Medicare / Medicaid



Table of Contents
Medicare.gov
Medicare Webinars & Trainings
MRC — Medicare Rights Center — Medicare Watch
CMA — Center for Medicare Advocacy — CMA Alerts
NSCLC — National Senior Citizens Law Center (NSCLC)
CMS — Centers for Medicare & Medicaid Services — CMS News / HHS News
Miscellaneous Articles & Information

HHS News Releases

      HHS Current News Release Page
  • Feb 16:   HHS ensures consumers get better value for their health insurance dollar : Administration actions saved consumers up to $323 million
  • Feb 15:   Affordable Care Act extended free preventive services to 54 million Americans with private health insurance in 2011
  • HEALTH CARE FRAUD PREVENTION AND ENFORCEMENT EFFORTS RESULT IN RECORD-BREAKING RECOVERIES TOTALING NEARLY $4.1 BILLION : Largest Sum Ever Recovered in Single Year

Medicare.gov
The Official U.S. Government Site for Medicare

Medicare.gov
CMS — Centers for Medicare & Medicaid Services — CMS News

Medicare Enrollment Information Sites

Medicare B specific:
IF YOU PLAN ON STILL WORKING and ARE NOT AUTOMATICALLY ENROLLED (sufficient work credits) in Medicare B at age 65, OR are not eligible for a special enrollment period due to group health insurance based on your own or your spouse's ACTIVE employment:
YOU MUST ENROLL IN MEDICARE B within the seven-month period beginning three months before and ending three months after the month of your 65th birthday, or face a possible penalty as well as a waiting period before Medicare B activates.
If you are already getting benefits from Social Security or the Railroad Retirement Board (RRB), in most cases, you'll automatically get Part A and Part B starting the first day of the month you turn 65.
If you're automatically enrolled, you'll get your red, white, and blue Medicare card in the mail 3 months before your 65th birthday or your 25th month of disability.
You need to sign up for Medicare Parts A and/or B if:   You aren't getting Social Security or Railroad Retirement Board benefits automatically, or have not reached full retirement age —
You have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B.
For example, if you're eligible when you turn (65), you can sign up during the 7-month period that begins 3 months before the month you turn (65), includes the month you turn (65), and ends 3 months after the month you turn (65).
  •   Find out when you're eligible for Medicare — Medicare.gov page
Enrollment Between January 1 - March 31 Each Year
If you didn't sign up for Part A and/or Part B when you were first eligible, you can sign up during the General Enrollment Period between January 1 - March 31 each year.   Your coverage will start July 1.
However, you may have to pay a higher premium for late enrollment.
You can sign up for Medicare at your local Social Security Office.

Fight the Good Fight for Medicare & Social Security

Tell Washington you're not a pushover — Don't let them cut your Medicare and Social Security benefits.
The stakes are clear, and couldn't be higher:
"Supercommittee" members are considering proposals requiring cuts to Medicare and Social Security that would dramatically increase health care costs for seniors, threaten our access to doctors, and reduce the benefit checks we rely on to pay our bills.
Congress needs to hear from you.
Call AARP's toll-free number and be connected to your members of Congress — 1-888-722-8514

Massachusetts EOHHS/Medicaid
MA Draft Proposal to Integrate Care for Dual-Eligible Individuals

ALERT —MEDICARE is NOT calling anybody!!

Do NOT give your Medicare # or your social security # to anyone unless YOU have initiated the call!
If you feel that something is "not quite right" with a phone call, simply hang up.
We suggest you contact your local police department or town which may then initiate a 'reverse" 911 call (or internet email setup) that can inform people quickly throughout the community about this scam.
If you have any questions or concerns regarding Medicare, please call 1-800-MEDICARE (1-800-633-4223).
Courtesy:   Emmett Schmarsow, Prog. Mgr. COAs & Senior Centers, Elder Affairs

Advanced Beneficiary Notices — Medicare Manual

Mandatory ABNs can be found at 1862(a)(1)(P)
2011 Version of Advance Beneficiary Notice of Noncoverage Must Be Used Beginning Sun Jan 1, 2012
In May 2011, CMS released an updated version of the Advance Beneficiary Notice of Noncoverage (ABN) (form CMS-R-131), which will replace the 2008 version of this form.
Providers and suppliers are allowed to use either the 2008 or 2011 version of the ABN through the end of this year; beginning Sun Jan 1, 2012, they must begin using the 2011 version.   ABNs issued after Sun Jan 1 that are prepared using the 2008 version of the notice will be considered invalid by Medicare contractors.   2008 versions of the ABN that were issued prior to Sun Jan 1 as long-term notification for repetitive services delivered for up to one year will remain effective for the length of time specified on the notice.
Information and a copy of the 2011 version of the ABN (form CMS-R-131) can be found online at http://www.CMS.gov/BNI, under the "FFS Revised ABN" link.

