HIMPower Magazine HimPower March 2018 | Page 29

can also specify with CMS approval at what level (or tier) they wish to cover it, and are encouraged to use step therapy. Some drugs are excluded from coverage altogether and Part D plans that cover excluded drugs are not allowed to pass those costs on to Medi- care, and plans are required to repay CMS if they are found to have billed Medicare in these cases. OUT-OF-POCKET COSTS No part of Medicare pays for all of a beneficiary's covered medical costs and many costs and services are not covered at all. The program contains premiums, deductibles and coinsurance, which the covered individual must pay out-of-pocket. PREMIUMS Most Medicare enrollees do not pay a monthly Part A premium, because they (or a spouse) have had 40 or more 3-month quar- ters in which they paid Federal Insurance Contributions Act taxes. The benefit is the same no matter how much or how little the beneficiary paid as long as the minimum number of quarters is reached. Medicare-el- igible persons who do not have 40 or more quarters of Medicare-covered employment may buy into Part A for an annual adjusted monthly premium. Most Medicare Part B enrollees pay an insurance premium for this coverage.  Robert Rhinesmith is a Registered Investment Advisor, Applewood Capital Management Asso- ciates, LLC. www.himpowermagazine.com  29