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Medical Marijuana and Medicare Coverage

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does medicare pay for medical marijuana

As more states embrace the idea of medical marijuana, many Medicare beneficiaries wonder, “Does Medicare pay for medical marijuana?” Often, the question stems from the fact that cannabis is still illegal at the federal level.  Medicare is a federal government program.

The Federal Government’s Stance on Medical Marijuana

Marijuana is a Schedule 1 controlled substance. The federal government believes that it has a high potential for abuse. It states that there is no accepted medical treatment that utilizes medical marijuana. Additionally, they assert that there are no accepted safety standards regarding the use of marijuana as a medical treatment.

Additionally, the Food and Drug Administration (FDA), the federal government agency which approves prescription drugs, has not recognized marijuana as a medicine.

Does Medicare Pay For Medical Marijuana?

No. Marijuana is not an approved treatment for any medical condition and not officially classified as a medicine. Therefore, Medicare will not cover medical marijuana, regardless of whether a beneficiary has a prescription.

Is There Any Medical Marijuana Insurance Coverage?

Probably not. Most private insurance companies take the same stance as the federal government in regards to marijuana as a viable treatment option for any medical condition, even if you have a prescription. This means that medical marijuana insurance coverage essentially does not exist.

Are There Any Marijuana-Based Medications?

Yes. The FDA has approved medications such as those containing cannabinoids, which are chemical compounds found in marijuana that can assist with specific health conditions.

For example, Marinol (dronabinol) contains cannabinoids, and often treats severe nausea and vomiting. They are often used with chemotherapy, and to increase the appetites of persons with AIDS.

Epidiolex (cannabidiol) is an oral solution that contains CBD, a chemical substance in marijuana that does not produce the euphoria or intoxication that commonly comes with marijuana use. It is used to treat seizures associated with Dravet syndrome and Lennox-Gastaut syndrome. These are both two severe forms of epilepsy.

Medicare does cover Marinol and Epidiolex through Medicare Part D and Medicare Advantage plans. Many private insurers will offer coverage as well.

Can You Use Medical Marijuana as a Medicare Beneficiary?

If medical marijuana is legal where you live, you may be able to use it even it if you are a Medicare beneficiary. As long as you have a current prescription, you can purchase medical marijuana on your own.

However, any costs associated with the purchase of medical marijuana will not go toward your Medicare prescription drug plan out-of-pocket maximum. This means the financial burden is entirely on your shoulders.

Additionally, since medical marijuana is not legal at the federal level, you cannot claim the cost as a medical expense on your federal income taxes. This is true regardless of whether it is legal in your state.

States also will not allow medical marijuana to count as a medical expense deduction. The majority of states follow federal rules regarding what is deductible, using your federal adjusted gross income as a basis for state income taxes. This means you cannot separately deduct the expense on your state taxes alone.

Is Medical Marijuana Different from Recreational Marijuana?

No.  By and large, medical marijuana isn’t different from recreational marijuana in states that have made both legal. Both options come from marijuana plants and feature many of the same chemicals.

However, there can be differences between individual marijuana products. Delta-9-tetrahydrocannabinol (THC) and CBD levels can vary from one strain or product to the next, impacting how “high” a person feels, how much it reduces pain, and similar effects. In states where medical and recreational marijuana are both legal, legislation often requires packaging that identifies how much THC and/or CBD is present. This serves as both a regulatory measure and it helps to inform buyers.

There are factors that may affect illegally purchased marijuana, such as the marijuana you purchase through a local drug dealer. Product purchased on the street may contain other substances, including potentially hazardous ones, or have varying compositions that impact effectiveness.

Ultimately, Medicare and other insurers are not likely to cover medical marijuana unless it is made legal at the federal level and becomes an FDA-approved treatment for specific medical conditions. Until that time, even those with prescriptions will have to manage the costs on their own.

Have you or someone you know ever used medical marijuana? Tell us about it in the comments below.