Medicare Preventive Services

CMS has posted 27 FAQs regarding preventive services for Medicare Fee-For-Service providers/suppliers to the Medicare Learning Networkฎ Products Preventive Services webpage;   to access the entire list of 27 FAQs, scroll to the "Related Links Inside CMS" section at http://www.CMS.gov/MLNProducts/35_PreventiveServices.asp and select "Preventive Services FAQs."   Or, click here.

Revised Standard Pharmacy Notice for Pharmacies

Beginning with the 2012 plan year, each Part D plan sponsor must have a system in place that transmits codes to network pharmacies to instruct the pharmacies to provide a printed notice to enrollees when a prescription cannot be covered ("filled") under the Medicare Part D benefit at the point-of-sale (POS).   The printed POS notice will tell enrollees how to request a coverage determination by contacting the plan sponsor's toll free customer service line or by accessing the plan sponsor's Web site.

Congressional Budget Office Report

New CBO issue brief entitled "Spending Patterns for Prescription Drugs Under Medicare Part D".

MAP 2012 (and 2011) Original Medicare Out-of-pocket costs



Medicare Rights Center


The Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs and public policy initiatives.

Medicare Interactive


You may know that November is National Family Caregivers Month.   The Medicare Rights Center has important guidance for anyone caring for a loved one with Medicare.   Visit our free, comprehensive online resource, Medicare Interactive, for answers about some of the most common concerns we hear from family members.
Pioneer Accountable Care Organization (ACOs) Model
Center for Medicare & Medicaid Innovation
Today, the Department of Health and Human Services announced that thirty-two leading health care organizations from across the country will participate in the Pioneer Accountable Care Organization (ACOs) Model.
Medicare Fact Sheet — The 2012 QMB, SLMB, and QI Programs
The Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI) programs are federal Medicare Savings Programs (MSPs) which help low income elders and younger Medicare beneficiaries access Medicare benefits.
In Massachusetts, the programs are called MassHealth Senior Buy-In (for QMBs) and MassHealth Buy-In (for SLMBs and QIs).
Medicare Fact Sheet — 2012 Policies
CMS issues final 2012 policies for Medicare drug and health plans
Most policy and technical changes effective in 60 days
Medicare Watch — Latest Issue and/or Subscribe
  • (3/6) President Obama Releases Fiscal Year 2013 Budget, Including Changes to Medicare — 2012 Feb 16
  • (3/5) What Does Means-Testing Really Mean?   Debate Continues Over Preventing Cuts to Medicare Physician Payments — 2012 Feb 9
  • (3/4) New Guidance on State Option to Put Dual-Eligibles Into Managed Care — 2012 Feb 2
  • (3/3) Compliance Still an Issue for Medicare Advantage and Prescription Drug Plans — 2012 Jan 26
    According to a recent memorandum released by the Centers for Medicare & Medicaid Services (CMS), some Part C Medicare private health plans, also known as Medicare Advantage plans, and Part D Medicare Prescription Drug Plans are facing compliance issues.   The memo presents the findings of 11 program audits conducted by CMS in 2011 to monitor and improve plan compliance under the Part C and D programs.
  • (3/2) QMBs Protected from Balance Billing — 2012 Jan 19
    This month, the Centers for Medicare and Medicaid Services (CMS) released a new informational bulletin reminding state Medicaid agencies that those eligible for the Medicare Savings Program, Qualified Medicare Beneficiary, also known as QMB, cannot be "balance billed."   In most states, to qualify for QMB, an individual's income must be at or below 100% of the Federal Poverty Level (FPL).   In addition, while some states have eliminated asset tests, most states have asset limits that restrict eligibility.
  • (3/1) The Myth of the $247 Medicare Part B Premium — 2012 Jan 12
    Recently, Medicare beneficiaries have contacted the Medicare Rights Center with concerns about an e-mail circulating to the general public.   This e-mail falsely claims that the Medicare Part B premium will increase to $247 in 2014 as a result of the Affordable Care Act (ACA).
  • (2/47) Congress Seeks Compromise: Medicare Rights Offers Comments on Part C and D Rules — 2011 Dec 22
  • (2/46) Yet Another Voucher Proposal — New Proposal May Mean Higher Costs for Medicare Beneficiaries — 2011 Dec 15
    Today, Representative Paul Ryan and Senator Ron Wyden introduced a new proposal that would convert Medicare into a premium support, or voucher, program. However, many of the details of the proposal remain unclear.
  • (2/43) A Call to Action as Supercommittee's Deadline Approaches — 2011 Nov 17
    Below is a sample message—either as is or personalized by you—you can deliver as a letter, phone call or e-mail to your representatives and senators, and to the members of the supercommittee. Now is the time to take action to protect Medicare and preserve it for current and future generations.
  • (2/42) Doing the Math: A Medicare Cost Worksheet and a Supercommittee Update — 2011 Nov 10
    Medicare beneficiaries, half of whom have incomes at or below $22,000 dollars per year and nearly half of whom suffer from three or more chronic conditions, already spend 15 percent of their incomes on health costs—three times as much as the non-Medicare population.
  • (2/41) Supercommittee Eyes Medicare for Cuts — 2011 Nov 3
  • (2/40) Congress Must Take Action to Protect Medicare Beneficiaries' Access to Care — 2011 October 27
  • (2/38) Petition Urges Supercommittee to Protect Medicare — 2011 Oct 13
  • (2/37) New Rules Released for Part C and Part D — 2011 Oct 6
  • (2/36) Deficit-Reduction Update — 2011 Sept 29
  • (2/34) Letter and "Medicare Voices" Report Sent to Supercommittee — 2011 Sept 15
  • (2/33) The Joint Select Committee on Deficit Reduction, also known as the "Supercommittee," held its first meeting today — 2011 Sept 8
  • (2/25) Lieberman-Coburn Medicare Proposal Would Raise Costs for People with Medicare — 2011 June 30
The Medicare Counselor — Latest Issue and/or Subscribe
Dear Marci Newsletters — Latest Issue and/or Subscribe

