[QUAD-L] Fwd: Medicare Watch #22, October 25, 2005

[DAANOO]

FYI some interesting Medicare items.  Q1 has been extended that helps low income with Medicare premiums. Dana

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Welcome to MEDICARE WATCH, a biweekly electronic newsletter of the Medicare Rights Center

Vol. 8, No. 22: October 25, 2005

 

Contents:

 

1.   FAST FACT

2.   MEDICARE AND MEDICAID CUTS ARE BACK

3.     MEDICARE PREMIUM ASSISTANCE PROGRAM EXTENDED

4.   CALLS FOR INCREASED OVERSIGHT OF PART DIMPLEMENTATION

5.   CASE FLASH: GETTING “EXTRA HELP” DESPITE ASSETS

 

 

1.   FAST FACT

 

Even though the average retired American spends about $640 a month on health care, most retirees and pre-retirees surveyed said they expect to spend less than $300 a month on health care (Aetna and the Financial Planning Association, October 2005).

 

2.   MEDICARE AND MEDICAID CUTS ARE BACK

 

            After nearly two months of delays, Senate Finance Committee Chairman Charles E. Grassley, Republican of Iowa, scheduled a markup of the committee’s budget package that has to include a net $10 billion in spending cuts.

            According to observers, Grassley’s package of spending cuts and increases was the result of weeks of negotiating between the committee’s moderate and more conservative Republicans.

            Grassley’s plan would cut a net $10 billion from Medicare and Medicaid over five years. The bill nets $4.26 billion in spending cuts from Medicaid and $5.76 billion from Medicare. The package also includes $1.8 billion in new spending to assist states affected by Hurricane Katrina with Medicaid costs and an increase in Medicare doctors’ reimbursements.

            Cuts to the Medicare program include eliminating the preferred provider organization “stabilization fund”; higher payments to insurers that cover sicker patients and lower payments to those that enroll healthier patients; and implementing a program to base reimbursement rates on quality measures.

            Neither the House Ways and Means Committee or House Energy and Commerce Committee is expected to turn to Medicare spending cuts. The House Energy and Commerce Committee package includes only changes to the Medicaid program and is likely to cut more than the required $14.7 billion set for the committee. The bill includes greater restrictions on asset transfers to qualify for Medicaid.

            The Ways and Means Committee is looking past Medicare to find $8 billion in cuts to the Supplemental Security Income program and the federal foster care and child support programs.      

 

3.   MEDICARE PREMIUM ASSISTANCE PROGRAM EXTENDED

 

            Just as some states had already started to disenroll low-income people from a recently expired federal Medicare premium support program, the House and Senate passed a two-year extension of the program that helps some 192,000 older adults and people with disabilities save more than $900 in 2005 and $1,000 in 2006.

            Under the Qualified Individual (QI) program, people with Medicare with incomes between $1,097 and $1,464 a month are eligible to have their monthly Medicare premiums paid by the federal government.

            Congress had let the QI program expire on September 30, because it was unable to resolve differences on this program and other parts of the legislation that included welfare benefits, unemployment insurance and programs to promote sexual abstinence.

            After returning from a 10-day recess, the House and Senate passed legislation that extended the QI program for two years as well as other health care programs, off-setting those costs by ending federal Medicaid payments for erectile dysfunction drugs.

            According to Representative Nathan Deal, Republican of Georgia, who sponsored the original House bill, the government can save $690 million over five years by stopping Medicaid coverage for sexual performance drugs.

           

4.   CALLS FOR INCREASED OVERSIGHT OF PART D IMPLEMENTATION

 

            Four Democratic members of the House Ways and Means Committee sent a letter on October 18 to Chairman Bill Thomas, Republican of California, calling for increased oversight of the implementation of the Medicare prescription drug benefit.

            Charles B. Rangel of New York, ranking minority member, signed the letter along with Pete Stark of California, Sander M. Levin of Michigan and John Lewis of Georgia.

            The letter cites a number of problems that have emerged, including the mailing of empty envelopes to low-income people with Medicare in June, the misleading informational flyer in Parade Magazine and a factual error in the Medicare & You handbook.

            The Democrats want the House Ways and Means Committee to immediately being hearings on the implementation of the Medicare prescription drug benefit.

           

5.   CASE FLASH: GETTING “EXTRA HELP” DESPITE ASSETS

 

Ms. G called her State Health Insurance Assistance Program (SHIP) hotline to inquire about “Extra Help,” a federal program that helps pay most of the costs of Medicare prescription drug coverage for those who are eligible. While her income fell under the income limits for the program (below $14,356 a year for an individual and $19,246 for couples in 2005), her assets exceeded the yearly limit ($11,500 for an individual and $23,000 for a couple) and made her ineligible for Extra Help (which is available by applying through the Social Security Administration).

 

However, Ms. G’s SHIP counselor was able to enroll Ms. G in a Medicare Savings Program (MSP) that has no asset limits in her state—the QI program. By enrolling in an MSP, Ms. G will be automatically enrolled in Extra Help and get her monthly Medicare Part B premiums paid.

 

To read more cases by subject, go to “Interesting Cases” on our web site at www.medicarerights.org/interestingcasesframeset.html.

 

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Medicare Watch is MRC’s fortnightly newsletter, established to strengthen communication with national and community-based organizations and professional agencies about current Medicare policy and consumer issues. Each edition contains the latest Medicare policy developments, case stories from our hotline and action steps that professionals can take to ensure that older adults and people with disabilities get good, affordable health care.

 

 

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