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Saturday, July 5, 2008 |  |
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Consumer Guide To Medicare
New information regarding Private Fee-for Service Plans.
Medicare beneficiaries with Part A and/or Part B are eligible to receive outpatient prescription drug coverage under Medicare Part D. In addition to the voluntary drug benefit, new preventive care services have been added to the overall benefit package to reflect the way medicine is practiced today. The law creating these new benefits in Medicare were signed into law by President Bush on December 8, 2003.
Whether you decide stay in traditional Medicare or choose a PDP, or a Medicare Advantage Plan, is completely up to you.
Most people have saved $1000 onaverage on their prescription drug costs. Many people will also be eligible for further assistance. If you receive a letter from the Social Security Administration, we encourage you to complete the form and return it for processing.
Recent Developments
New Medicare Premium, Deductible, and Coinsurance Charges for 2008
The Centers for Medicare and Medicaid Services (CMS) has announced the new Medicare premiums, deductibles, and coinsurances. The standard Medicare Part B premium is increasing by 3.1 percent to $96.40 a month, the smallest increase since 2001. The increase is lower than previously expected in part due to the correction of an accounting error. Money for certain hospice benefits had been inadvertently drawn from the Part B trust fund rather than the fund that pays hospital costs. In addition, the lower premium assumes that physicians will take a 10 percent cut in their reimbursement rates. It is expected that Congress will act to offset some of or all of that pay cut, meaning that future-year premiums will reflect the additional expense.
Here are all the new Medicare figures:
- Part B premium: $96.40/month (was $93.50) Part B deductible: $135 (was $131)
- Part A deductible: $1,024 (was $992)
- Co-payment for hospital stay days 61-90: $256/day (was $248)
- Co-payment for hospital stay days 91 and beyond: $512/day (was $496)
- Skilled nursing facility co-payment, days 21-100: $128/day (was $124)
New Plan Performance Information Now Available
Medicare collects quality assurance information from Medicare plans and providers. Medicare also collects information from people with Medicare about how satisfied they are with those plans or providers. This information about quality is posted at www.medicare.gov. The website has ‘search tools’ that walk you through the steps for getting information you can use to compare what each plan or provider offers in your area.
CMS announces new rates for 2007
CMS proudly announced late last week that the cost of the prescription drug benefit will be lower next year than in 2006. The $24 average premium for Part D Medicare beneficiaries paid in 2006 will remain the same or possibly go lower in 2007, and the low-income benchmark and the national benchmark -- the amount Medicare pays plans -- will be lower as well, resulting in lower overall costs, says CMS.
Click here to learn about several options are available for those who experience coverage gaps.
There are a number of options for those who have found themselves with a gap in their Part D coverage. This document provides some resources developed by CMS, the agency that runs Medicare, and PhRMA, home to many brand drugs taken by seniors.
Information for Veterans on the Medicare Prescription Drug Benefit
Medicare Rx Education Network - This non-partisan network of 40 national organizations representing seniors, patients, people with disabilities and chronic diseases, pharmacists, insurers, healthcare providers, and businesses is chaired by former U.S. Senator John Breaux. The network will share resources, coordinate activities and disseminate information to Medicare beneficiaries and their caregivers about the new Medicare Part D drug coverage.
Quick facts about Medicare Prescription Drug Coverage: If you applied for extra help
Quick facts about Medicare Prescription Drug Coverage: If you have limited income and resources
Medicare Expands Drugs Available Under Program to Help Beneficiaries with Severe Illnesses: Enrollment Slots Still Available in Demonstration Program - CMS feels there are many beneficiaries with serious diseases including cancer, multiple sclerosis, and rheumatoid arthritis who could benefit from the access to the drugs available through this demonstration. A link to the application for the demonstration is near the end of the press release. (August 13, 2004)
Additional Resources
BenefitsCheckupRx.org assesses current prescription drug coverage and tells beneficiaries what their rights and options are based on their situation.
The National Alliance for Caregiving is dedicated to providing support to family caregivers and the professionals who help them and to increasing public awareness of issues facing family caregivers.
Medicare Prescription Drug Improvement and Modernization Act of 2003: Frequently Asked Questions
Further Help with Your Medicare Questions? - The State Health Insurance Assistance Program (SHIP) has counselors in every State and several Territories that are available to provide free one-on-one help with your Medicare questions or problems.
MMA Assistance from CMS - This new web page is designed to provide quick and easy access to all activities associated with the Medicare Modernization Act including information on the new drug coverage and low-income subsidy.
Assistance for Medicare Beneficiaries with Limited Income and Resources - U.S. Social Security Administration
Find prescription savings programs using the Medicare Prescription Drug Benefit Calculators - Access to Benefits Coalition
NAHU's Actions
NAHU Web seminar on Medicare Basics
Web seminar question & answer session
Additional Resources
For more information, please contact John Greene.
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