Center for Medicare Advocacy   &   CMA Alerts

CMA Advocates Homepage

2012 Medicare Part D Cost Sharing — preliminaryThe Affordable Care Act includes a provision establishing a Center for Medicare and Medicaid Innovations (CMMI) that is authorized to test models to reduce Medicare and Medicaid expenditures while preserving or improving quality for beneficiaries of those two programs.   The provision includes appropriations of $5 million for fiscal year 2010 and $10 billion for fiscal years 2011 through 2019.The Medicare Trustees issued their annual report on Medicare's financial status on Friday, May 13, 2011.
Medicare Facts & Fiction — Quick Lessons to Combat Medicare Spin
We Can Fix Medicare AND the Deficit — Our Six Point Plan
CMA ACTION Alerts Page
  • Ryan-Wyden: Wolf in Sheep's Clothing (2011 Dec 16)
    Have you heard?   This week, Rep. Paul Ryan (R-WI) and Sen. Ron Wyden (D-OR) outlined yet another effort to privatize Medicare; a twist on Rep. Ryan's voucher plan from earlier this year.
  • End "Observation Status!" (2011 Oct 21)
    Tell Your Members of Congress that you Support the Improving Access to Medicare Coverage Act of 2011
If someone you know has been denied Medicare because a condition is not showing "improvement," coverage is being unfairly denied. The Center for Medicare Advocacy is working to eliminate this unfair standard.   Contact us today:   improvement@medicareadvocacy.org
CMA Alerts Page
(Check this page for Past & Current Alerts)
Recent CMA Alerts
  • The President's Proposed 2013 Budget: Impact on Medicare
  • Investing in Our Future: Strengthening Medicare for 2012 and Beyond
  • CMS Issues Final Version of New Medicare Part D Pharmacy Notice
  • Reminder: Medicare Advantage Enrollees Have Until February 14th to Disenroll From Their Plan
  • 2012 Poverty Guidelines: How Poverty Levels Affect Eligibility for Many Federal Public Benefit Programs
  • Center for Medicare Advocacy Files Amicus Brief In Support Of the Affordable Care Act
  • The Medicare Advance Beneficiary Notice of Non-Coverage (ABN): A Tool for Limiting Beneficiary Liability
  • Medicare Cost-Sharing for Qualified Medicare Beneficiaries:Balance Billing is Prohibited.   Period
  • Voluntary Nursing Home Improvement Campaign Does Not Work:   Nursing Facilities Participating in Advancing Excellence Still Among Worst Performers
  • New Medicare Part D Pharmacy Notice Rule In Effect; Stay Tuned for Final Model Notice
  • Ryan-Wyden: Wolf in Sheep's Clothing
    Have you heard?   This week, Rep. Paul Ryan (R-WI) and Sen. Ron Wyden (D-OR) outlined yet another effort to privatize Medicare; a twist on Rep. Ryan's voucher plan from earlier this year.
  • Payroll Tax Extension Includes Important Provisions for Medicare Beneficiaries
  • Special Focus Facility Study: Nursing Facilities' Self-Regulation Cannot Replace Independent Surveys
  • Center Attorney Toby Edelman Testifies at Senate Aging Hearing About Overuse of Antipsychotic Drugs in Nursing Facilities
  • Forcing Dual Eligibles Into Private Health Plans is No Quick Fix
  • Supercommittee Fails to Reach an Agreement
  • You CAN Leave the Nursing Home (for Thanksgiving and Holidays)
  • Medicare Does Not Require "Improvement" for Coverage
  • Health Care Reform Update: Where Are We, and What's Up for 2012
  • The President's Plan for Economic Growth & Deficit Reduction: A First Look at the Impact on Medicare
  • Preserving Access to Necessary Care: Ending "Observation Status"
  • Hospice -- Care When It's Needed Most
  • Annual Enrollment Starts October 15 and Ends December 7 for Medicare Part C & Part D Plans
  • Study Finds that Use of Hospitalists Shifts Costs from Inpatient Care to Post-Discharge Setting
  • Nursing Home Reimbursements — A Major Medicare Fiction
  • More Facts About People with Medicare; Nursing Home Demographics Rules
  • Real Solutions to Save Medicare Dollars in Skilled Nursing Facilities
  • CMS Permits States to Extend Certain Medicaid Spousal Protections to Same-Sex Couples
  • Medicare Secondary Payer Practices that Harm Medicare Beneficiaries


