10,000 People Are Now Enrolling In Medicare – Every Day

President Obama wants you to know: He loves America’s seniors. (And is even intimidated by a few of them.)

“The toughest justice on the Supreme Court is also the oldest … the notorious RGB,” Obama joked at Monday’s White House Conference on Aging, name-checking 82-year-old Ruth Bader Ginsburg. The president also warned attendees not to race Diana Nyad, unless they wanted to get dusted by the 65-year-old swimmer.

And thanks to advances in health care and our nation’s safety net, all of America’s seniors are “living longer. They’re living healthier,” Obama added, in a more serious vein.

But here’s a sobering statistic that President Obama glossed over: About 10,000 people are now enrolling in Medicare every day.

That’s a record surge in Medicare enrollment, and it’s expected to continue for the next 15 years, as the Baby Boomers age into their golden years. It also means that the total number of Medicare beneficiaries is expected to double within the next twenty years.

The CBO projects that 80 million Americans will be Medicare-eligible by 2035, if current trends hold.

Medicare65 graph

Some analysts have a name for the wave of change that’s coming — they call it the “silver tsunami.”

And it has huge ramifications for the rest of our economy, and especially for the health care industry.

Older Americans, for instance, generally need more ongoing and expensive care. The government currently spends more than $10,000 per Medicare beneficiary every year, with costs spiking in an enrollee’s last years of life.

“From the government’s perspective, they will spend, on average, nearly $450,000 for the new age 65 Medicare beneficiary during their expected lifetime,” actuaries at the Health Care Cost Institute reported in 2013.

It’s another reason why White House leaders are so insistent on changing how Medicare pays for patient care, in hopes of reining in federal spending. (And there are signs for optimism here; as Margot Sanger-Katz wrote at the New York Times last year, Medicare spending per capita is actually falling.)

America’s changing demographics already are having a noticeable effect.

In the past decade, the number of all U.S. jobs has grown by 6% — but the number of home health jobs has grown by 60%, as more aging Americans with chronic illness need support and care. Meanwhile, more doctors are hanging up their stethoscopes, as anunprecedented number of physicians hit retirement age.

And one driver for Aetna’s $37 billion acquisition of Humana is that Humana is a major player in the Medicare Advantage sector — a rapidly growing insurance market.

There’s another demographic change worth noting: America’s fertility rate has reached a record low.

While total births have been relatively constant — there are nearly 4 million children born in the United States every year — the number of children born per person has fallen dramatically, the CDC reports.

(For contrast, there were nearly 4.3 million births in 1960, when the U.S. population was 180 million, versus 3.9 million births in 2013, when the U.S. population was 317 million.)

That won’t mean much in the short-term. But as the number of elderly Americans steadily climbs as a percentage of the population — about 20% of all Americans will be Medicare-eligible by 2030, up from 13% today — it will put increasing pressure on working-age Americans to support them.

And we’re going to have to grapple with hard questions. How will we pay for a much-bigger Medicare program? And who will care for our seniors?

But some are seeing the humor in the changing face (and needs) of America, too. “Invest in Depends, not Pampers,” the Tenneesse Globe quipped on Sunday.

This article was provided by http://www.forbes.com/sites/dandiamond/2015/07/13/aging-in-america-10000-people-enroll-in-medicare-every-day/

What seniors have to say about protecting Medicare Advantage

medicareMedicare Advantage provides high-quality, affordable, coordinated care to nearly 16 million seniors and individuals with disabilities. Additional proposed cuts to the program would result in these beneficiaries facing higher costs, reduced benefits, and fewer coverage options.

Recently proposed cuts to Medicare Advantage would increase costs and reduce benefits for California seniors and individuals with disabilities who rely on the critical program. New data from Oliver Wyman shows Medicare Advantage cuts would cost California beneficiaries $100-$120 per month. Last month, seniors shared their Medicare Advantage stories with California Reps. Mimi Walters and Norma Torres, who were among 40 California lawmakers who recently sent letters to CMS to protect seniors’ MA benefits.

Below are some Coalition members in California who would experience negative effects from additional cuts. Here’s why it’s important to protect their Medicare Advantage benefits:

– Stephen Henderson of Palm Springs, CA:
“Without my Medicare Advantage program my prescriptions would be too expensive. I wouldn’t be able to afford them. I am very happy with my doctors and my program benefits. Why would Congress want to take money from a program that works?”

– Carolyn Hunley of Palm Springs, CA:
“Being able to go to the gym and participate in classes that are designed for seniors is just one of the things I like about my Medicare Advantage program.”

The Five-Star Rating System and Medicare Plan Enrollment

Part D drug plans and Medicare Advantage plans vary greatly in terms of costs and coverage.  Each January, plans change their coverage and costs for the new calendar year.  Every fall, you should go over your plan’s coverage and compare it with other plans in your area to make sure you have the coverage that is best for you. Examine a plan’s coverage, costs, drug coverage and the pharmacies in its network to see if it best meets your needs.  After considering those factors, you can use the plan’s star rating from Medicare to help you select a plan that’s right for you.