Can Your Aging Parents Afford to Live in Your State?

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Most and least affordable states for elder care
At least in five Americans has to care for an older family member, but nearly two thirds of them don’t have a plan for paying the costs over the next five years. This has become astronomically expensive, so it’s important to consider what you and your aging parents will be able to afford.

Once your parents show signs that they might need help with daily activities, you’re faced with a difficult decision: Taking on their care yourself might involve more time and energy than you can spare, but the cost to hire help will blow your mind.

Get a load of these median monthly prices for different types of elder care, according to Genworth:

  • Private room in a full-service nursing home: $8,121
  • Semiprivate room in a full-service nursing home: $7,148
  • Private one-bedroom in an assisted living facility: $3,750
  • Adult day health care: $1,517
  • In-home health aide: $4,099
  • Home-maker services: $3,994

Most Affordable States

Perhaps there’s some consolation in the fact that prices vary from one part of the U.S. to the next, especially for the more involved services.

Apparently the state of Oklahoma has the most affordable options for adults 65 and over, according to Caring.com. After that comes Mississippi, Missouri, Wisconsin, Idaho, South Carolina and Tennessee.

At the opposite end of the spectrum, the most expensive states for senior care are North Dakota, Hawaii, New Jersey, Rhode Island and Wyoming. More details on affordability appear at the table at the bottom of this article — compiled by Caring.com — which ranks them based on the average cost of living and available elder care services.

Children Shoulder the Costs

These costs end up on the shoulders of adult children because of insufficient insurance coverage on elder parent’s end of things: Medicare only pays for a very small amount of long-term care, although Medicaid does make up for some of the difference.

While the solution to the situation is to get long-term care insurance, by the time people think of taking out this type of coverage, the premiums are already too steep to be affordable.

That means the costs of caregiving end up interfering or at least impacting the adult children’s ability to plan for their own financial future, according to a survey by Aging Care.

Sacrificing Self Care

Over a third of caregivers pay at least $300 a month to pay for their elder parents’ expenses, and more than half have sacrificed spending money on themselves in order to cover these costs.

What’s worse, the situation can impact caregivers’ current employment: one in four have either had to quit their jobs or been fired from them as a result of the caregiving. Nearly half are earning less money because of having to spend time caregiving.

In fact, 59% of Americans feel that having to care for two seniors is more challenging than caring for two toddlers, according to a survey by Northwestern Mutual.

The survey found that one third of caregivers feel sadness and anxiety all the time and nearly half feel tired. At the same time, just under half feel that it’s an opportunity to return the care given to them in childhood — and 81% say they would do it again if given the chance.

Part of what makes caring for older parents challenging is that even if you can afford to hire someone to do it for you, the parents still may have the ability to refuse the outsider providing the help, making it fall back onto the adult child.

Readers, do you currently care for an aging relative, and if so, how is it impacting your finances? What kind of plans do you have for your future finances?

Can Your Aging Parents Afford to Live in Your State?

State Overall Rank Cost of Senior Care Rank Cost of Living Rank Elderly Support Rank
Oklahoma 1 3 5 24
Mississippi 2 6 1 35
Missouri 3 12 10 22
Wisconsin 4 19 23 6
Idaho 5 14 4 31
South Carolina 6 4 21 26
Tennessee 6 8 6 37
Texas 6 9 19 23
Ohio 9 27 11 15
Arizona 10 22 3 30
Kansas 10 18 18 19
Alabama 12 1 9 46
Minnesota 13 31 26 1
Florida 14 13 28 18
Utah 15 2 20 39
Kentucky 16 25 2 35
West Virginia 16 28 14 20
Arkansas 18 11 31 21
Georgia 19 7 15 41
Louisiana 20 5 16 43
Pennsylvania 21 15 35 17
Michigan 22 23 8 37
North Carolina 23 10 17 45
Colorado 24 35 32 9
Nebraska 24 20 13 43
Oregon 26 36 37 4
Washington 26 37 38 2
New Mexico 28 21 24 33
Virginia 29 26 30 24
Nevada 30 16 34 31
Iowa 31 30 12 43
Indiana 32 29 7 50
Illinois 33 24 35 29
Maryland 34 33 42 15
South Dakota 35 17 26 48
Montana 36 32 21 39
Vermont 37 48 40 5
California 38 39 48 8
Massachusetts 38 46 46 3
Connecticut 40 43 47 7
Maine 41 49 39 13
New Hampshire 41 45 44 12
Delaware 43 41 33 28
New York 44 41 49 13
Alaska 45 50 45 10
North Dakota 46 34 25 47
Hawaii 47 47 50 11
New Jersey 48 44 41 26
Rhode Island 49 40 42 34
Wyoming 49 38 29 49