National Senior Citizens Law Center (NSCLC)


Table Helps Calculate Medicaid Eligibility Under Pickle Amendment

Social Security announced this fall for the first time since 2009 that there will be a cost of living adjustment in Social Security and SSI benefits effective January 1.
This adjustment will affect the calculation of Pickle Amendment eligibility for Medicaid in 2012.
Gordon Bonnyman of the Tennessee Justice Center updated this table and instructions that enables advocates to calculate Medicaid eligibility under the Amendment quickly and simply.
Download the Table

NSCLC Advocate Alerts

•   A Helpful Advocacy Tool:   CMS Memoranda on Balance Billing Protections for Qualified Medicare Beneficiaries

For Part D Advocates
Due to a coding error, CMS will be conducting a secondary reassignment of certain beneficiaries eligible for the Part D low-income subsidy (LIS) in late November.   This reassignment will move beneficiaries who are currently enrolled in de minimis plans and should have been reassigned as a part of our annual reassignment process in October.
CMS will mail reassignment notices (printed on blue paper) to the affected beneficiaries in early December.
CMS will mail a second blue letter to these beneficiaries in January.
This second notice will identify which drugs in their current drug regimen are on the formulary of the 2012 plan to which they are being reassigned, and how to request an exception or appeal, or file a grievance.•   QMB Program Needs Fixes to Operate Effectively

NSCLC Monthly Webinars

This Webinar is free and part of a monthly Webinar series presented by the National Senior Citizens Law Center.
Title:   Improving the Qualified Medicare Beneficiary Program for Dual Eligibles
Date:   Wednesday, November 16, 2011
Time:   11 AM - 12 PM Pacific / 2 PM -3 PM Eastern
Register:   https://www3.gotomeeting.com/register/635597582

NSCLC News Articles:


•   Dual Eligibles Receiving Medicaid HCBS Services Now Have Zero Part D Copayments Under ACA
•   Mandatory Managed Care for Dual Eligibles Could Harm Patients and Stifle Innovation
•   Medical Health Plans of America — Letter to Washington
•   AHIP Proposal: Achieving Medicare/Medicaid Integration for Dually Eligible Beneficiaries
•   Medicare Part D LIS recipients may be getting their LIS rider late this year
•   Dual Eligibles Encounter Problems Accessing Needed Benefits (2011/07/15)
•   Consumer Protection for Dual Eligibles Important in New Integrated Care Models (2011/07/13)



