Tag Archives for Medicare Part A

The ABCs of Surviving Medicare Open Enrollment 

Published in RINewsToday on October 20, 2025

It’s that time. The Medicare Open Enrollment period began last week and runs until December 7th. During this period, Rhode Island’s 243,000 Medicare beneficiaries (data from late 2024 to early 2025) are encouraged to explore their Medicare options, carefully review, compare options, and make necessary changes to their existing Medicare plan for the following year.

During the Medicare Open Enrollment period, you can join a new Medicare Advantage plan or Part D prescription drug plan, switch from Original Medicare to Medicare Advantage, or switch from Medicare Advantage to Original Medicare (with or without a Part D plan).

You can make as many changes as you want during this period. The last change you ultimately make will take effect on January 1, 2026.

Medicare Options

According to Healthinsurance.org, an independent website that provides consumer information and education on health insurance options, here’s a snapshot of Medicare plans chosen by Rhode Island beneficiaries.

As of September 2024, 144,610 Rhode Islanders were enrolled in Medicare Advantage plans. These plans, offered by private health insurance companies, are alternatives to Original Medicare. Medicare Advantage plans cover all the healthcare benefits that Original Medicare covers (e.g., hospital services and outpatient/medical/physician services), but the out-of-pocket costs can differ significantly, as Advantage plans set their own co-pays, co-insurance, and deductibles (within parameters defined by CMS).

Approximately 115,000 to 120,000 Rhode Islanders are enrolled in Original Medicare, representing about 49-51% of the state’s Medicare beneficiaries. Original Medicare, covering individuals aged 65 and older as well as certain younger people with disabilities, is a “fee-for-service” plan composed of two main parts: Part A for hospital insurance (covering inpatient hospital care, skilled nursing care, hospice care, and some home health services) and Part B for medical insurance (covering doctor visits, preventive care, and durable medical equipment). These two parts cover a wide range of medically necessary services, with beneficiaries paying a portion of costs, such as coinsurance and deductibles.

Medicare Part D is an optional prescription drug benefit offered by private insurance companies approved by Medicare. This benefit helps cover the cost of outpatient prescription medications. Approximately 83% of the total 243,377 beneficiaries in September 2024 have some form of prescription drug coverage through a Medicare Part D plan.

Finally, according to the U.S. Centers for Medicare & Medicaid Services, as of 2024, more than 50,000 Medicare beneficiaries in Rhode Island had Medigap policies. These policies are standardized supplemental insurance plans sold by private companies to cover the “gaps” in Original Medicare (Part A and Part B), including deductibles, co-payments, and co-insurance.

Taking a Close Look at Your Current Coverage

Even if you’re satisfied with your current coverage, the state’s Office for Healthy Aging recommends that Medicare beneficiaries closely review and compare their Medicare options to ensure their needs are met in the upcoming year. “Medicare beneficiaries will receive a lot of mail during Medicare Open Enrollment so it is very important to pay attention to any changes in the plan’s costs, including premiums, deductibles, and cost-sharing amounts. Make sure your providers and pharmacies are still in the plan’s network.”

All Medicare beneficiaries (or those approaching Medicare eligibility) can receive free, unbiased counseling from State Health Insurance Assistance Program (SHIP) counselors. These services are voluntary and meant to help people understand the complexity of plans and make informed choices. SHIP counseling is an offered resource, not a condition of having Medicare or enrolling in a plan.

What to Bring to Your SHIP Appointment

You can enroll in Medicare plans or manage your coverage without using OHA or SHIP partners’ counseling.  There is a risk of not choosing the best plan to meet your medical needs, missing savings or subsidies, and increasing stress or confusion in making the right choice.

After making an appointment, a SHIP counselor will request the beneficiary bring their Medicare card, current plan(s) cards, and a list of prescriptions and doctors to the meeting.

The OHA and its nine partners (see box below) are provided with training, certifications, and resources through the federal SHIP grant ensuring they stay up to date on what every Medicare Advantage, Traditional Medicare, and Medicare Part D plan offers.

Every October, OHA and its SHIP partners meet with presenters from Rhode Island’s Medicare Advantage plans to become aware of updates on all the 2026 plan changes.

