Posts tagged 'AARP'
As most of us who read or listen to the news know, there are some extensive efforts by Congress at this time to stop the Bush Administration from enacting regulations making cuts to the pay of doctors and creating other problems for Medicare and Medicare beneficiaries.
There are many points that AARP is looking at backing as far as the Senate Bill by Max Baucus along with several Senators, because AARP thinks these will improve Medicare.
Some of the most important issues AARP has highlighted have been limiting premium increases to Medicare beneficiaries and not limiting payments to physicians treating and caring for Medicare beneficiaries.
AARP CEO, Bill Novelli, states that the bills improvements will directly benefit Medicare beneficiaries. By the same token, Novelli says that “physicians treating Medicare beneficiaries need to be paid fairly.”
The bill will include some other important benefits. It will ensure that more lower-income people in Medicare have access to more financial assistance and a better, more streamlined application process, rather than the sluggish process that leaves individuals in limbo for months and sometimes years, waiting to be accepted for much needed, medically necessary services.
AARP states that the bill that Chairman Baucus has proposed improves Medicare, keeps doctors in the program and does it without unnecessary increases in premiums for people in the Medicare program. This is essential because in the past, some benefits were subsidized and saved by unaffordable increases in premiums. Though premiums have to sometimes be raised to balance the programs out, some raises have been simply unacceptable and unaffordable. AARP feels that this bill will keep all parts of the puzzle balanced and give Congress the time to look at long-term solutions that will work as a win-win for as many parties as possible.
We will provide updates as the deadline later this month draws closer. There is more information available almost daily. This is an important issue and AARP plus many others throughout the country are happy and relieved that there are some sensible options and solutions being explored.
AARP is working hard to protect Medicare recipients from extreme Medicare premium increases. AARP volunteers delivered over 20,000 petitions to Texas Senator Kay Bailey Hutchison and John Cornyn in Dallas and Austin protesting the fact that premiums have doubled since the year 2000.
Congress must deal with this issue by June 30th to make sure that Medicare recipients are not denied access to physicians and the essential medical services their physicians provide. Though Medicare recipients have continued to pay their share, even when they have felt it has become an unfair share, things are now out of control, according to recipients and to AARP. It is time to deal with this issue – before time runs out – and it is essential to make sure that doctors can continue to treat their patients and patients can continue their access to and relationships with their doctors.
Though this particular situation and protest is taking place in Texas, where all Texans are under the strain of high prices for everything from bread to gasoline, Texas is not the only state that is dealing with Medicare struggles. Too many Medicare beneficiaries in Texas – and around the country – who cannot afford basic necessities, are now being forced to pay Medicare premiums that often put the beneficiaries in a situation where they have to choose between Medicare and the necessities of life.
AARP Texas President has stated that AARP is “asking the Senators to fix the problem of getting physicians paid and not just vote to raise premiums.” AARP has pointed out that Congress has simply been using band aids and not real long-term fixes to take care of Medicare issues. These fixes seem to continue to include increases in premiums to Medicare recipients rather than long term solutions that will not penalize the very individuals that these benefits are supposed to help.
Time will tell what will happen in Texas and how Congress will treat the 20,000 petitions. AARP, Congress and Medicare recipients will not only be watching Texas results, but, in these difficult times, they will be watching the Medicare issues throughout the country.
Imagine having medical services performed, thinking you are covered by Medicaid, but instead, finding out that you have a lien against you instead.
This has happened to some people in Missouri who have become part of a class action lawsuit to eliminate the liens and get the financial situation resolved.
The Plaintiffs in the case are claiming that the liens are against monies that are not compensation for past medical bills and services and the liens are a violation against the plaintiffs, who are asking the supreme court for help in settling the situation.
The court granted a Class Certification because the money in dispute which resulted in liens is Workers’ Compensation funding that several hundred individuals received after accidents or injuries that kept them from working. Their contention is that the Workers’ Compensation payments, which mainly replace lost salary, have absolutely nothing to do with Medicaid benefits, which are for medical expenses. Another reason for the class action suit is to be sure that all of the plaintiffs will be treated the same and treated fairly.
Medicaid has said that many of the claims should be barred due to the fact that the statute of limitations eliminates them from being able to participate in a class-action lawsuit. The court ruled that this issue could be determined later, as well as issues of class certification.
In the meantime, this will be an interesting issue to watch. It is not a situation that comes up often, however with cuts in Medicaid budgets and services, as well as states who are dealing with tight budgets and fiscal cuts, issues – especially precedent-setting lawsuits such as this one – important precedents are being set for the future and could affect q great many people – even you. If you need information regarding your rights regarding Medicare or Medicaid, not only can you check with www.medicare.gov and www.medicaid.gov, but also AARP, The Disability Law Center in your area and the Medicaid Legal Information Institute at Cornell University on the internet at topics.law.cornell.edu/wex/Medicaid.