Centers for Medicare & Medicaid Services — CMS News

MEDICARE PREMIUMS AND DEDUCTIBLES FOR 2012

FACT SHEET — 2011 October 27

CMS News & News Releases

      CMS Current News Release Page

SHIP Navigator Newsletter

National SHIP Resource Center Reintroduction
At the start of the new fiscal year, we here at the National SHIP Resource Center thought it might be helpful to reintroduce ourselves and explain just who does what — especially for those who may be new to the SHIP network.
Subscribe to E-Letter:   Subscribe

CMS Bulletin Updates

The CMS National Medicare Training Program

The CMS National Medicare Training Program On-line Training Library
The CMS National Medicare Training Program On-line Training Library has been updated with 2012 Medicare premium and deductible rates and information.
Please visit the 2012 Premium & Deductibles Page in the Training Library to access the 2012 Medicare rates, recent press release, comprehensive fact sheet, and web resources.
These documents will help you as you counsel people with Medicare to help them make good health care choices.
New Materials available for download
5-Star Plan Ratings
Medicare uses information from member satisfaction surveys, plans, and health care providers to give overall performance star ratings to plans.

Miscellaneous Medicare Part D Publications for 2012

  • Processing Low Income Subsidy Status Changes for 2012 [Medicare Part D] (2011 Dec 2)
    For Part D Advocates 2011-2012
    Due to a coding error, CMS will be conducting a secondary reassignment of certain beneficiaries eligible for the Part D low-income subsidy (LIS) in late November.   This reassignment will move beneficiaries who are currently enrolled in de minimis plans and should have been reassigned as a part of our annual reassignment process in October.
    CMS will mail reassignment notices (printed on blue paper) to the affected beneficiaries in early December.
    CMS will mail a second blue letter to these beneficiaries in January.
    This second notice will identify which drugs in their current drug regimen are on the formulary of the 2012 plan to which they are being reassigned, and how to request an exception or appeal, or file a grievance.

Medicare Learning Matters (MLM) — Medicare Learning Network (MLN)

American Sign Language (ASL) Video on Medicare

Today, the Centers for Medicare & Medicaid Services (CMS) released an educational video in American Sign Language (ASL) to provide important information about the Medicare program to people who are Deaf or hard of hearing.
The video consists of an overview of the Medicare program, including what Medicare is, who qualifies, the four parts of Medicare (A, B, C, and D), new preventive services under the Affordable Care Act, and help paying Medicare costs.
The video will be available on Medicare.gov, cms.gov and the CMS YouTube channel.
To access go to http://www.youtube.com/watch?v=eskZVAg7v0o.
To download, go to http://downloads.cms.gov/media/video/ASLOverview.mp4.
ABCs of the Initial Preventive Physical Exam and Annual Wellness Visit
Materials from Thu July 21 "ABCs of the Initial Preventive Physical Exam and Annual Wellness Visit" National Provider Call Now Available.
Annual Reassignments for certain Low Income Subsidy (LIS) Eligible Individuals
This CMCS Informational Bulletin is to inform you that in June, the Centers for Medicare & Medicaid Services (CMS) started the process of annual reassignments for certain LIS-eligible individuals and issued a June 29, 2011, Informational Bulletin laying out the steps in that process. This is the second of two Bulletins about this process for 2011. This Bulletin provides an update on the next steps in the process to ensure that States understand their role in ensuring that dual eligible beneficiaries have timely, affordable, and comprehensive coverage under the Medicare Part D prescription drug benefit.
Medicare Preventive Care Benefits
A word of caution about the wellness benefit.   The wellness visit must be coded appropriately by the provider as a wellness visit not as a routine annual physical or it will be denied, and there are still costs for some screenings.   Attached is a brochure that the AMA has provided to physicians to assist in answering patient questions and a document from NCOA that spells out the benefits and contains additional links.
Courtesy — Cynthia Phillips

HHS News Releases

      HHS Current News Release Page

Health Reform to Require Insurers to Use Plain Language in Describing Health Plan Benefits, Coverage

