Held Harmless

“Large amounts don't grow on trees.
You've got to pick-a-pocket or two, boys.”

You’ve Got to Pick-a-Pocket or Two, Oliver!

“It was so cold in Washington that I saw a politician with his hands in his own pockets”

Fred Allen, Johnny Carson

“The difference between a politician and a pickpocket is that a pickpocket doesn’t always get indignant… when you tell him to keep his hands to himself.”

Joseph Sobran

Federal law offers a little known temporary protection for current Medicare enrollees, against legislative increases in Medicare costs:  premiums, co-insurances, and co-payments.  Seniors who are currently receiving a Social Security benefit cannot be immediately required to pay increased Medicare costs unless, (or until), they receive a concurrent raise in Social Security benefits.

This protection feature is called hold harmless… and a person so protected from cost increases is said to be held harmless.  Protection applies only to Medicare enrollees who are receiving a Social Security check at the time that the cost increases are approved and enacted.

Raises in Social Security benefits usually come in the form of federal cost of living adjustments, (COLA).  Folks who are held harmless from Medicare cost increases are only spared cost changes until such time that they receive the next raise from Social Security.  The cost protection is only as good as that next COLA pay raise.

 

Medicare enrollees NOT held harmless from cost increases include the following:

• Eligible for Social Security but not currently receiving a Social Security check.
• Not eligible to ever receive a Social Security benefit.
• Newly enrolled in Medicare during the year in which cost increases take effect, with no established history of Medicare expenses.
• Earning an income high enough to exceed a federal threshold for expense protection.

 Seniors who turn sixty five years old now, or within the next five years; and who are eligible for Medicare enrollment… cannot immediately apply for a full Social Security benefit.  They face modern program enrollment guidelines that delay full program eligibility until participation ages of sixty six, sixty seven, or sixty eight.  These Medicare enrollees would not be held harmless for any expense increases that happen before they were allowed to draw a first Social Security check.

The following is a brief listing of just some of the important Medicare cost increases that were approved to take effect in 2016:

Medicare Part B Monthly Premium:               $104.90   (2015)          $121.80   (2016)

Medicare Part B Annual Deductible              $147.00   (2015)          $166.00   (2016)

Medicare Part A Hospital Deductible            $1216.00 (2015)          $1288.00 (2016)

Additionally, daily room rates for a hospital admission and for a convalescent stay in a skilled care facility have also been increased.  The Medicare Part A Hospital Deductible applies to EACH medically unique hospital admission, and can be assessed as many times during a year as there are hospital admissions.

More bad news, anyone?  Starting in 2020 Medicare supplement insurance products like Medicare Advantage and Medigap will no longer be allowed to cover payment of the $166.00 Medicare Part B annual deductible.  Supplement policies are currently allowed to cover that cost.  All new Medicare enrollees without exception will be forced by federal law to yearly shoulder the financial burden.  This requirement will NOT be enforced retroactively; as persons enrolled in Medicare supplements before 2020 will forever be held harmless.

Another popular proposal to shift more Medicare expense burden back onto elderly enrollees… would require that a six month elimination period be attached to each Medicare supplement insurance policy.  An elimination period would delay payment of supplemental insurance benefits for the first one hundred and eighty days of the supplemental insurance contract.  Enrollees would be required to pay policy premiums during the first six months of the policy, while being denied payment of any insurance benefits.

A six month elimination period for Medicare supplement insurance policies is already allowed by federal law.  Elimination periods for Medicare supplements are currently on the federal books.  However, although their use is now permitted… it is not yet encouraged or required by Medicare.

If Medicare cost increases in such troubled financial times seem a bit unfair and insensitive to the circumstances of most Medicare enrollees, that’s only because such is exactly the case.  The added expenses will weigh particularly heavily upon the poorest of seniors.

Simply put, members of the U.S. Congress have recently approved steep increases in Medicare premiums, co-insurances and co-payments that go into effect this year… because they believe that seniors do not already pay their fair share of Medicare expenses.  The changes were silently snuck through in a last minute omnibus budget bargain passed during the holiday season late last year… with little media fanfare, and absent public scrutiny.

Congress does not generally believe that Medicare enrollees have enough skin in the game, that seniors are suffering a fair share of the country’s financial pain. Whether or not that fiscal philosophy hits the mark… Congress deserves feedback from all seniors about the cost increases.  Voter reaction is always important… but it is doubly important in a federal election year.

Little consideration was given by legislators last December… for the ability of ALL elderly enrollees to absorb new Medicare costs.  Ability to pay was not taken into account.  Even the poorest and least capable of seniors must now pay the piper.  You’ve got to pick a pocket or two, boys.

If congressmen are not held accountable for paying down Medicare’s tab by picking the purses of the elderly, both the financially capable and the poor alike… it’s only this current crop of U.S. Congress members who are truly held harmless in such hurtful bargains.

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