When we look at the Medicare system of healthcare for individuals age 65 and above, it is important to look at the amount of coverage seniors receive, the amount of co-pays and other out-of-pocket expenses they are responsible for and just how it all works in today’s economy.
With the economy as it is currently, it has become very difficult for individuals and families to pay for the very basics, much less any extras. Because costs have escalated enormously – especially during the past couple of years – people, especially seniors, have to make some truly difficult choices as to what they can and cannot pay for, and how it is possible to find the funds to do so.
Unfortunately, Medicare has become one of those things that seniors have to make difficult choices about. With over 44 million individuals on Medicare, there is a lot involved in these choices. For instance, AARP has stated that most beneficiaries of Medicare are under the false impression that the program is all-inclusive and pays for everything. They do not realize that most Medicare recipients are paying at least 25% out of pocket for medical care.
If that isn’t bad enough, there is talk of raising the premiums for the plan. So, in addition to paying co-pays for everything from doctor visits to prescriptions to hospital and nursing home stays, the monthly amount to keep individuals covered through Medicare could go up, too.
Every year for the past five years, Congress has raised the premiums for Medicare in order to cover payments to physicians. Rather than fixing the system, Congress has continued to raise the premiums that seniors have to pay. Unfortunately, this has put any seniors at risk and in a situation where they need to choose between medicine and medical care they need and food, shelter and clothing.
It is right and fair for seniors to pay their share; however, it is not fair that the costs continue to rise constantly. Congress needs to look for another way to cover these expenses and find a way to give seniors a break. They are looking at different ways to get this done.
If you are a Medicare recipient or will be one soon, it is important to do your research, find out what is best for you, and determine what you can afford. Visit www.medicare.gov or www.keepmedicarefa.org for information on Medicare coverage and premiums, plus the efforts to keep premiums fair and affordable
Over ten years ago, a woman in New Jersey heeded home care with basic daily needs after a serious illness. Medicaid would pay for a home health worker to come into her home and help care for her; however the overtaxed New Jersey home health care system had no available workers.
The woman’s daughter did not know what else to do besides putting her in a nursing home. Before that happened, however, an alternative idea was that the Medicaid funds could be used for the woman to hire family to take care of her.
Through this first small step for Medicaid, but huge step for this individual’s family, the Cash and Counseling program began. Grants were given to New Jersey, Arkansas and Florida to pilot the program, and since that time in the late 1990’s, this program has spread to many states in the country.
It has been an excellent program for any reasons. One situation is that the individual is being taken care of at home by their family and not a stranger. They are in familiar place, where statistics show that they will have better resources, more interaction with family and friends, and less isolation and loneliness, all of which lead to faster and stronger recovery. In addition, staying at home and not in a nursing home is certainly much more cost effective and will definitely help the person’s health stay or become more stable.
The federal government has made it easier to participate in this program because it has eliminated the requirement for people to get a Medicaid waiver to participate. According to AARP, this will save a tremendous amount of money. AARP says that home health care costs about a half of what care in a nursing facility costs, and most individuals and their families prefer to stay at home to be cared for unless they are extremely ill or frail.
If you or someone in your family or circle of friends are in this situation, be sure to contact Medicaid at www.medicaid.gov to get further information. It is quite possible that health care can be continued at home with the comfort of being surrounded by family and friends.
Most people who are Medicaid recipients know that their income must stay below a certain level in order for them to maintain their Medicaid eligibility and benefits. Therefore, they must carefully check their finances so that they do not exceed that amount and lose their benefits. This is critical, since Medicaid is a lifeline for many who can’t otherwise get health care and need to continue treatment, medicine or both.
There has been a lot of confusion regarding the tax rebate checks that are being distributed right now. Individuals receiving Medicaid are worried about whether this extra money will count as income and cause them to lose their benefits.
The answer to this is, “No.” The economic stimulus rebate will not count as income; therefore will not cause individuals to lose their Medicaid, according to South Dakota State University.
Some Medicaid programs count resources as assets, so it is best to check the information at www.ssa.gov, which is the federal Social Security Administration website. Some nursing-home waiver and other SSI-related programs count resources as assets, so it is important to check the site to see if any of these situations apply to you. They could include Disabled Adult Children, Widow/Widower, Grandfathered Children or a few others. You can get specific information regarding these situations on the site.
