• July 2010: A new tax of 10% will be charged for indoor tanning services.
• Year 2010: Businesses with less than 25 employees may get a tax break to help them provide health insurance.
• Year 2011: Tax-free funds in a Healthcare Reimbursement Arrangement (HRA) or Flexible Spending Account (FSA) can no longer be used for over-the-counter drugs unless prescribed by a doctor.
• Year 2013: Medical expenses will be deductible on federal taxes only after they exceed 10% of adjusted gross income (up from the current 7.5%).  Those over 65 can deduct expenses over 7.5% through 2016.  For individuals earning over $200,000 and couples earning over $250,000 a year, Medicare payroll taxes will increase by about 1%.  They will pay a new tax of 3.8% on unearned income, such as dividends and interest.  Contributions to flexible spending accounts will be limited to a maximum of $2500 a year (this will be adjusted each year for inflation).
• Year 2018: A new tax will be charged on so called “Cadillac” employer-sponsored health insurance plans that exceed $10,200 for individual coverage and $27,500 for family coverage.

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