CMS News & News Releases

      CMS Current News Release Page

CMS gives consumers access to more details about infection rates at America's hospitals
New data will save lives, cut costsAffordable Care Act helps 32 health systems improve care for patients, saving up to $1.1 billion
Leading health care providers will be Pioneer Accountable Care OrganizationsPioneer Accountable Care Organization Model: General Fact Sheet HHS to give states more flexibility to implement health reform
Approach will help ensure consumers have quality, affordable coverage starting in 2014CMS announces first results for program to improve care for dialysis patientsMedicare Gives Employers, Consumers Information to Make Better Health Care Choices
Health care law will allow patients to compare options, find best valueMedicare Expanding Competitive Bidding Program to Save Billions
Program Expanded by Affordable Care ActMedicare covers screening and counseling for obesity
Decision adds a new preventive service for Medicare beneficiariesMedicare's Dec. 7th Open Enrollment deadline nears
HHS expands initiative to protect Medicare and seniors from fraud
Medicare awards grants to expand 52 Senior Medicare Patrol programsCMS Announces New Demonstrations to Help Curb Improper Medicare, Medicaid Payments
Efforts will Build on 2011 Decreases in Medicare, Medicaid Improper PaymentsMedicare expands coverage of cardiovascular disease prevention services
New, free preventive services for Medicare beneficiaries support Million Hearts initiative
Seniors save more than $1.2 billion on prescriptions thanks to the Affordable Care Act
More than 22.6 million people with Medicare received free preventive services this year
Universal American reinstated in Part D
CMS reports that Universal American, which had been under suspension, has been reinstated as of today.   The company can take enrollments that would be effective as of September 1.

HHS announces new incentives for providers to work together through Accountable Care Organizations when caring for people with MedicareMedicare Covers Screening and Counseling for Alcohol Misuse and Screening for DepressionMedicare Provides Assistance to Help Low-Income Beneficiaries Get Big Savings on Prescription Drug CostsMedicare prescription drug premiums will not increase, more seniors receiving free preventive care, discounts in the donut holeAffordable Care Act cuts health care red tape, saves $12 billionAffordable Care Act Delivers Cheaper Prescription Drugs to Nearly 500,000 People
Thanks to the Affordable Care Act, nearly 500,000 people with Medicare Part D who reached the gap in coverage know as the "donut hole" have received an automatic 50% discount on their covered brand name prescription drugs.Up to $500 million in Affordable Care Act funding will help health providers improve care
Partnership for Patients announces Federal contracting opportunitiesMore people with Medicare receiving free preventive care
New CMS campaign to educate seniors about new free preventive care provided by Affordable Care Act CMCS is pleased to announce today the release of a State Medicaid Director's letter regarding Same Sex Partners and Medicaid Liens, Transfers of Assets, and Estate Recovery.   The purpose of this letter is to ensure that States are informed of the existing options and flexibilities in setting their Medicaid eligibility policy.   Specifically, the letter advises States of existing choices and options regarding spousal and domestic partner protections related to liens, transfer of assets, and estate recovery.CMS PROPOSES TO EXPAND ACCESS TO SEASONAL INFLUENZA IMMUNIZATION Proposed Requirement Would Make Flu Shots Available to Patients at Most Commonly Visited Medicare-certified Health Care Facilities.

Additional Resources


Families USA

Share the News:   New Preventive Services for Medicare
These new benefits will only be effective if seniors and people with disabilities understand their new rights.

KAISER FAMILY FOUNDATION REPORTS

Kaiser Family Foundation Resources on Deficit-Reduction Plans

With Congress' debt-reduction Super Committee facing a Wednesday deadline, the Kaiser Family Foundation has compiled a number of its resources that shed light on how the ongoing national debate about deficit reduction may affect Medicare, Medicaid and other health-care programs.
The resources include summaries and comparisons of relevant elements of major deficit-reduction plans, analyses of specific savings proposals, and explanatory briefs and backgrounders describing key issues related to the debate.   All can be found online at http://www.kff.org/medicare/Medicare-Medicaid-Deficit-Resources.cfm.
Medicare Advantage Fact Sheet — Update

