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Medicare Part B drug costs are primarily calculated using the Average Sales Price (ASP) methodology. Here's a breakdown of the process:

• Data Collection: Manufacturers submit sales data, including discounts, to the Centers for Medicare & Medicaid Services (CMS).
• Calculation: CMS calculates the ASP for each drug based on the submitted data.
• Payment Rate: Medicare pays for most separately payable Part B drugs at a rate of ASP plus 6% 

This methodology ensures that the payment rates reflect the actual market prices of the drugs, including any discounts or rebates provided by manufacturer.

Learn more: https://www.cms.gov/medicare/payment/fee-for-service-providers/part-b-drugs/average-drug-sales-price

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Medicare Supplement (Medigap) plans can experience rate increases typically once or twice a year. The timing and frequency of these increases depend on the insurance company and can vary. Here are some key points:

1. Annual or Semi-Annual Increases: Most insurance companies raise rates annually, often around your birthday or the policy anniversary month. Some companies may increase rates twice a year
2. Factors Influencing Rate Increases: Rate increases are influenced by several factors, including rising healthcare costs, inflation, and the overall claims experience of the insurance company
3. Notification: Insurance companies are required to notify you in advance of any rate increases, so you will have time to review and consider your options 
4. Variation by Plan and Company: The amount of the rate increase can vary significantly depending on the specific plan and the insurance company. For example, Plan F, Plan G, and Plan N may have different average rate increases

You can use our CSG quoting tool to see a company’s rate history using the “Market Analytics” button. We recommend that five years after issuing someone on their first Medicare Supplement plan that you attempt to requote them for a less expensive rate while they are still young and healthy. This is especially true since carrier products are entering and exiting the market all the time.

Get a quote: https://www.urlinsgroup.com/medicare-quoting-tools.html 

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The late enrollment penalty for Medicare is charged by the Centers for Medicare & Medicaid Services (CMS). This penalty is added to your clients monthly premium if they didn't sign up for Medicare Part A, Part B, or Part D when they were first eligible and didn't have other creditable coverage.

If they believe they shouldn't have a late enrollment penalty, they can take the following steps to address it:

Starting January 1, 2025, there are two new Special Enrollment Periods (SEPs) for dually eligible individuals and those eligible for Extra Help (low-income subsidy):

1. Review the Notice: Carefully read the notice they received about the penalty. It should explain why the penalty was assessed. 
2. Gather Documentation: Collect any documents that support their case. This might include proof of other creditable coverage (like employer-sponsored insurance) during the period in question.
3. Request Reconsideration: Fill out the "Part D LEP Reconsideration Request Form" provided with their notice. This form allows them to formally request a review of the penalty decision. 
4. Submit the Form: Send the completed form and any supporting documents to the Independent Review Entity (IRE) as instructed on the form.
5. Follow Up: The IRE will review their request and notify them of their decision, usually within 90 days. 

Part D penalties will be invoiced with their carrier plan. This is not a carrier issue and not their determination, but they can help get it resolved.

Learn more: https://www.cms.gov/medicare/appeals-grievances/prescription-drug/late-enrollment-penalty-appeals