Changes in 2026

According to AARP, expect some significant changes in 2026. The first Medicare-negotiated drug prices will go into effect for drugs like Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, and NovoLog/Fiasp. Additionally, according to CMS, savings are expected to lower enrollees’ out-of-pocket spending by an estimated $1.5 billion next year. Finally, the new cap on annual out-of-pocket expenses for Part D drugs will increase to $2,100.

You can call 1-800-MEDICARE to make changes by phone. You can also use Medicare’s Plan Finder tool to compare plans at www.medicare.gov/plan-compare to compare options and enroll in some plans online. Alternatively, you can contact plans directly to enroll.

Find a Medicare plan

However, the Office of Healthy Aging cautions, “Unfortunately, we are still waiting for CMS to release some of the 2026 cost and premium changes, and due to the government shutdown, this may be further delayed.”

A Final Note… Beware of Scams and Fraud

Open Enrollment is also prime time for scams. Scammers who claim to represent Medicare may call asking for your Medicare number, Social Security number, or bank information, especially before you enroll. Medicare will never call, email, or text out of the blue to ask for personal information or payment. If you’re unsure, hang up and call 1-800-MEDICARE to verify.

To schedule an appointment with a State Health Insurance Assistance Program (SHIP) Counselor please contact one of the below agencies.

PARTNER AGENCYLOCATIONPHONE NUMBER
Aging Well84 Social St, Woonsocket, RI 02895401-766-3734
Johnston Senior Center1291 Hartford Ave, Johnston, RI 02919401-944-3343
Westbay Community Action Agency487 Jefferson Blvd, Warwick, RI 02886401-921-5237
South Kingstown Senior Center25 St Dominic Rd, Wakefield, RI 02879401-789-0268
Westerly Senior Center39 State St, Westerly, RI 02891401-596-2404
The Aging & Disability Resource Center (ADRC)50 Valley St, Providence, RI 02909401-462-4444
East Bay Community Action Agency100 Bullocks Point Ave, East Providence, RI 02915401-435-7876
Leon Mathieu Senior Center420 Main St, Pawtucket, RI 02860401-728-7582
Progreso Latino626 Broad St, Central Falls, RI 02863401-728-5920
Edward King House35 King St, Newport, RI 02840401-846-7426

Source:  OHA, Oct. 2025

With the Latest SSA Trustee Report Released, Congress Must Act Now to Fix Social Security

Published in Blackstone Valley Call & Times on June 24, 2025

Just before Medicare celebrates its 60th anniversary this July and Social Security marks its 90th birthday in August, the Social Security Board of Trustees recently released its annual report on the financial status of the Social Security Trust Funds.

According to this year’s estimate, by 2033, projected revenues will only cover 77% of scheduled benefits—unless Congress takes action to address the program’s looming shortfall. Combining the Old-Age and Survivors Insurance (OASI) and Disability Insurance (DI) trust funds would extend coverage for another year, ensuring 81% of scheduled benefits through 2034, instead of 2035, as previously estimated.

The trustees also reported that Medicare’s Hospital Insurance Trust Fund (Medicare Part A, which covers certain healthcare services) will be able to pay full benefits until 2033, a year earlier than the previous estimate of 2024. At that point, the fund is expected to cover 89% of benefits.

For 2024, the Social Security Administration (SSA) paid $1.47 trillion in benefits to about 68 million beneficiaries, while its administrative costs were just $7.4 billion—representing a very low 0.5% of total expenditures. However, the projected 75-year actuarial deficit is 3.82% of taxable payroll, higher than the 3.50% projected in last year’s report.

Frank Bisignano, Commissioner of Social Security, stressed that ensuring the financial stability of the trust funds remains a top priority for the Trump Administration. “We must work together—Congress, SSA, and others—to eliminate waste, fraud, and abuse to protect and strengthen the trust funds for millions of Americans who rely on it for secure retirement or disability benefits,” he stated.