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New Medicare Cards: What Beneficiaries Need To Know

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New Medicare cards and what you need to know about them
If you’re a Medicare beneficiary, check your mail very carefully. You’ll be receiving a new Medicare card with an important new identification number that you’ll need soon.

Your current Medicare ID card contains a Health Insurance Claim Number (HICN), which is the same as your Social Security number. Your HICN serves as your identification for health care plans and providers as well as Medicare/Medicaid systems and the Railroad Retirement Board.

Because of the increased potential for identity theft through exposed Social Security numbers, Congress established that a separate identifier be created for Medicare through the Medicare Access and CHIP Reauthorization Act of 2015.

New Identifier

The new Medicare Beneficiary Identifier (MBI) will be an 11-character string with random numbers and capital letters.

Beginning in April 2018, the Center for Medicare and Medicaid Services (CMS) is sending out new Medicare cards to beneficiary addresses that are on file with the Social Security Administration (SSA). Be sure that the SSA has your correct address, or you may not receive your card and miss the transition period.

Don’t panic if you don’t receive your card in the next few months. Mailings will begin in April 2018 and last through April 2019, with seven separate segments of the country receiving their new Medicare cards at different times. The initial mailing covers the DC area and nearby states, along with several Western states and American territories.

When Will It Arrive?

To know when to expect your card to arrive, find your region in the current rollout schedule and check Medicare.gov for changes to the schedule later in the year.

When you receive your new Medicare card, shred the old one – don’t just throw it away. Otherwise, you leave your information open to any criminals sorting through your trash. (It does happen.)

“Everyone should have a shredder,” says National Financial Educators Founder and Chief Education Officer Adam Carroll. “As simple as that sounds…. every single thing that comes in that has even your address on it should be shredded. And the reason for that is there are people who are going out, and they’re figuring out ways to grab your information, whether it be your address, your Social Security number, your checking account information, whatever it may be, and they’re using that to create accounts in your name somewhere.”

What About Prescription Drug Cards?

Do not destroy Medicare Advantage or prescription drug plan cards, because those are separate entities. Your Medicare Advantage card already has an ID number separate from your Social Security number, and it will still serve as your main card for Medicare usage.

If you have a Medicare Advantage card and receive a new Medicare card with a MBI number, contact CMS to clarify your situation.

Unfortunately, scammers have found ways to turn identity theft prevention into an opportunity. Seniors who don’t know about the new Medicare cards or don’t understand the purpose may be taken in by criminals attempting to steal their identities.

Beware of These Red Flags

Consider the following red flags:

  • Someone contacts you claiming to be from Medicare to discuss your card. Medicare staff will never call you and ask for personal information.
  • Anyone mentions a fee or charge for the new Medicare card. The new card is completely free of charge.
  • You receive a call to verify your MBI number orr other personal information such as your address. Someone is trying to acquire your information for identity theft.

Plenty of Time

You have plenty of time to receive your new card with your new MBI number without affecting your health care.

Both identifiers (HICN and MBI) will be valid during the transition period, which begins in April 2018 and runs through the end of 2019. To make the transition easier, it’s best to update your records at all your health care providers/plans when the new card arrives.

The transition to the new Medicare card should be relatively simple. Just make sure that you receive your card in a reasonable time after the mailing period for your area, and avoid any offers from criminals trying to sow confusion and steal your information during the transition period.

This article was provided by our partners at moneytips.com. Photo ©Medicare.gov

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SSA And IRS Announce Changes For 2016

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Tax Changes For 2016

A month into the final quarter of the year, the Social Security Administration (SSA) and IRS have announced that there will be changes affecting your Social Security withholdings and 401(k) deferral for 2016.

Social Security Wage Base Remains at $118,500 for 2016

The 2016 social security wage base will be $118,500, which is unchanged from 2015. As in prior years, there is no limit to the wages subject to the Medicare tax. Because of this, all covered wages are still subject to the 1.45 percent tax.

Just like 2015, wages paid during 2016 in excess of $200,000 will be subject to an extra 0.9 percent Medicare tax that will only be withheld from employees’ wages. Employers will not pay the extra tax.
The 2016 FICA tax rate, which is the combined Social Security tax rate of 6.2 percent and the Medicare tax rate of 1.45 percent, will be 7.65 percent for 2016 up to the Social Security wage base.

Another factor that will remain unchanged from 2015 is the maximum social security tax employees and employers will each pay. The amount will remain at $7,347.

Social Security wages for self-employed individuals in 2016 will also be $118,500. There is no limit on covered self-employment income that will be subject to the Medicare tax. The self-employment tax rate will be 15.3 percent up to the Social Security wage base. In 2016, the maximum Social Security tax for a self-employed individual will be $14,694.

FICA coverage threshold increases for domestic, election workers

The threshold for coverage under Social Security and Medicare for domestic employees (like nannies or babysitters) will be $2,000 in 2016, up from $100 in 2015. The coverage threshold for election workers will be $1,700 in 2016, also up from $100 in 2015.

401(k) Deferral, Over-50 Catch-Up Contributions Unchanged in 2016

There will also be cost-of-living adjustments for dollar limits on benefits and contributions under qualified retirement plans and other items for the 2016 tax year. However, pension plan limitations will not change for 2016 because the increase in the cost-of-living index did not meet the statutory thresholds that trigger their adjustment.

Elective deferral limits for employees who participate in 401(k), 403(b), most 457 plans, and the federal government’s Thrift Savings Plan remains unchanged at $18,000. Catch-up contribution limits for employees aged 50 and over who participate in 401(k), 403(b), most 457 plans, and the federal government’s Thrift Savings Plan remains unchanged at $6,000.

Limits on annual contributions to an Individual Retirement Arrangement (IRA) remains unchanged at $5,500. The additional catch-up contribution limit for individuals aged 50 and over is not subject to an annual cost-of-living adjustment and remains $1,000. However, other limitations will change because the increase in the index did meet the statutory thresholds.

If you would like more information about the changes you’ll see in 2016, visit the IRS website.

Dignity Healthcare Settles for $37 Million for Over-Charging Patients

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Dignity Healthcare settles charges it overe charged for healthcare for $37 million
Dignity Healthcare has decided to settle allegations of patients having been over-charged rather than fight them in court. Dignity Healthcare, commonly known as Catholic Healthcare West, is one of the largest hospital networks in the US. It has hospitals in Arizona, California and Nevada, with 39 hospitals in total. To date, 13 of the hospitals have been accused of over-billing patients for services that should have been outpatient services or for services that are completely unnecessary.

And to make them sound less “dignified,” the hospital groups have been over-charging patients on government funded medical programs. This means they have been one of the factors in rising taxes to pay for public medical programs such as Medicare and Tricare. Tricare is military healthcare services.

“Charging the government for higher cost inpatient services that patients do not need wastes the country’s vital health care dollars,” said Acting Assistant Attorney Joyce R. Branda for the Justice Department’s Civil Division.

