Questions & Answers(Medicare/Prescription Drugs)

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Questions & Answers

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Medicare prescription drug bill -- No one's happy


By The Capital-Journal editorial board
The Republicans don't like it. They think it will bankrupt the nation.
Neither do the Democrats. They think it will bankrupt senior citizens.

And the American Association of Retired Persons is under fire for endorsing the plan for a prescription drug plan under Medicare.

So since no one's happy, that must mean Congress did something right.

The Senate followed the House's lead and passed the most sweeping changes in Medicare in almost four decades.

The historic legislation creates a prescription drug benefit for seniors and lets private insurors get a foot in the door in the government's health care program for older Americans. It not only increases access to prescription drugs for 40 million eligible seniors; it also fundamentally shifts the program to more reliance on HMOs and insurance companies.

Of course, the landmark legislation has its critics, but for vastly different reasons.

Some Republicans who bolted the party to vote against the new legislation said it's much too expensive for the nation's taxpayers. Such profligate spending is anathema to conservative Republicans, even those who have parents who will benefit from the program.

Some Democrats don't like the program because it lessens the federal government's role in providing health care to Americans. They're not particularly interested in allowing Republicans to chip away at what has become one of the nation's most expensive entitlement programs.

Listen to this: Nine Republicans voted against the bill and 11 Democrats voted for it.

Both senators from Kansas, Sam Brownback and Pat Roberts, supported the bill. In the House, however, Republican Reps. Jim Ryun and Jerry Moran and Democrat Dennis Moore voted against the bill.

How's that for strange bedfellows.

So, are senior citizens angry?

You bet. Some are so upset at the AARP's endorsement of the Medicare bill that they are ripping up or burning their AARP membership cards and flooding the lobbying group's Internet message board with complaints that the organization sold them out.

It all boils down to philosophy.

Those who opposed the bill believe a bad program left in place beats a potentially worse program put into force.

Those who favored the bill believe it's now or never.

We won't know which side is right until the dust settles.

But you can take this to the bank: A whole bunch of senior citizens are really upset.

And they vote

[admin]

Presuming President Bush signs the Bill recently passed by Congress:



Starting this spring, people with Medicare will be able to join a drug discount card that Medicare has approved. This card will immediately provide savings on your prescriptions. Individuals whose income is less than $12,124 each year or married couples whose income is less than $16,363 may qualify for $600 to help pay for prescription drugs.



Beginning in 2006, all people with Medicare will have access to a voluntary prescription drug benefit with significant savings for seniors and people living with disabilities.



Medicare will contract with private companies to offer new discount cards.



Prescription drug discount cards that are approved by Medicare will display a Medicare approved mark on the card. This mark will also be featured on materials that explain the cards to people with Medicare who may be interested in enrolling in a card.



Beginning in 2006, Medicare will offer several ways for seniors to voluntarily receive prescription drug coverage.



If you are in the Original Medicare Plan, you may enroll in a Prescription Drug Plan. Prescription Drug Plans are private plans that will contract with Medicare to provide drug coverage to people with Medicare who live in a certain area.



People with Medicare will be able to enroll in a private health plan, known as Medicare Advantage Plan. These plans may be a local Health Maintenance Organization or a regional Preferred Provider Organization. Medicare Advantage Plans will offer drug coverage in addition to other medical benefits.



Some people with Medicare may receive prescription drug coverage through a former employer, just as they do today, and Medicare will help that employer pay for the coverage.



Health and Human Services Secretary Tommy G. Thompson's November 25, 2003 news statement titled "Secretary Thompson Applauds Final Passage of Medicare Bill" is available for viewing on www.hhs.gov.


Provided by:
The Centers for Medicare & Medicaid Services (CMS)

[admin]

From the website: TheCMS.org

The New York Times, Sunday, November 30, states many senior citizens feel let down by the new legislation . Why? Costs is the answer.

The Times gives the following costs for seniors:

First $ 250 Senior Pays 100%

Next $2,500 Senior Pays 25%
Medicare 75%

Next $2,800 Senior Pays 100%

Beyond $5,l00 Senior Pays 5%
Medicare 95%


Where you stand is where you sit. The Times says that Low Income Seniors "without any insurance for prescription drugs stand to gain most from the new Medicare benefit. They could receive extra assistance, reducing their premiums, deductibles, and other costs."

Bottom line, low income seniors are given a benefit, middle income seniors a small benefit, except substantial benefit in the case of a substantial illness.

In a time when the Federal government is recording record deficits, the legislation is a great start. Novelli made the right decision.

[admin]

Q&A on Medicare

For the 40 million seniors and disabled Americans who rely on Medicare, some big changes are in the works.

Congress has added a new benefit -- an option to buy insurance coverage for prescription drugs. It has also told beneficiaries that they will pay more for the existing Medicare coverage for doctors' services, medical equipment, outpatient hospital care and certain other services -- known as Part B medical insurance.

Combined with other modifications, the changes are the most extensive since Medicare was created in 1965.