In responding to the released Trustee’s report, House Ways and Means Social Security Subcommittee Ranking Member John B. Larson (D-CT) criticized the current administration’s approach, calling the Trustees’ Report a wake-up call to enhance Social Security for the first time in more than 50 years. Larson also pushed back against misleading claims from President Trump and Elon Musk about waste and abuse within the system. “Seniors, veterans, and disabled workers rely on these earned benefits, and they’re counting on Congress to do its job,” Larson said. “While Republicans push for privatization, Democrats have a plan to protect and expand Social Security.”

Larson’s Social Security 2100 Act, introduced in the last Congress with 189 cosponsors, aims to strengthen Social Security by expanding benefits and increasing payroll taxes to ensure the program’s long-term solvency.

Media Headlines on Social Security’s “Insolvency” Create Unnecessary Fear

Some media outlets, including The Washington Post, have raised alarms with bold headlines warning that Social Security could become “insolvent by 2033” or even “bankrupt.” In a statement, Bob Weiner, former Chief of Staff to the U.S. House Committee on Aging, rejects these claims, noting that the SSA currently holds a $2.7 trillion surplus. According to Weiner, the Trustees’ warning that the program may cover only 81% of benefits by 2034 is being misinterpreted as insolvency or bankruptcy. “That’s neither bankruptcy nor insolvency. Congress can fix this, perhaps by raising the income cap on Social Security taxes,” Weiner explains.

Weiner points out that, in 2026, the income cap for paying Social Security taxes is set to be $181,800. He also emphasizes that Social Security has faced repeated budget cuts to fund tax breaks for the wealthy. “We must protect Social Security as a priority,” Weiner says. “As Speaker Emerita Pelosi often reminds us, ‘First, do no harm.’”

Aging Groups Give Their Thoughts About Fixing Social Security

In statements, Social Security advocacy groups have also weighed in on and give   comments on the latest Social Security and Medicare Trustee reports.  

Nancy Altman, President of Social Security Works, argues that the program is fully affordable and costs only about 6% of the GDP at the end of the 21st century. She believes Congress will act to avert the projected shortfall, as it always has in the past. The key question to ask, Altman says, is whether lawmakers will choose to bring in more money through higher taxes or reduce benefits.

Altman strongly opposes cutting benefits, charges that politicians who don’t support increasing Social Security revenue are, by default, advocating for cuts. She highlights the impact of income inequality, which has cost Social Security over $1.4 trillion since 1983. “If the wealthy paid their fair share into the program, we could easily protect and expand Social Security’s modest benefits,” she notes.

While Americans are divided on many issues, Altman points out that there is broad consensus in support of Social Security. “The real crisis facing Social Security is not a future shortfall, but the ongoing sabotage it’s experiencing now,” she says. Altman specifically references the role of Elon Musk’s DOGE, which has pushed out thousands of Social Security staff members, including nearly half of its senior executives, resulting in an irreplaceable loss of institutional knowledge.

Despite these challenges, Altman notes that Social Security is run efficiently, with administrative costs well under a penny for every dollar spent. A major increase or decrease in administrative spending would have minimal impact on the program’s finances.

Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare, says this year’s comments on the Trustees’ report, mirrors those he made last year – It’s time to rebuild reserves in the Social Security Trust Fund. However, he warns against harmful proposals such as raising the retirement age or means-testing benefits, both of which would cut benefits for millions of Americans.

“Raising the retirement age to 69 or 70 would significantly reduce lifetime benefits. These ideas have been part of Republican proposals to address the projected shortfall,” Richtman explains.

Richard Fiesta, Executive Director of the Alliance for Retired Americans, urges aging advocacy groups not to remain complacent. “Republicans in Congress are eager to cut the benefits Americans have worked a lifetime to earn,” he warns. “We cannot allow Social Security to be privatized or dismantled.”

Fiesta also calls for stronger Medicare reform, urging Congress to curb the high cost of prescription drugs and hold Medicare Advantage insurance corporations accountable for rising costs that don’t benefit patients.

A Final Note…

Social Security is an essential lifeline for millions of Americans, and its future is now at a crossroads. Can a partisan Congress work together to find a political viable fix?

While the media reports Social Security’s impending insolvency and bankruptcy, there is no doubt that Congress must act soon to ensure the program’s long-term sustainability. Whether through increasing revenue or reforming benefits, the decision on how to strengthen Social Security will shape the future of retirement and disability benefits for generations to come. It’s time for Congress to act.

