In early March I finally had my turn to get the shot. As I lined up outside the Hagerty Center I was pleasantly surprised - in and out in 25 minutes. That included all the paperwork and waiting time after I received the vaccine. mRNA vaccines are new but they have been known about and studied for decades. They were long recognized as a preferred way to deliver a vaccine in part because of their ability to handle some mutations. Unfortunately they were too expensive to manufacture and distribute so the idea just sat on the shelf.
That is until the pandemic. When the country was put on a war footing, with virtually unlimited funding, the opportunity opened up to make them available. Now that the cost barrier has been broken we have access to new and better vaccines. The benefit could be as revolutionary as penicillin and comes at a time when it was beginning to look like virus's and germs would regain the upper hand.
Herd immunity is now within reach and the 70% number has been bandied about but I believe 80% would be more effective. Herd immunity is based on antibodies and there are only two ways to get them. Get a vaccine or get the disease. I know many young people have forgotten the scourges and deaths that were the result of smallpox, diphtheria, polio, scarlet fever and gangrene. My family has experienced all of these and we only need to look back 5 generations to see it.
Up to now covid costs have been borne by insurance companies and the government with no patient liability. That will not remain the case. In only a few months deductibles, copays and out-of-pocket maximums will begin to apply. Someone who has symptoms and tests positive should plan on at least 2 weeks of lost wages. Set aside about $1,500.00 so you can have groceries and a roof over your head. If you end up hospitalized it will only take 2 days to run through your deductible and out-of-pocket limit on most plans. Plan on another $6,900.00 there. All told relying on the sickness to give you immunity will expose each person to almost $10,000.00 in potential costs. It may be higher for families or couples.
The unseen cost is the toll it can take on heart, lungs, kidneys and brain health. Life expectancy has been shortened and it will be decades before the full impact is known. Weakened systems may take years to fail so those costs are kicked down the road. In 1902 at the age of 7, my grandmother lost all her hair when she had scarlet fever and diphtheria at the same time. She recovered and her hair came back - but the heart murmur was with her the rest of her life and was her eventual cause of death over 70 years later.
Everyone will eventually play a part in herd immunity. The question is how much are you willing to pay for it?
• With PIP, there are no deductibles or co-pays. With Medicare, you are responsible for all applicable deductibles and copays.
• Not all medical specialists participate with Medicare.
• Important to note: if a Senior Citizen receives a settlement from an accident claim, Medicare is entitled to recover the cost of any medical expenses paid to the claimant.
When health care reform via the Health Insurance Marketplace was first introduced it included a fee called the Patient Centered Outcomes Research Institute Fee. It was originally identified as a best practices panel that would be appointed to make sure finite health care dollars were wisely spent and not wasted on procedures that would not appreciably extend quality of life. Immediately opponents identified it as a death panel that would ration healthcare. Physicians can best answer if this is the case now that some of the higher cost specialties have had the government change how they practice medicine via quality measures. In the meantime the fee or tax is still being collected to fund the PCORI.
The IRS has announced that the 2019 calendar plan year Patient-Centered Outcomes Research Institute Fee (PCORI) for the July 2020 filing will be $2.54 per covered individual (up from $2.45).
As a reminder, health reimbursement arrangements (HRAs) are considered self-funded health plans and are therefore subject to the PCORI fee.
In IRS Notice 2020-44, the IRS has now released the fee for plan years ending on or after October 1, 2019 and before October 1, 2020, which includes 2019 calendar plan years that will report and pay the PCORI fee this July.
For additional information and help determining your PCORI fee, check out this PCORI fee calculator here.
PIP (Personal Injury Protection) is one of the costs that made Michigan the most expensive auto insurance in the country. Effective July 2nd drivers in Michigan will have additional options when choosing the level of PIP coverage they will have. Seniors on Medicare will have the option of dropping PIP altogether. In general we are recommending that seniors keep their full PIP coverage. We can site an example for why this is a good idea but the coverage speaks for itself.
Medicare is always considered a secondary payer in auto accidents and covers benefits subject to Medicare rules. Members will be required to pay their plan copays, if any.
There are many items covered under an auto policy’s medical coverage that Medicare does not cover, including, but not limited to:
If Medicare pays for auto-related claims, Medicare can seek reimbursement from any settlement that a beneficiary receives for pain and suffering, thereby leaving less to compensate the beneficiary.
This is the very first agency update we've published in the News portion of our website.
This is the area of the website where we're going to be writing brief updates about important news, updates, and other changes within our agency.
Some of the things we may share here in the news section are: