Page 40 - Delaware Medical Journal - November/December 2019
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The Social Security Administration (SSA) is the division responsible for helping people enroll in Medicare Parts A and
B. SSA employees are available to help answer questions, but not all of them have a detailed understanding of TEFRA/DEFRA and the details needed to make decisions on Medicare. For example, many of our clients have been recommended to enroll
in Medicare Part A (the hospital portion of Medicare) regardless of their group size. Part A has no monthly premium for anyone who has been working for 10 years or
more and paying Medicare taxes. With no cost, it would seem to make sense to have hospital coverage with Medicare, even if you intend to keep practicing and staying on your group plan. However, enrolling in Medicare Part A would void your ability
to contribute to a Health Savings Account (HSA). If your practice is considered a large group (at least 20 employees) and you are enrolled in a Health Savings Account eligible plan, joining Medicare would
take away the tax deduction for HSA contributions.
Rather than outline a dozen scenarios, we advise everyone with Medicare questions
to seek guidance from a professional
who is accredited with Medicare. Those
of your group and outline the costs and or a later date.
To understand the costs of Medicare, it’s important to know the various parts of Medicare and their costs:
MEDICARE PART A – Hospital Coverage
As we discussed above, Part A is free to most people who have turned 65 and been working for 10 or more years.
MEDICARE PART B – Outpatient Professional and Facility Services (office visits, labs, etc.)
Part B coverage runs as little as $135.50 per month for most people. However,
that amount can rise dramatically (up to For example, if a physician is married and has a salary of $300,000, he or she would pay $352.20 per month for Part B.
MEDICARE PART D – Prescription Drug Coverage
Here in Delaware, Part D coverage ranges from $20-$80 per month. However, like Part B, Medicare Part D penalizes anyone with larger incomes. (if your joint income-tax return shows income of over $170,000) and goes up to category.
MEDICARE SUPPLEMENT – Wraps around copays and deductibles in Medicare Parts A & B
Medicare supplement coverage has a wide range depending on the coverage and your age. However, for a 65-year- old, those plans run from approximately $50 per month up to $150 per month depending on the coverage. The most commonly purchased plans in Delaware have been Supplement Plan D and
Plan F.
Medicare calculates these premiums for each year based on the tax return you filed two years previously. When we look at the costs for 2020, it would be based off the income on your tax return for 2018. This amount adjusts every year. Unfortunately, the negative is that a retired physician with a large income could see two years of higher premiums for Medicare Parts B and D. However, as your income drops in retirement, so will those Medicare premiums.
Important dates for Medicare: For a physician already enrolled in Medicare coverage, remember that the Part D prescription drug plans renew for all Delawareans on January 1. You are given the ability to look at the plans and prices (based on your specific prescription drugs) every year and make a change. The enrollment window opens on October 15 and runs through December 7. During that time, you may
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Del Med J | November/December 2019 | Vol. 91 | No. 6