View the 2025 Trustees Report at www.socialsecurity.gov/OACT/TR/2025/.

Trustee reports: Social Security and Medicare still face financial woes

Published in RINewsToday on April 10, 2023

Over a week ago, the Trustees of the Social Security and Medicare trust funds released their annual reports on the financial health of these two programs. As in prior years, the trustees found that the Social Security and Medicare programs both continue to face significant financing issues.

The latest Social Security projections show the program is quickly heading toward insolvency and calls for Congress to find policy solutions sooner rather than later to prevent abrupt changes to tax or benefit levels.  The Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM) and other aging advocates are urging Congress to take prompt action to strengthen and expand Social Security, while Republicans have been calling for cuts to future retirees’ benefits and at least partly privatizing the program. 

This 270- page 2023 Social Security Trustees Report warns that if Congress does not act, Social Security’s Old-Age and Survivors Insurance and Disability Insurance (OASI and DI) Trust Funds, which help support payouts for the elderly, survivors and disabled, will become depleted in 2033 (that’s a year earlier than forecast last year), becoming totally insolvent in 2034 when beneficiaries would only receive about 80% of their scheduled benefits. 

According to the Social Security Administration (SSA), roughly 66 million people received monthly Social Security checks in 2022 (175,840 in Rhode Island). A vast majority, or about 57 million of those beneficiaries, received benefits through the OASI Trust Fund, compared to nearly 9 million people who received benefits through the DI Trust Fund. 

The trustees say that Social Security funds would be fully depleted in 2034 because of expectations of a slowed economy and reduce labor productivity, considering inflation and economic input.

Although the DI Trust Fund asset reserves are not projected to become depleted during the 75-year projection period, being able to pay full benefits through 2097, the combined Social Security funds would only be able to pay 80% of the scheduled benefits after 2034, says the trustees report.

Taking a look at Medicare’s fiscal health

Medicare, the hospital insurance trust fund referred to as Medicare Part A, will only be able to pay scheduled benefits in full until 2031, according to the 273-page trustees’ annual report. The program covered 65 million seniors and people with disabilities in 2022, and will only be able to cover89% of total scheduledbenefits at that time.

Although the Medicare Part A Hospital Insurance trust fund will become insolvent in just eight years, Medicare spending as a whole (including Parts A, B, D, and Medicare Advantage, will continue to grow over the coming years.

The Medicare Trustees project a shortfall of 0.62 percent of payroll, or 0.3 percent of Gross Domestic Product (GDP), noting that it would take about a 21 percent (0.6 percentage point) increase in the payroll tax rate or a 13 percent spending cut to restore the program’s solvency.

The improvement of Medicare’s hospital trust fund’s finances over last year’s projections can be tied to lower estimates for health care spending after the height of the Covid-19 pandemic along with more projected income that the trustees estimate coming from a larger number of covered.

Dueling political statements

With the Social Security and Medicare Trust Fund reports released on March 31, 2023, the Chair and Ranking Members of the House Ways and Means (HWM) were quick to issue dueling statements to give their political spins. HMW’s Subcommittee on Social Security has jurisdiction on bills and matters related to the Social Security Act.

House Ways and Means Chairman Jason Smith (R-Missouri) charged that reckless Democratic spending has impacted the financial viability of the Social Security and Medicare Programs.  “Thanks to President Biden’s economic failures, seniors’ hard-earned benefits are further under threat. Social Security’s combined trust funds are expected to become insolvent a full year sooner than forecast in the previous report as a result of a slowed economy and Democrats’ inflation continuing to outpace wage growth. And Medicare’s latest report comes amidst Biden’s plans to slash seniors’ access to innovative new cures and treatments,” says Smith, stressing that “the first step to protecting these programs is “growing the economy – not budget gimmicks or tax increases that hold back economic growth.

