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    Column-You’ve got mail from Medicare Advantage, so be careful

    (Reuters) – I have been enrolled in traditional Medicare for a couple of years now, and one professional benefit is that I receive the same direct marketing pitches that my readers get every year from health insurance companies during the annual fall enrollment season.Much of it encourages me to enroll in Medicare Advantage – the commercially offered managed-care alternative to the traditional program. And this year, Advantage plan marketers have a new enticement: the changes that take effect next year in Medicare’s Part D prescription drug coverage. If you are enrolled in traditional Medicare, this pitch should throw up a big red flag, because shifting to Advantage is something you might later regret – and it can be difficult to reverse. The Part D reforms are important, and generally positive. The big change for 2025 is a hard cap on out-of-pocket prescription costs. This reform was phased in under the Inflation Reduction Act of 2022 championed by the Biden administration and Democrats in Congress. Previously, there was no limit to what you might pay if you needed high-cost drugs for conditions like cancer and multiple sclerosis.This year, the cap is $3,300; the final step is a $2,000 cap in 2025. This will provide thousands of dollars in relief to seniors – about 4.6 million Medicare Part D enrollees had already reached $2,000 or more in out-of-pocket drug costs by the end of June this year, according to federal government data. It also will give seniors greater predictability in planning their healthcare spending.But health insurance companies are revising their offerings to a greater extent than usual for next year because of changes required by the Act. If you are enrolled in traditional Medicare with a standalone Part D plan, you may find your premium jumping, or changes in deductibles or cost-sharing arrangements. That means it is important to re-check your coverage this autumn if you are in a standalone plan. The same is true if you have a Medicare Advantage plan with drug coverage wrapped in with no extra premium – the terms of that drug coverage may be changing, too.Health insurance companies are using these changes to convince traditional Medicare enrollees to shift into Advantage. I received a letter recently from  my own current prescription drug plan provider, which I am dropping because the premium and projected total costs are jumping sharply. “Since your plan premiums are increasing in 2025, now is the time to explore your plan options,” the letter states. “(Our Medicare Advantage plan) may be a better fit for you. Plus, switching to (our Advantage plan) could lower what you pay for prescriptions and monthly premiums next year.” The letter goes on to pitch the usual Advantage enticements, such as dental coverage, gym membership and the like.This is a very compelling pitch – no wonder Medicare Advantage enrollment has been growing so quickly in recent years. More than half of eligible Medicare beneficiaries (54%) are enrolled in Medicare Advantage in 2024, a figure projected to hit 64% by 2034, according to KFF, a healthcare policy research organization. But here are a few things the letter does not say: – Instead of switching to Advantage, another option that I have is to simply search the Medicare Plan Finder for a less costly Part D plan. That is what I did – instead of a $35 increase, my premium actually will fall about $25 per month in 2025, as will total projected annual costs including the deductible and cost-sharing. – I might need to look for new doctors. If I join this Advantage plan, I will need to restrict myself to in-network healthcare providers in order to access the cost savings described in the letter, possibly causing disruption to my current healthcare.- I probably cannot go back later. Enrollees in traditional Medicare (such as myself) usually pair their Part A, B and D coverage with a Medigap supplemental policy. If I drop that now in order to join a Medicare Advantage plan, I may not be able to get a Medigap down the road if I decide to go back to traditional Medicare. Medigap insurance providers are required to sell me a policy when I first sign up for Medicare, but down the road they can use pre-existing conditions to turn me away, unless I live in one of four states that have some amount of protected access rights for this critical supplemental coverage (New York, Connecticut, Massachusetts and Maine).- The drug coverage might not fit my needs. The drug coverage wrapped into an Advantage plan may – or may not – be the best fit for me, depending on the medications I take. It is important to evaluate not only the healthcare provider network, but the drug coverage.- Here is the big thing the letter does not say. Medicare Advantage might work just fine for younger and healthier retirees. But the highest rates of dissatisfaction in Advantage are reported by the oldest and sickest enrollees in the program. Consumer advocates who work with Medicare enrollees often report that the highest rates of Advantage disenrollment are among the oldest and sickest patients, who encounter problems with denial of care or extra red tape in the form of requests for prior authorization. During annual enrollment, the ad blitz for Medicare Advantage is intense, and it lacks any context about what it can mean to give up your traditional Medicare coverage.Annual enrollment ends on Dec. 7. It is always a good idea to review your Part D or Advantage plan coverage, so start by consulting the federal government’s Medicare Plan Finder. If you need assistance help, consult your State Health Assistance Program. The opinions expressed here are those of the author, a columnist for Reuters. More

