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Congress is proposing to drastically reduce Medicare reimbursement for home health services to the chronically sick and elderly. They plan on cutting $57 billion out of the Medicare home health benefit over 10 years. Home health represents only 4.5% of the total Medicare budget, but 11% of the proposed total cuts.
Home health is a key solution for lowering the cost of health care. It is the most cost effective way to care for the sick and elderly. More importantly, the sick and elderly want to stay in their home. They recover more quickly at home with family and friends. Without home health care, seniors will be readmitted into hospitals and transferred to nursing homes, both of which will put a greater financial burden on our Medicare system.
Click here to Read More and Sign the Petition.
Although Medicare covers the majority of healthcare costs, it does not cover 100% of these expenses. Patients are responsible for deductibles and copayments on medical services and prescription drugs. Sometimes meeting these obligations can be very difficult, and for some, even impossible.
There are extra help programs that could help. I’d like to tell you about them.
First, the State Medicaid programs are available for qualified individuals who meet certain income and asset limits. If your income as a single person is $902.50 per month or less, or as a couple $1,214.17 per month or less, and you have limited resources, you could be eligible for a program that can pay your Medicare premium, deductibles, and copayments. In addition, this would automatically qualify you for assistance with your prescription plan premiums, deductibles, and copayments as well.
Even if you do not qualify for this program, you still may be eligible for others. If your income as a single person is $1,353.75 per month or less, or as a couple $1,821.25 per month or less, and you have limited resources, you could qualify for extra help with your Medicare healthcare or prescription costs.
To apply for these programs, you should contact your local Social Security office, visit social security online at www.ssa.gov, or call your local Medicare counseling program State Health Insurance Assistance program, or SHIP. The number for TN is 1-877-801-0044.
If your income does not meet the requirements and you are still having difficulty paying for your medications, talk with your physician about patient assistance programs and generic medicines that can also help you save money.
Whatever you do, don’t go without proper healthcare because you think you can’t afford it. There is help available; you just have to ask for it.
Article provided by Mary Beth Best, Medicare advocate with Voice, Inc.
The Medicare prescription benefit, or Medicare Part D, was added to the program in 2003 under the Medicare Modernization Act. Since then, there has been lots of confusion and misconceptions about the benefit.
There are 3 important parts of the prescription benefit:
1) Initial Coverage Period
2) Coverage Gap (donut hole)
3) Catastrophic Benefit
The Initial Coverage Period of part D may include a deductible of no more than $295 in 2009. A plan can offer a deductible less than that and as little as $0, but not any more than $295. After the deductible has been met, the plan will cover at least 75% of the cost of prescription medications; the beneficiary will pay 25% copayment. The plan could arrange this in a “flat fee”, such as $20 on generics or $35 on name brand prescriptions, but it cannot exceed 25%. The Initial Coverage Period continues this way until the total cost of medications reach $2,700.
At this point, the Coverage Gap, or the donut hole, begins. This is a period of time that the beneficiary must pay 100% of the medication costs, but also must continue to pay the Part D premium, until the out of pocket costs reach $4,350. This is the TROOP, or “true out of pocket” for the beneficiary, not the total cost of medications.
If a beneficiary pays more than $4,350 out of pocket, then the Catastrophic Benefit will begin. During this time, the government pays 95% of the cost of the medications for the remainder of the year. This process restarts every year in January.
For some, there is extra help. Those with low income and limited resources can apply for financial assistance through Social Security or state Medicaid office.
Annual Enrollment Period is each year November 15th – December 31st. During this time, you can re-evaluate your current coverage and switch plans. You can apply for Extra Help any time during the year.
This is video was produced in cooperation with Mary Beth Best, Medicare Advocate with Voice, Inc.
When making decisions about your Medicare coverage, it is important to understand your options.
Medicare is a government entitlement benefit for those who are 65 or older or are permanently disabled workers who have paid into the Social Security system during working years. There is one Medicare program; however, there are 2 specific ways to elect to receive your benefits.
The original or traditional format of Medicare is administered directly through the government and is called “Fee for Service”. This means that benefits are paid to providers as services are needed. Medicare A is 100% paid by the federal program and covers hospitalization, hospice, and home health care. Medicare part B covers medical services and equipment, and 75% of this benefit premium is paid by the federal program. The beneficiary pays the remainder of the premium. In 2009, the Medicare B premium is $96.40 per month.
With Traditional Medicare, patients can see any doctor who accepts assignment and Medicare will pay 80% on most medical services and treatments, after a deductible is met.
Medicare Advantage plans are provided by private insurance companies. The companies receive funds from the Medicare program to create, develop, and manage Medicare health plans. Advantage plans can come in the form of HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), or PFFS (Private Fee for Services).
With an Advantage plan, the arrangements of copayments, premiums, and deductibles will be different for each plan. You may also be required to use only the specific network of doctors and other medical providers within the plan.
When making your decision, it is vital that you understand the differences between Traditional Medicare and Medicare Advantage plans. The choice is yours. Make it count.
This article was given to us by Mary Beth Best of Voice Inc
CareAll Home Care Services founder Jim Carell is the spotlight in this video from Channel 4 and Comcast in Nashville. Mr. Carell discusses the different Medicare plans and their advantages. He also speak to how Medicare works, where the money comes from and also how the Medicare plan differs from the Medicare Advantage plan. Watch the video below or click here to learn more about Medicare.