On the other hand, House Ways and Means Committee Ranking Member Richard E. Neal (D-MA) counters Smith’s political perspective. “While Democrats are committed to the long-term health of these programs, Republicans are launching another shameful assault on the economic well-being of millions of workers and retirees with their plan to make drastic cuts to Social Security and Medicare, warns Neal. “Their playbook is clear: slashing a critical resource that Americans have rightfully earned to give another tax cut to the top 1%. Democrats won’t let their reckless attacks stand, and we will continue to defend and protect Social Security and Medicare for generations to come.”

Rhode Island Congressmen were quick to give their comments about the release of the two trustee reports, too. “Unlike the nearly three-quarters of House Republicans who endorsed slashing Social Security in 2022 – reducing benefits by $729 billion over 10 years – House Democrats are working to protect Social Security for generations to come,” says Congressman David N. Cicilline, representing Congressional District 1.  Cicilline, who is retiring his seat on May 31, 2023, has pushed to expand and strengthen Social Security over his six-terms in office.

Cicilline asks: “Sixty-six million Americans rely on this essential program to make ends meet and we cannot allow Republicans to make any cuts to this hard-earned benefit. The drug spending savings implemented by our Inflation Reduction Act will not only keep money in seniors’ pockets but will also drive down costs to Medicare itself. We’ve been taking real action to strengthen these programs and help our seniors – what have Republicans done?”  

As Rhode Island’s newly elected Congressman, Seth Magaziner says he will “fight tooth and nail to protect Rhode Islander’s hard-won Social Security benefits.”   In responding to the trustee’s report about Social Security’s financial woes, Magaziner called for raising the cap on Social Security taxes, forcing “millionaires and billionaires to pay the same rate as teachers and fire fighters.”

“I stand ready to work with anyone who is serious about strengthening Social Security, not cutting hard-earned benefits,” says Magaziner. 

While there are few fixes being proposed by either party or leader, some fixes identified by the Program for Public Consultation at the University of Maryland that “Americans might be willing to support” include:

–        raising the Social Security payroll tax cap

–        reducing benefits for high earners

–        gradually raising the retirement age

–        increasing the payroll tax

–        raising the minimum benefit

–        changing cost-of-living adjustment calculations

–        increasing benefits for beneficiaries over age 80

Social Security advocacy group gives its two cents

“Contrary to conservative claims, Social Security is not ‘going bankrupt’; the program will always be able to pay benefits because of ongoing contributions from workers and employers. In fact, this is yet another Trustees report showing that Social Security remains strong in the face of turmoil in the rest of the economy,” says Max Richtman, NCPSSM’s President and CEO in a release on the Social Security Trustee Report. He notes that the program’s insolvency date has stayed roughly the same even after a global pandemic and recent economic upheavals. 

Congress can strengthen Social Security by bringing in additional revenues into the program, says Richtman.  NCPSSM endorses legislation introduced by Senator Bernie Sanders (D-Vermont) and Congressman John Larson (D-Connecticut) to keep the trust fund solvent for the rest of this century while expanding program benefits.  Both bills would adjust the Social Security payroll wage cap so that higher-income earners begin contributing their fair share, he notes.

As to Medicare, in a release Richtman called on Congress to take “pre-emptive action now” to protect the Medicare Part A trust fund from becoming depleted in 2031, three years later than estimated in their previous report, at which time Medicare could still pay 89% of benefits.  

“Beyond trust fund solvency, the Trustees reported that the standard Medicare Part B premium will rise next year to $174.80 per month – a $10 or six percent monthly increase,” says Richtman. “Any increase is a burden to seniors living on fixed incomes, who too often must choose between paying monthly bills or filling prescriptions and getting proper health care.  Seniors need relief from rising premiums and skyrocketing out-of-pocket health care costs,” he said. 

“We support President Biden’s plan to strengthen Medicare’s finances, as laid out in his FY 2024 budget.  His plan would bring more revenue into the program, rather than cutting benefits as some Republicans have proposed.  Building on the prescription drug pricing reforms in the Inflation Reduction Act, the President’s budget proposal would lower Medicare’s prescription drug costs — and some of those savings would be used to extend the solvency of the Part A trust fund,” said Richtman.

For a copy of the 2023 Social Security Trustee Report, go to https://www.ssa.gov/OACT/TR/2023/.

For a copy of 2023 Medicare Trustee Report, go to https://www.cms.gov/oact/tr/2023.