If you or someone in your family is part of any of these programs, Medicaid will not count the tax rebate as income during the month the rebate is received or for two months afterward. That means that this money will not be counted when Medicaid is deciding whether a person is eligible for that month and the two months after the rebate is received. It is important, however, to note that if the money has not been spent or otherwise disbursed by the fourth month, it will be counted as a resource for the programs listed in the previous paragraph.
If you are a Medicaid recipient, hopefully this clears up the confusion so you can breathe a bit easier now. If you have further questions, go to www.medicaid.gov or www.ssa.gov for more information.
There is a lot of information around about what a Medigap or Supplemental Medicare Insurance policy is and what it covers. What it does not cover is just as important to you if you are contemplating whether or not you should purchase a supplement.
The 12 Medigap plans cover basic benefits, but each differs depending upon what state you are in. The twelve plans are labeled A through L, with plan A being the basic policy. Plan B through L offer the same basic coverage found in plan A, and also offer other additional benefits. Plans K and L offer similar coverage as plan A, but the cost sharing is different.
None of the standard or basic Medigap plans cover certain benefits, such as long term care for help with bathing, dressing or using the bathroom. They also do not cover vision, dental care or hearing aids, private duty nursing or prescription drugs. As mentioned, there are other variations based on the state you are living in and receiving benefits from.
To explore the differences and to look for coverage you can contact your state insurance department, or find The Guide to Health Insurance for People with Medicare: Choosing a Medigap Policy.
Another offering is Medicare Select, which is a type of Medigap policy that often costs less than standard Medigap plans. That’s the plus part. The negative is that you can only go to certain participating physicians and hospitals if you need any sort of medical treatment or assistance. To find out if Medicare Select is available in your state, simply call your state insurance department.
Since Medicare Part A is the most basic plan let’s start there. Plan A covers your hospital stay up to 60 days. Starting with day 61, you are responsible for costs through day 150. Since Medicare doesn’t pay at that point, All Medigap plans cover days 61 to 150, though you will have to pay the shortfall, as the Medigap plans don’t cover the entire cost during that time. You will also be responsible for any deductible before Medigap kicks in.
With Part B, you will pay your annual deductible which is $135 in 2008. Medicare then pays 80% of the doctor and other medical services, 50% of some health services and 100% of some preventative services.
Since Medicare does not pay for all services, as described in the paragraphs above, this is where a Medigap policy takes over. Plans B through J cover expenses such as the deductible above, skilled nursing home costs, some deductibles for other services, including at home recovery, preventive care, prescription drugs and foreign travel emergency or urgent care.
As you can see, the expenses that the right Medigap policy covers can offset a lot of out of pocket expenditures. It is an excellent idea to research this type of coverage so that you can see how cost-effective the coverage could be and whether it is right for you. To research the plans more thoroughly you can call Medicare at 1-800-MEDICARE or you can check on the internet at www.aarp.org and www.cms.gov. These sites have links to other information, as well.
Whatever you decide to do, research thoroughly, ask questions, calculate the cost of purchasing a Medigap plan vs. the cost in out of pocket expenses if you don’t purchase one. Get information from your employer, your insurance agent and any other sources on the web. Another great way to get information is to ask friends what type of insurance they have and how happy they are with the coverage.
They say that people spend more time looking for furniture or buying groceries than they do researching their insurance, yet it is your insurance – especially Medigap – that can literally make them or break them. Don’t get caught without protection. Determine what your needs are and then do your homework. You’ll be glad that you did.
There are estimates that at least 40% of individuals that have Medicare Part D do not understand their coverage.
Part D is designed to cover many of the drug/medication costs of individuals enrolled in the plan. Since Part D is not part of the original basic Medicare coverage, there is usually a premium charged. An individual can purchase a Medicare prescription drug plan or a Medicare Advantage Plan.
Both types of plan have limits to them, so it is essential that you research the plans that are available and find what is right for you. With most plans, you will pay a premium and they will pay part or all of your prescriptions. There is extra help for individuals on very limited income.
It is important to note that depending on the plan you choose you could be liable for up to $2,500 in prescription costs. It is important to consider the cost, the amount of co-pays and the amount of coverage you will have. Additionally, there are supplemental plans – often at little or no cost – from organizations such as AARP, Humana and many other companies. These plans cover some costs that Medicare Part D does not. Sometimes these plans offer a discount on prescriptions.
To research Medicare Part D, drug costs, which prescription plan is right for you, and other information, visit the official Medicare website at www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227) and ask a representative for the information you need. You can also check for supplemental plans by checking the internet and type “Supplemental Prescription Medicare Coverage” into Google or any other search engine, and you will find several pages of plans.
Whatever you decide and whatever questions you have, take the time to do a little research so you can find the coverage you need – and so that you can understand the coverage you have.
