By SYLVIA GORDON
Guest Columnist
The short answer is inflation, COVID and a new Alzheimer’s drug.
Last year there was legislation put through for COVID relief that artificially kept the price of Medicare Part B lower than it should have been. You, like the rest of the nation, neither noticed that gift from the government, nor were appreciative. It went unnoticed. This year we have to incorporate that rate increase we avoided last year on top of the regularly schedule rate increase. COVID caused more pressure on Medicare, as well as overall medical inflation. If that wasn’t enough (and it was) we also have the unprecedented new Alzheimer’s drug Aduhelm to thank.
Aduhelm is the first drug to come along in years to treat Alzheimer’s. With millions of Medicare members suffering from this disease, this was heralded as bright spot in 2020. However, there is no proof that this drug works. The FDA approved it because of its promise.
I’ve had Alzheimer’s in my family, and I like the sound of this. But on closer inspection, there is no clinical proof of the efficacy of this drug. Why do you care? Because a course of treatment costs $56,000 per year. If you have a Medicare Supplement, expect higher than usual rate increases in 2022 as the companies plan to absorb this rate increase. If you have a Medicare Advantage plan, enjoy a year without impact. You won’t see the reverberations from this till 2023. If you ONLY have original Medicare A & B (which I highly recommend that you don’t) you could be out $11,200 or 20 percent of the cost of Aduhelm versus $0 on a Medicare Supplement or a copay on a Medicare Advantage plan.
The Cleveland Clinic and Mount Sinai hospitals announced they would not be administering this drug, which is an infusion in a doctor’s office, not a pill. With such big names rejecting this drug, I’m shocked that Medicare moved ahead with it. I hope that it proves to work, but the precedent is alarming. Every person on Medicare Part B is paying a few extra dollars each month for this and the prospect of other high-dollar drugs to come.
If you are on Medicare, a 14.5 percent monthly increase in Part B means that the average American will pay $170.10. If you have very low income, Google “Indiana Medicare Savings Program” to see if you are eligible for assistance with Part B.
If you are ready to retire and wondering what the historical increase to Part B has been, in the past four years it averaged about 4 percent. So this is a very high-water mark and not the news we need heading into another COVID winter.
Sylvia Gordon is the president of Gordon Marketing, headquartered in Noblesville, where she trains on Medicare and Social Security in all 50 states. You can contact her at sgordon@gordonmarketing.com.