Medicare Watch

Medicare Rights Updates Fact Sheet, "Medicare: Strong and Built to Last"

The Medicare Rights Center has released an updated version of its fact sheet, “Medicare: Strong and Built to Last,” which discusses the future of Medicare and the role the program plays in keeping American families healthy and financially secure. With the election now over, policymakers will once again turn attention to the deficit reduction debate—which may have serious implications for Medicare. In response to proposals that would lower the debt only by cutting Medicare benefits or shifting costs to beneficiaries, “Medicare: Strong and Built to Last” reiterates that rising health care costs in the system overall pose the real problem to the nation’s deficit.

Radical plans, including the premium support, or voucher, model passed by the House of Representatives in March of this year, fail to address this underlying cause of increased Medicare spending. Instead, such models would impose an additional financial burden on Medicare beneficiaries who can least afford it. Half of all people with Medicare earn below $22,000 a year and already spend more than 15 percent of their annual incomes on health care costs.

In fact, Medicare can—and should be—the solution to controlling expenses throughout the health care sector: Medicare spending is expected to grow at a lower rate than private insurance over the next decade. Moreover, Medicare is well-positioned to continue providing Medicare beneficiaries and their families with health and financial security. Thanks to the Affordable Care Act, Medicare will be able to pay fully on claims until 2024, an extension of eight years. Through efforts to fight waste, fraud and abuse, and decrease overpayments to Medicare private health plans, the law improves Medicare’s fiscal outlook, saving the program an estimated $700 billion over the next ten years, all while keeping benefits intact.

In the coming weeks, Medicare Rights will release a series of fact sheets about proposals to change the Medicare program. Proposals to raise the Medicare eligibility age from 65 to 67, redesign the Medicare benefit or limit coverage provided by Medigap plans, supplemental coverage to Medicare, share one commonality: they would reduce the federal deficit only by increasing costs for people with Medicare. Keep checking Medicare Watch to read these fact sheets, learn more about what these proposals involve and find out about better solutions for controlling health care costs without harming seniors and people with disabilities.

Read “Medicare: Strong and Built to Last.”

Kaiser Family Foundation Releases Report Comparing States' Proposals on Integrating Care for Dual Eligibles

Twenty-six states have submitted proposals for a federal demonstration program to integrate Medicare and Medicaid services for dually eligible beneficiaries, or people enrolled in both programs. The Kaiser Family Foundation (KFF) recently released a report comparing states’ proposals in the areas of target population, implementation date, enrollment, financing, benefits, beneficiary protections, stakeholder engagement and demonstration evaluation.

Most states are proposing to enroll all dually eligible beneficiaries within a specific geographic area into these demonstrations. A few states have proposed limiting the number of duals enrolled by either age or types of services used. Most states will also passively enroll their target populations into the demonstrations and then give beneficiaries the option of disenrolling later. All state proposals aim to improve care coordination and quality for dually eligible beneficiaries and reduce state expenditures in both Medicare and Medicaid. While two states initially planned to begin implementation sometime this year, demonstrations will most likely launch in 2013 or 2014. So far, Massachusetts and Washington have released a Memorandum of Understanding with the Centers for Medicare & Medicaid Services (CMS).

Read the KFF report.

Medicare Reminder

Fall Open Enrollment is the time of year when you can change your Medicare coverage. You can join a new Medicare private health plan (Medicare Advantage (MA) plan) or stand-alone prescription drug plan (PDP). If you have an MA plan, you can also return to Original Medicare with or without a stand-alone PDP. Keep these six things in mind while you are deciding on your Medicare coverage for 2013.

1. Fall Open Enrollment occurs from October 15 to December 7 of every year. If you enroll in a plan during this time, your coverage starts January 1. If you were affected by Hurricane Sandy and are unable to make a plan selection by December 7, you will receive an extension. See our Spotlight below for more information.

2. Review your Annual Notice of Change (ANOC). Even if you like your current Medicare coverage, you should carefully read your ANOC to make sure the plan still features the benefits you need. Plans can change how they cover your care each year.

3. Help is out there. If you want to join a stand-alone PDP, use the Plan Finder tool on Medicare.gov to compare plans based on the drugs you take, the pharmacy you go to and your drug costs. If you want to join an MA plan, call 800-MEDICARE to find out what plans are offered in your area. After you have researched a plan, call the plan itself to make sure your doctors, hospitals and pharmacies are in-network and that the plan covers all of your drugs. You can also call your State Health Insurance Assistance Program for more assistance.

4. The best way to enroll in a new plan is to call 800-MEDICARE. Enrolling in a new plan through Medicare is the best way to help protect you if there are problems with enrollment.

5. If you are dissatisfied with the MA plan you enroll into during Fall Open Enrollment, you can disenroll from that plan and join Original Medicare with or without a stand-alone PDP during the Medicare Advantage Disenrollment Period (MADP). The MADP spans January 1 to February 14.

6. Understand what you will pay for drugs and what new drugs will be covered by Medicare Part D in 2013. Beginning in 2013, Medicare Part D plans must cover benzodiazepines, as well as barbiturates for people with epilepsy, certain types of cancer and chronic mental health conditions. Medicare coverage of drugs in the prescription drug coverage gap, also known as the doughnut hole, is changing as well. In 2013, someone in the doughnut hole will have greater discounts than in previous years, thanks to the Affordable Care Act.

Read more about the 6 things you should know about Fall Open Enrollment for 2013 at www.medicareinteractive.org, or call our helpline at 800-333-4114.

 

Spotlight

The Centers for Medicare & Medicaid Services (CMS) is granting an extension of the Medicare Open Enrollment Period in order to give beneficiaries affected by Hurricane Sandy and their families adequate time and presence of mind to fully weigh the scope of their health care needs. CMS has responded to the concerns of the Medicare Rights Center and other advocates, people with Medicare, and their families by extending the Open Enrollment Period. Without the extension, Medicare beneficiaries affected by Hurricane Sandy would have had to make new plan choices by December 7, and if they did not, they would have been locked into their current plan for another year. 

Individuals who were affected by Hurricane Sandy and who are unable to make a Medicare enrollment decision by December 7 can call 800-MEDICARE (800-633-4227) to make a plan selection at any time, 24 hours a day, seven days a week. Each request will be reviewed to determine the best course of action, based upon individual circumstances. Enrollment into a plan after December 7 will be effective the month after the enrollment request is made.

If you have questions about your Medicare coverage or the Fall Open Enrollment Period, you can contact the Medicare Rights Center at 800-333-4114.

Read Medicare Rights’ letter to CMS.

Read Medicare Rights’ press release.