The hospital has agreed to settle out for $37 million in lieu of the ordinance filed by a former employee named Kathleen Hawkins. She filed the ordinance in the US district court for the Northern District of California, and she is set to receive 6.25 million dollars in the settlement herself.

After an investigation by the Justice Department, the government has found a list of three common violations across the accused locations. All of the violations include some form of over-charging by labeling inpatient services when the services are clearly outpatient services.

From 2006 to 2010, patients who underwent cardiovascular procedures such as a inserting a stent or pacemaker, were charged for inpatient time and services, when they are considered outpatient surgeries. Patients were also admitted for the treatment of spinal compression fractures or kyphoplasty procedures. These therapies are minimally invasive and don’t require inpatient treatment. Last but not least, after considerable investigation and questioning, hospitals admitted that they openly admitted patients when it was not medically necessary, and the common medical diagnosis could have been monitored in an observation setting.

Other hospitals would do well to take note of these proceedings. The Justice Department is now on high alert of possible other abuses.

“Hospitals that attempt to boost profits by admitting patients for expensive and unnecessary inpatient hospital stays will be held accountable,” said Special Agent in Charge Ivan Negroni of HHS-OIG’s San Francisco.

(Photo courtesy of David Goehring)

The Growth Rate of Type 2 Diabetes Finally Stabilizes in Americans

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The number of Americans diagnosed with diabetes stabilizes in American
Americans have a lot of preventable diseases, with diabetes being one of them. After nearly twenty years of constant increase, the growth rate of type two diabetes has finally leveled off in American adults. This news comes from a study undertaken by researchers at the Centers for Disease Control and Prevention (CDC). The CDC team says this result could be the knock-on effect of another positive health trend in American society – the first plateau of obesity America has seen since 2004.

However, it’s not all good news. The Journal of the American Medical Association (JAMA) reported this week that Diabetes, which is a metabolic disorder, continues to spread among African Americans and Latinos. Also, the likelihood of a diabetes diagnoses is still rising for those between the age bracket of 20-44 who do not have a high school education.

Shakira Suglia is an epidemiologist at Columbia University’s Mailman School of Public Health. She wasn’t involved in the JAMA study and says, while it’s positive that many Americans are getting the healthy eating and exercise message, “We’re just not reaching certain populations” when it comes to effective education on keeping diabetes away.

The rate of diabetes was measured in two ways in the study. The first was prevalence (the rate amongst the entire population) and the second was incidence (measured by the amount of new diagnoses made within a time frame.) While rates of prevalence tell researchers about the overall impact of the disease on public health, incidence rates allow authorities to calculate an individual’s risk of developing the disease. This allows researchers to compare the disease risk among gender, age or ethic groups groups in society.

The LA Times reports the rates of diabetes over the last four decades was, “Fueled by the runaway spread of obesity in the 1970s and 1980s, the rate of Type 2 diabetes among American adults ages 20 to 79 more than doubled from 3.5% in 1990 to 7.9% in 2008. In 2012, that figure was essentially unchanged at 8.3%. In addition, for every 1,000 Americans in that age group, 3.2 were diagnosed with diabetes in 1990 and 8.8 would be newly diagnosed in 2008. By 2012, that figure fell to 7.1.”

Weight-based health problems such as obesity and diabetes also have a major effect on healthcare spending. It’s been estimated that healthcare costs for those with these conditions is almost twice as high as it is for someone who doesn’t.

Shakira Suglia made further comments on the results of the study. “With certain populations, you have to look beyond messages that promote more healthful eating and more exercise. For adults working two jobs to feed their families, or coping with violent neighborhoods, these factors fall down on the list of priorities, so there has to be a bigger effort to go beyond [the message of] ‘eat healthy and exercise’ and to ask, how do we facilitate that?”

(Photo courtesy of Victor)