What are the Medicare Star Ratings?
Medicare uses a Star Rating System to measure how well Medicare Advantage and prescription drug (Part D) plans perform. Medicare scores how well plans did in several categories, including quality of care and customer service. Ratings range from 1 to 5 stars, with five being the highest and one being the lowest score. Medicare assigns plans one overall star rating to summarize the plan’s performance as a whole. Plans also get separate star ratings in each individual category reviewed. The overall star rating score provides a way to compare performance among several plans. To learn more about differences among plans, look at plans’ ratings in each category.

Medicare reviews plan performances each year and releases new star ratings each fall. This means plan ratings change from one year to the next. Medicare sets the categories and reviews each plan the same way. You should look at coverage and plan costs, such as if the Part D plan covers all the drugs you take and has a premium you can afford before you consider the star rating.

Medicare health plans are rated on how well they perform in five different categories: Staying Healthy: Screenings, Tests, and Vaccines, Managing Chronic (Long-Term) Conditions, Plan Responsiveness and Care, Member Complaints, Problems Getting Services, and Choosing to Leave the Plan, Health Plan Customer Service

Medicare drug plans are rated on how well they perform in four different categories:
Drug Plan Customer Service, Member Complaints, Problems Getting Services, and Choosing to Leave the Plan, Member Experience with Drug Plan, Drug Pricing and Patient Safety


What should I consider when choosing or changing my coverage?

it is overConvenience

Where are the doctors’ offices? What are their hours? Do the

doctors use electronic health records or prescribe electronically?

Which pharmacies can you use? Is the pharmacy you use in the

plan’s network? If it’s in the network and your plan has preferred

pharmacies, is your pharmacy preferred? (You may pay more at

non-preferred pharmacies.) Can you get your prescriptions by mail?



How much are your premiums, deductibles, and other costs? How

much do you pay for services like hospital stays or doctor visits?

Is there a yearly limit on what you pay out-of-pocket? Your costs may

vary and may be different if you don’t follow the coverage rules.


How well does the plan cover the services you need?

Doctor and hospital choice

Do your doctors and other health care providers accept the type

of coverage you have? Are the doctors you want to see accepting

new patients? Do you have to choose your hospital and health care

providers from a network? Do you need to get referrals?

Prescription Drugs

Do you need to join a Medicare drug plan? Are your drugs covered

under the plan’s formulary? Are there any coverage rules that

apply to your prescriptions?

Quality of Care

Are you satisfied with your medical care? The quality of care and

services offered by plans and other health care providers can vary.

Medicare has information to help you compare how well plans and

providers work to give you the best care possible.


Will you have coverage in another state or outside the U.S.?

Your other Coverage

Do you have, or are you eligible for, other types of health or

prescription drug coverage (like from a former or current employer or union)? If so, read the materials from your insurer or

plan, or call them to find out how the coverage works with, or is

affected by, Medicare. If you have coverage through a former or

current employer or union or other source, talk to your benefits

administrator, insurer, or plan before making any changes to your

coverage. If you drop your coverage, you may not be able to get it


Where can I get my questions answered?

Call us at our offices at 909-792-3300. We will set up an appointment that is convenient for you and discuss your options.


January 1, 2015

New coverage begins if you make a change during Open Enrollment. New costs and benefit changes also begin if you keep your existing Medicare health or prescription drug coverage, and your plan makes changes.


Medicare Open Enrollment Oct. 15th to Dec. 7th

Citibank conf. room

Which Plan is Right for Me?

“If you’re happy with your Plan, you can keep your Plan”. Where have we heard that before? Regarding Medicare Advantage plans, in many cases that is true, however this year in particular in the Inland Empire a popular Chronic Illness diabetic plan called SCAN Balance is being discontinued. I have already met with many of you on this plan, dialed in your medications and helped you select a new plan that best meets your needs. If you’re on this plan and have not chosen a new one for 2015 please call my office and schedule an appointment as soon as possible.

It is less than half way through Open Enrollment and I can tell you where most of my clients have been gravitating to: SCAN Classic plan; AARP Medicare Complete Plan 2 by United Health Care; Humana Gold Plus; Blue Shield 65 Plus and Health Net’s Healthy Heart and Gold Select plans.

We have other plans too. Everyone’s situation is unique, and requires balancing your medications, benefit requirements and medical groups.

NEWS FLASH…Loma Linda Medical Groups and Hospital are now available as a Primary for the AARP Medicare Complete plans.

I really do enjoy the challenge year to year assisting you in this ever changing health care landscape. Sometimes it just takes a phone call; other times a face to face meeting.

So, if you are happy and your benefits haven’t changed much, you can keep your plan and you need do nothing. If you’re not sure PLEASE call and let’s schedule a review.

As we all enter this holiday season, Terri and I are so thankful for you and wish you and yours a
Wonderful Thanksgiving and Blessed Christmas and New Years.

All the best,


CA Lic #0B56846