The bottom line for beneficiaries: Many people will come out ahead if they buy the new drug insurance. But there will be a variety of these new drug plans, and it will likely take some pencil-and-paper calculations to determine which one best fits a person's needs.

Following are some questions and answers about how to navigate the new options.

Question: Can I buy coverage for prescription drugs right away?

Answer: No. The insurance will not be available until 2006. As a temporary measure, seniors will be able to buy a drug card that entitles them to discounts on prescription drugs.

Q: How can I tell if I should buy a drug card?

A: This will require some shopping around. The drug cards will cost $30 a year. But they will be offered by private companies, and each one will have a different list of covered drugs and discounts.

A look at existing drug cards -- a handful are already on the market -- has some experts worried that it will be hard for seniors to determine which card offers the best deal. Some cards state a drug discount as "retail price minus 12 percent," for example, while others give the discounted price -- say, $49.04 for 100 pills. Consumer advocates hope that federal officials will require the card companies to make it easier to compare plans.

Q: If drug discount cards are already on the market, why did Congress authorize new ones?

A: If they meet certain requirements, the new cards will be able to use the Medicare name in their marketing -- a kind of quality seal of approval, said Tricia Neuman, a Medicare specialist at the Henry J. Kaiser Family Foundation, an independent health policy organization. Congress is betting that the Medicare imprimatur will prompt more people to buy the new cards, and that card companies will be able to use the higher volumes to bargain for deeper discounts from drug manufacturers.

Q: Once the drug benefit starts in 2006, how can I tell if it is a good deal for me?

A: First off, people should look at the drug coverage they may already have, consumer advocates say. About 12 million Medicare beneficiaries are covered as part of their retirement package from companies or the government. They may want to stick with their current coverage rather than consider one of the new plans.

"Employer coverage is the gold standard for drug coverage,

[admin]

The new medicare/prescription drug legislation has a lot of programs.

"The bottom line for beneficiaries: Many people will come out ahead if they buy the new drug insurance. But there will be a variety of these new drug plans, and it will likely take some pencil-and-paper calculations to determine which one best fits a person's needs.

Following are some questions and answers about how to navigate the new options."

Read Article http://www.gazettenet.com/story.cfm?id_no=11270032

[admin]

This discount card program is the first major program to go into effects under the medicare/prescription drug program.

Read some informative answers http://www.medicareadvocacy.org/Presc%20drugs_QsAboutDiscountCards.htm

[mickeythuy]

I have question, but I don't know how to post on the cyberactive, so i just hit the repply. Please help. thank you.

More recently on the Medicare front, Congress has just approved a prescription drug benefit for Medicare. For $35 a month, beneficiaries can enroll in a private plan administering the benefit. The new benefit covers 75% of drug costs up to $2250 per year (after a $250 deductible) and will begin in 2006. Coverage would then stop until the resident spends $3600 out of pocket. Medicare would pay 95% of the cost after that. The bill also includes $86 billion in tax breaks and subsidies to employers to encourage them to retain retiree drug plans and $14 billion to encourage insurers to offer the benefit. The program is expected to cost $400 billion over 10 years.
a) Evaluate the pros and cons of this proposal on the basis of cost, quality, access and equity.
b) Would you advise a Medicare recipient to enroll in this benefit? Why or why not.

[admin]

Endorsing Medicare bill best for AARP members

By WILLIAM D. NOVELLI
First published: Sunday, December 14, 2003

There has been almost as much "analysis" of AARP's support for the just-passed Medicare prescription drug bill as there was of the bill itself. Our support has generated criticism from both the left and right, including some of our traditional allies. But we made the right decision. We will weather this storm and move on.
Many of the criticisms are coming our way because the issue is a political football for the 2004 elections. Some opponents of the legislation are charging that it will destroy Medicare. These scare tactics are designed to alarm seniors and create a furor against AARP. In response, we are telling our members the truth and countering misinformation about what is in the bill.

AARP supported this legislation for one reason and one reason only: It will provide important prescription drug coverage and financial relief for millions of current and future Medicare beneficiaries. Though certainly not perfect, the bill represents an historic breakthrough after years of partisan gridlock in Congress and an important milestone in the nation's commitment to strengthen and expand health security for older Americans and their families.

Read article
http://www.timesunion.com/AspStories/story.asp?storyID=198703&category=OPINION&BCCode=&newsdate=12/14/2003

[admin]

Source: Treasury Department

Beginning Jan. 1, the new Medicare law will allow some people under age 65 to set aside tax-free money in health savings accounts to pay for medical expenses.

To qualify, individuals must have at least a $1,000 deductible on their health-insurance policy and a $5,000 cap on out-of-pocket expenses. Family policies must have at least a $2,000 deductible with a $10,000 cap on out-of-pocket expenses.

A single person can set aside up to $2,600 a year, and a family can save up to $5,150. Those aged 55 to 65 can set aside additional money, up to $500 in 2004, increasing to $1,000 annually in 2009 and thereafter. A married couple can make two additional contributions as long as both spouses are at least 55.

Contributions will not be taxed when they are put into the account, investments accrued from the account will not be taxed, and the money in the account will not be taxed when it is withdrawn as long as it is used to pay qualified medical expenses.