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    Pope says Vatican’s pension fund faces ‘serious imbalance’

    VATICAN CITY (Reuters) – Pope Francis said on Thursday the Vatican’s pension fund is facing a “serious imbalance” that may require changes to its operating structure, and appointed a senior cardinal to take over the fund’s administration.In an unusual letter sent to all the world’s cardinals and to the leaders of the Vatican’s various offices, the pope did not quantify the scope of the issue. He said the changes would include “making difficult decisions that will require particular sensitivity, generosity, and willingness to sacrifice on the part of everyone”.Francis appointed Cardinal Kevin Farrell, an Irish-American prelate who has led the Vatican’s office for family issues since 2016, to take over as the fund’s administrator.The pope has expressed uncommon concern about the Vatican’s budget several times in recent months. In October, he ordered the third reduction in three years for the pay packages of the cardinals who lead the Vatican. He has also asked them to pursue a “zero deficit” agenda.The Vatican has not released a full budget statement in several years but is known to be facing a serious budget deficit.The Vatican’s finance czar estimated in 2022 that the net liability of the pension fund for post-employment benefits amounted to some 631 million euros ($664 million).The headquarters of the Catholic Church comprises two entities: the internationally recognised sovereign entity of the Holy See and the Vatican, a 108-acre city-state within Rome.They maintain separate budgets, and Vatican City income, including from the popular Vatican Museums, has often been used to plug the Holy See’s deficit, which according to Italian media stood at around 83 million euros ($87 million) last year. ($1 = 0.9505 euros) More

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    The global green transition will survive Trump

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    How to put Europe’s savings to work

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    US is vulnerable to inflation shocks, top Fed official warns

    Standard DigitalStandard & FT Weekend Printwasnow $29 per 3 monthsThe new FT Digital Edition: today’s FT, cover to cover on any device. This subscription does not include access to ft.com or the FT App.What’s included Global news & analysisExpert opinionFT App on Android & iOSFT Edit appFirstFT: the day’s biggest stories20+ curated newslettersFollow topics & set alerts with myFTFT Videos & Podcasts20 monthly gift articles to shareLex: FT’s flagship investment column15+ Premium newsletters by leading expertsFT Digital Edition: our digitised print editionWeekday Print EditionFT WeekendFT Digital EditionGlobal news & analysisExpert opinionSpecial featuresExclusive FT analysisFT Digital EditionGlobal news & analysisExpert opinionSpecial featuresExclusive FT analysisGlobal news & analysisExpert opinionFT App on Android & iOSFT Edit appFirstFT: the day’s biggest stories20+ curated newslettersFollow topics & set alerts with myFTFT Videos & Podcasts10 monthly gift articles to shareGlobal news & analysisExpert opinionFT App on Android & iOSFT Edit appFirstFT: the day’s biggest stories20+ curated newslettersFollow topics & set alerts with myFTFT Videos & Podcasts20 monthly gift articles to shareLex: FT’s flagship investment column15+ Premium newsletters by leading expertsFT Digital Edition: our digitised print editionEverything in PrintWeekday Print EditionFT WeekendFT Digital EditionGlobal news & analysisExpert opinionSpecial featuresExclusive FT analysisPlusEverything in Premium DigitalEverything in Standard DigitalGlobal news & analysisExpert opinionSpecial featuresFirstFT newsletterVideos & PodcastsFT App on Android & iOSFT Edit app10 gift articles per monthExclusive FT analysisPremium newslettersFT Digital Edition10 additional gift articles per monthMake and share highlightsFT WorkspaceMarkets data widgetSubscription ManagerWorkflow integrationsOccasional readers go freeVolume discountFT Weekend Print deliveryPlusEverything in Standard DigitalFT Weekend Print deliveryPlusEverything in Premium Digital More

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    COP29 summit battle intensifies over finance, fossil fuels and gender

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    China’s solar stranglehold and Taiwan’s AI aims