Kaiser Health News

http://www.kaiserhealthnews.org/

Recent Kaiser Reports


Proposals to raise premiums for higher-income Medicare beneficiaries are currently being discussed along with other options to reduce federal spending on Medicare.
Two New Reports Examine 2012 Medicare Advantage Plan Options and Premiums and the Quality-Based Star Rating System To Be Used for Bonus Payments in 2012A Quarter Of Medicare Drug Plans Get Poor RatingsNew Rule Targets Poor Performers In Medicare Advantage, Part D Program
The Centers for Medicare and Medicaid Services unveiled a rule Monday that would allow the agency to drop plans that fail for three years to earn at least three stars under a five-star rating system.Data Spotlight and Report Examine Medicare Drug Benefit's Coverage Gap
A new data spotlight and report from the Kaiser Family Foundation reviews how the coverage gap in Medicare's drug benefit known as the "doughnut hole" is working, with updated data and new analysis.Raising Medicare's Age of Eligibility to 67 Would Achieve Significant Savings,
But Shift Costs To 65- and 66-Year-Olds, Other Individuals, Employers and Medicaid, New Analysis Shows.
Courtesy Diane Paulson, Medicare Advocacy Project, 197 Friend Street, Boston MA
New Analysis Estimates Impact of Medigap Reforms On Medicare Spending and Out-of-Pocket Costs — 2011 July 20
A new analysis, http://www.kff.org/medicare/8208.cfm, commissioned by the Kaiser Family Foundation examines three potential Medigap reforms, including one that is similar to a recommendation of the National Commission on Fiscal Responsibility and Reform (known as the Bowles-Simpson Commission).   The analysis estimates that the three options could save between $1.5 billion and $4.6 billion in Medicare spending in a single year.

Medicare Part D, "Donut Hole" News

The Good News:   The Medicare Part D "donut hole" is closing.
The Bad News:   Not until the year 2020.
This is where Prescription Advantage can help.

— 2010 —


Harvard Pilgrim Has Cancelled Its Medicare Advantage Plan
As you can see from the article below, HPHC has cancelled its Medicare Advantage plan.   According to the report they are instruction the 22,000 individuals that they can pick up the HP supplemental plan.   Please note -- this supplemental plan does not include prescription drug coverage.   These individuals will need to also purchase a prescription drug supplemental plan.   I suspect each/all of you may get calls on this or related matters as the open enrollment period approaches. — Jessica Costantino, AARP
Medicare Open Enrollment 15 November 2010
Medicare Prescription Drug (Part D) Plans and Medicare Advantage Plans change every year.   Many plans will no longer be available in 2011.
Don't give your personal information to anyone who calls you about the $250 rebate check!
Call 1-800-MEDICARE (1-800-633-4227) to report anyone who does this.
TTY users should call 1-877-486-2048.
For further information regarding "Donut Hole" concerns, please contact:
Cynthia Phillips, State SHINE Director, Executive Office of Elder Affairs, Suite 517, One Ashburton Place, Boston, MA 02108
Phone: 617-222-7416 — Fax: 617-727-9368 —   Email: Cynthia.Phillips@state.ma.us
Medicare Update:   Medicare & The New Health Care Law — What it Means for You.   Many Medicare Beneficiaries to receive $250 check.
Medicare beneficiaries will soon receive information in the mail about the immediate benefits they may see from the new the Affordable Care Act.   The first benefit that several million Medicare beneficiaries will receive is a one-time check for $250, if they enter the Part D donut hole and are not eligible for Medicare Extra Help.   The donut hole, or coverage gap, is the period in the prescription drug benefit in which a beneficiary pays 100 percent of the cost of their drugs until they hit the catastrophic coverage.   Next year, all beneficiaries who enter the gap will get a 50 percent discount for covered brand name Part D drugs.   Also beginning next year, Medicare beneficiaries will get preventive care services like colorectal cancer screening and mammograms without cost-sharing, in addition to an annual wellness visit.   A fact sheet about Medicare and the new health care law is available in English and Spanish.
This information has recently been updated, and can be read by visiting this link:   http://www.disability.gov/health/health_insurance/medicare
Paul J. Lanzikos, Executive Director, North Shore Elder Services, 152 Sylvan Street, Danvers, MA 01923-3568 978/624-2245 — 978/624-2244 (TTY)

Kaiser Family Foundation's analysis of how the health care bills in Congress affect the Medicare and Medicaid programs

Medigap Training Outline
The Centers for Medicare and Medicaid Services has published an informative training document on Medigap insurance.
Medicare's Role for Women — Kaiser Family Foundation

What is Medicaid?   A brief primer dealing with health care reform





MCOA Logo   Massachusetts Association of Councils on Aging

    116 Pleasant Street, Suite 306, Easthampton MA 01027-2781
    Phone:   413-527-6425       Fax:   413-527-7138

    webmaster — peter@mcoaonline.com