The money can be spent on prescription drugs, qualified long-term-care services and long-term-care insurance, COBRA coverage, Medicare expenses and insurance premiums.

Preventive-care services, as well as coverage for accidents, disability, dental care, vision care and long-term care, are not subject to the deductible.

Distributions made for any other purpose are subject to income tax and a 10 percent penalty. The 10 percent penalty is waived in the case of death or disability and for distributions made by individuals age 65 and older.

Individuals, family members and employers can make contributions, which are tax-deductible. Employer contributions are made on a pre-tax basis and are not taxable to the employee. Employers will be allowed to offer the savings accounts through a cafeteria plan.

The account can be transferred tax-free to a spouse upon death.


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Online: Centers for Medicare and Medicaid Services, www.cms.hhs.gov
Mitch Mitchell, (817) 390-7420 mitchmitchell@star-telegram.com

[admin]

By transferring prescription costs from Medicaid to Medicare, Texas may save up to $1.7 billion over eight years.

Read article http://www.dfw.com/mld/dfw/news/7520390.htm

[admin]

There are definite winners and loosers in the new Medicare legislation. If you are a senior whose primary interest is to lower the price of prescription drugs you are a looser; on the other hand if you are a low income beneficiary or want some help in payiing your current drug bills, you are a winner.

Click to read article http://www.clevelandjewishnews.com/articles/2003/12/24/news/local/bcover1226.txt

[peggy]

I,m not sure I agree with the paragraph that states the new legislation prohibabits seniors from buying a private medigap policy,I have a policy with AARP that pays what medicare doesn't,the $840 deductible for hospital, the $100 deductable,but I don't have a drug benefit with the plan and if thats what you are referring to then you should clarify that,but if you are correct,then thats another flaw I wasn't aware of,and if that is true then I do believe, I will tell meicare they can keep their part "B" and give me back my $58.00,tell AARP to get lost, and I save some money,I won;'t have any health insurance, bit I haven't had any for the last ten years anyway!!!!

[peggy]

This new legislation is going to save somebody money, but it isn't going to be the seniors!!! Like your statement about Texas!!! and another thing is, its not only Jewish people, that will be hurt,its us Christian folk too!! and all the other seniors,white,black,brown,green or purple, can't you people keep distinctive culture out of anything?????? This affects all seniors, no matter what culture you belong to or what color you are, is this really too difficult for people to grasp,now I'm not just talking about medicare,but we all better get on the same page concerning alot of problems.

[admin]

Much controversey surrounds AARP support of the Medicare bill.
Read one insider views.

"After weighing all the pros and cons of the legislation, the AARP Board of Directors, a group of volunteer leaders from across the country, decided to support passage of the prescription drug act for one reason and one reason only — it will provide important prescription drug coverage and financial relief for millions of current and future Medicare beneficiaries."

Read article http://wvgazette.com/section/Columns/200401014

[admin]

Much has been written on this subject. A media watchdog at the University of Pennslyannia thinks the answer is yes.

" In its latest attack ad, the liberal group MoveOn.org shows a cowboy-booted figure physically tripping up elderly couples by jerking on a rug, while a narrator says President Bush “is pulling the rug out from under Medicare” and “sided with the drug companies who've given him huge contributions.” The ad accurately cites two features of the new prescription drug bill that critics cite as defects, but fails to mention that most seniors will be financially better off when the new law takes effect in 2006."

Read article http://www.factcheck.org/article.aspx?docID=125

[admin]

The public continues to ask questions about the new prescription drug act. Does it help or hurt?

"The short-term impact in New York is not likely to be dramatic," says James R. Tallon, president of the United Hospital Fund, a federated charity (the nation's oldest) that researches and analyzes health care issues in New York City and issues public-health grants. "There will be some benefit to the hospitals, especially rural hospitals, like those upstate. They used to be reimbursed less than urban hospitals, on the assumption that their costs were lower; now much of that gap has been closed. Hospitals in New York City probably won't be affected that much."

"Over the long term, we're just not sure what will happen," he says. "

Read article
http://www.gothamgazette.com/article/health/20040112/9/835

[admin]

Many of your answers to questions about the new Medicare act are answered in the new educational campaign of HHS.

"HHS Secretary Tommy G. Thompson today unveiled a nationwide education campaign to inform seniors with Medicare about the new benefits being offered to them. The first major segment of the education campaign is a television ad that will air nationwide starting today."

Read Article: .http://releases.usnewswire.com/GetRelease.asp?id=110-02032004

[admin]

Why Does Not The Government Bargin for Drug Prices?

One controversial component of the new Medicare Act is a prohibition on the US government from dealing with drug makers to get the best prices for the cosumer. One member of Congress takes exception to this proposal.

"When a member of the audience questioned why the government couldn't take over the dissemination of drugs by using its bulk buying power to negotiate lower prices like Wal-Mart, she was told by Blunt that such a suggestion was socialization of medicine and that he, for one, was opposed to such a method."

Read article http://www.joplinindependent.com/display_article.php/mariwinn1077256653