    $1 for 4 weeksThen $75 per month. Complete digital access to quality FT journalism. Cancel anytime during your trial.What’s included Global news & analysisExpert opinionFT App on Android & iOSFT Edit appFirstFT: the day’s biggest stories20+ curated newslettersFollow topics & set alerts with myFTFT Videos & Podcasts20 monthly gift articles to shareLex: FT’s flagship investment column15+ Premium newsletters by leading expertsFT Digital Edition: our digitised print edition More

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    The risks of being too gloomy on Trump tariff plans

    Unlock the White House Watch newsletter for freeYour guide to what the 2024 US election means for Washington and the worldThe writer is chief economist at INGDonald Trump’s resounding victory has upset conventional economists almost as much as American liberals. The Republican candidate’s pledge to implement trade tariffs and other protectionist measures has provoked a spate of dire economic prognostications. But much of the current doom-mongery doesn’t consider mitigating factors — and risks undermining the credibility of globalisation’s defenders.These are difficult times for economic experts. Politicians hardly seem to take their advice seriously any more. Economists continue to warn about the dangers of deglobalisation in the form of higher prices and less GDP growth but electorates are rolling their eyes. Trump’s victory amplifies this trend.Some economists estimate that “blanket” tariffs on all imported goods will add up to a big hit to the global economy, leaving American and European households worse off. For example, the Peterson Institute for International Economics estimates that tariffs will add more than $2,600 in annual costs to the typical US household. The prestigious Wharton school at the University of Pennsylvania warns a trade war “could reduce GDP by as much as 5 per cent over the next two decades”. Not to be outdone, the IMF estimates US GDP will be 1.6 per cent lower by 2026 as a consequence of Trump-like policies.However, there are a couple of problems in general with forecasting the impact of tariff rises. First, some forecasts do not always place enough emphasis on likely mitigants, or the economic mechanisms that will soften the blow. For example, a stronger dollar would lower the inflationary impact of tariffs in the US, by reducing the effective price of imports of good and services priced in euros or pounds. Corporates will certainly adapt and find ways to cushion the blow — rerouting the trade via other countries, adding more value in the US rather than at home — and economic simulations usually underestimate these. Also, monetary policy will help out. In Europe, for example, the European Central Bank could lower interest rates.Second, Trump has also promised economically supportive policies, such as deregulating the energy sector, which could help cut prices, and also low taxes, which would support net income.In addition, there is a big but well-known question mark over the extent to which tariffs will be implemented. Trump is a dealmaker; ergo, it seems reasonable to assume he will make deals. And, judging from his last administration, American corporates might be able to convince the president-elect of the negative impacts on their businesses given a huge share of imports are intra-company.Economists’ forecasts sometimes sound worse to the average consumer than they probably are. For example, Wharton’s estimated 5 per cent GDP hit would occur over two decades; that hardly constitutes a crisis. Similarly, the IMF’s 1.6 per cent GDP decrease over two years is substantial, but not enough to constitute a meaningful recession in itself.Tellingly, the IMF does not expect Trump’s proposals to lead to significant inflation, but that has not been given much attention. And even the direst economic conjecture has not yet forecast price increases similar to those seen recently, particularly in energy and food. In sum, the shock effect of proposed tariffs are pretty slight compared with the economic stress that consumers and corporates have experienced over the past few years. To be sure, economists are not wrong to say protectionism comes with a hefty price. But, much like Brexit, the damage done by tariffs specifically and deglobalisation generally is likely to be slow and cumulative. There are multiple downsides to presenting it as a shock. First, it reduces fragile confidence and thus businesses and consumers may refrain from investing or shopping, hitting growth more than necessary. Second, governments may rush to policies and compromises that are overdone, such as concessions in a trade deal or tit-for-tat protectionism.Third, it could slow momentum for much-needed European economic integration, including capital markets and banking unions, as politicians wait for a crisis that will never come before starting their negotiations. Finally, voters will see overly pessimistic warnings on inflation and other economic damage as yet another reason not to listen to experts.The consequences of deglobalisation will show up in the slow erosion of long-term productivity and economic wellbeing. It will leave us all poorer in the long-run. That’s less catchy — but a crucial defence of why it matters. Overly gloomy warnings of a Trump shock risk weakening crucial support for globalisation and open trade even more. More