Archive for the ‘issues’ Category

Medicare Prescription Drug Part D: Two Years Later, Not So Horrible

Monday, October 1st, 2007

 

After all the “horribilizing” – and the confusion, complexity and doubts expressed

when the new prescription drug program became available in 2005 – a University

of Michigan Analysis reveals that the Medicare Part D prescription drug program

has succeeded in boosting drug coverage for older Americans, especially for those

who need it the most.

More than 90% of Americans 65 and older now have prescription drug coverage,

compared to just a little more than 75% in 2004, according to U.M. Economist

David Weir. “The key findings are that Part D participation is widespread and this

helped to ‘level the playing field’ in the sense that low income seniors are now just

as likely to have prescription coverage as high-income seniors.”

Weir stated that the most surprising result is the change in confidence with the

program. In 2005 people expressed a lot of confusion and worry about making

bad decisions. But now that most know the drill, seniors should not just sit and be

comfortable with a plan they picked a year ago.

Our own Jackie Drulliard, Medicare/Medicaid Assistance Program volunteer, reminds

us that “while more seniors have coverage, it is very important that they review

their plan annually during the enrollment period. Many plans change their coverage

and what seemed like a good plan last year might not meet your health or financial

situation this year. One senior’s premium went up to over $80 per month this year.

Had she reviewed her options she could have gotten a comparable plan for $17 a

month.”

It seems we are all in for a shell game – not only as seniors, but also as companies,

organizations, and individuals who look for the best deal and then find the deal

changes at year end. Though more are covered, we must continue to be active

consumers and check plans annually. If you need help, call the Monroe Center

and ask for an appointment with Jackie Drouillard.

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The future of Medicare

Monday, July 30th, 2007

In my opinion, the major flaw in America’s health care system is that it is driven and guided by reimbursement.  If the insurance covers it, in most cases you get the service, if it doesn’t you go without or pay out of pocket.  The problem is compounded because currently there is no way in the health care arena to control the cost of doing business and health insurance premiums and deductibles are rising as rapidly as the coverage is shrinking.

The closer I get to Golden Pond the more I’m concerned about access to quality health care.  I’m encouraged by the advances in technology and medical care that can keep a body functioning and fit in the “Golden Years”.  On the other hand, with the rising out of pocket costs I’ll be lucky to afford  even “Rusty Years”.

Medicare is the national health care plan that provides health insurance for seniors, normally beginning at age 65.  Doctors who treat Medicare patients are reimbursed by the program.  Many under the age of 65 do not realize that Medicare pays only 80% of the ALLOWABLE costs and if you pay extra for a supplemental policy that only picks up the remaining 20% of the ALLOWABLE cost (Medicare determines the allowable cost).  More and more docs are requiring patients to pay the difference between what they charge and what Medicare and supplemental insurance reimburses.

Cuts in Medicare payments to Doctors next year could cause many to limit the number of new Medicare Patients they take on according to the American Medical Association.  This has serious consequences considering that the Abbies (aging baby boomers) will begin turning 65 in about four years.

Congress needs to act immediately to restore the cuts and expand Medicare or as of January 1, 2008 Medicare will see a 10% reduction in funding and that means doctors will have to stop taking patients because their Medicare reimbursment  won’t cover the cost of the service or, increase out of pocket expenses for the patient or both.

The cuts by the federal government are an attempt to control the double digit increases in Medicare costs but they have only resulted in shifting the burden to doctors, hospitals and patients. 

One thing everyone can do immediately (and you don’t have to write to Congress) is to drop their “deathstyles” and develop healthy aging “lifestyles”; eat healthy, exercise the body, mind and spirit and surround yourself with loving family and friends.  You can also (this requires getting informed)  join in our aging advocacy efforts.  Democracy only works well when people participate in the process. 

Contact me if  you would like to receive Aging Advocacy Alerts or more information on how you can be part of the solution.

 

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