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National Immunization Month

Fall is right around the corner, which means many kids are headed back to school. For me, the end of summer invokes memories of fresh school supplies, a new sweater or two, and sometimes a trip to the doctor for dreaded shots. Though I’ve long-since graduated from school, this is a good time of year to remember that getting the appropriate vaccinations is important and not limited to children.

This August, in honor of National Immunization Awareness Month, we’re sharing how important it is for seniors to take control of our own health by staying up to date on our vaccines. For those of us who have grandchildren, it is even more critical, as we don’t want to put our young loved ones at risk for an illness that could’ve been prevented by immunization.

By remaining diligent about necessary vaccinations, we can work together to help prevent infectious diseases. Doing so should be easy since some of the most commonly needed vaccines are covered under Medicare Part B and Part D. As always, remember to consult your doctor if you have any questions about what is included in your coverage or what vaccine is appropriate for your needs. As a starting point, be sure to read on and check out our list of the CDC’s recommended vaccinations for seniors who are 65 years old and up.

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The Results Are In: Seniors Are Satisfied with Medicare Part D Coverage!

If you feel fortunate to have reliable access to medications through Medicare, you’re not alone! Our partners at Medicare Today have released the results of their annual national survey. According to the latest Senior Satisfaction Survey, nearly 9 in 10 seniors are satisfied with their prescription drug coverage. In addition to overall satisfaction, the survey showed that 93 percent of seniors find their plan convenient to use, 84 percent think it’s a good value and 86 percent said their plan works well.

Medicare Today’s newest video provides an overview of the survey results and explains how Part D’s structure helps preserve the benefits that matter most to beneficiaries like you and me:

For more information on the survey results, read more from Medicare Today below. Also, make sure to visit their website and follow @MedicareToday on Twitter to stay updated.

 

New National Survey: Nearly 9 in 10 Seniors Satisfied with Medicare Part D

 Policymakers Weighing Changes to Prescription Drug Program Must Keep in Mind Seniors’ Approval of Part D’s Choices, Value & Convenience, Medicare Today Chair Said

 WASHINGTON – More than a decade after its initial launch, the Medicare Part D prescription drug program remains overwhelmingly popular with American seniors, according to Medicare Today’s annual Senior Satisfaction Survey.  The nationwide survey of approximately 2,000 seniors conducted by Morning Consult found that 87 percent are satisfied with their Part D coverage and 90 percent believe their prescription drug costs would be much higher if they didn’t have prescription drug coverage through Part D.

“This survey shows the program continues to work extremely well,” said Mary R. Grealy, chair of Medicare Today and president of the Healthcare Leadership Council, a coalition of chief executives from all sectors of American health care. “Part D provides affordable access to prescription medications for seniors and individuals with disabilities, and beneficiaries are satisfied with the choices the program offers. They understand the great value it adds to their lives.”

Additional key findings in the survey include:

  • 84 percent of seniors believe their plan is a good value
  • 93 percent of seniors reported that their plan is convenient to use
  • 86 percent said their plan works well and without hassle
  • 83 percent reported it is important to them to have a variety of plans from which to compare and choose

At a time of uncertainty around healthcare issues, with some politicians proposing significant changes to the Part D structure, Ms. Grealy stressed the importance of not disrupting a program that works well and provides such high value to seniors.

“Now more than ever, it is critical that Part D be protected against needless and potentially damaging changes that would lead to uncertainty and threaten to undermine a program on which seniors depend so strongly” said Ms. Grealy.

For more information and full survey results, please visit Medicare Today’s website: www.medicaretoday.org

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About the Survey

Morning Consult conducted a national survey of 1944 adults who are 65 and older and have prescription drug coverage. The interviews were conducted from June 18 – July 6, 2017. Results from the full survey have a margin of error of plus or minus two percentage points.

About Medicare Today

Medicare Today is a coalition of national and local organizations representing seniors, health care providers, employers, patients and consumer groups focused on providing beneficiaries with reliable information on the Medicare program and its benefits. Medicare Today was created by the Healthcare Leadership Council, an alliance of chief executives of the nation’s leading healthcare companies and organizations from all health sectors.



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Protect Seniors’ Access to Medicare: Support Repeal of IPAB

kane-reinholdtsen-145944Attention seniors! If you are like me and depend on Medicare for your health care services, now is an important time to be paying attention to what is happening in Washington, DC. It is expected that the Independent Payment Advisory Board, known as IPAB, could soon become a reality.

If you are a longtime reader, then you may already know about IPAB from our previous post. If not, here are the basics:

IPAB was established by the Affordable Care Act. If Medicare spending exceeds a certain level, then a board of 15 unelected officials are given a broad-range of authority to make decisions about mandatory cuts to Medicare spending.

This is a big problem for Medicare beneficiaries like you and me. These bureaucrats are unelected and in no way accountable to voters. They are required to make spending cuts, but not to maintain quality of care. This means IPAB could soon be determining what will be covered under Medicare – from treatments, to procedures, to medications.

And don’t be fooled by the fact that the president hasn’t appointed members to the board yet. Unfortunately, spending cuts are still mandated by law, so all of IPAB’s power is shifted to the Secretary of Health and Human Services. Proposed changes by IPAB or the HHS secretary can even bypass congressional approval. In this case, the future of health care for millions of seniors could be determined by just one individual.

Across the country, more than 670 organizations made up of patients, doctors, hospitals, employers and veterans are advocating for the repeal of IPAB. Additionally, there is bipartisan support from lawmakers to ensure IPAB never becomes a reality. However, time is running out. As seniors, we must join in and encourage Congress to repeal IPAB today. Our health depends on it.



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National Colorectal Cancer Awareness Month

SSO Colorectal Cancer ImageMarch is National Colorectal Cancer Awareness Month. Here at Seniors Speak Out it’s important to be aware of diseases like colorectal cancer that affect older Americans. Because colorectal cancer, also known as colon cancer, is the second leading cause of cancer-related deaths – and a cancer that can be screened for often – it is so important that we visit the doctor regularly for screenings.

The first step to preventing colorectal cancer is to learn what it is and how it impacts your body. Colon cancer is a malignant growth that begins in the colon or large intestine. It includes both cancers of the colon and those that form in the rectum. Most colon cancers begin with the formation of benign polyps, or non-cancerous growths in the large intestine. Often, these growths produce absolutely no symptoms, which is why it is important to visit your doctor annually for testing.

The U.S. Preventative Services Task Force (USPSTF) recommends adults begin regular screening for colorectal cancer beginning at age 50, though those with a family history of this cancer should begin sooner.

Colonoscopies used to be a dreaded rite of passage for seniors. But there is good news! There are now various options to test for the disease.

Stool tests can be conducted annually, while a colonoscopy is recommended by USPSTF to be done every 10 years in the absence of polyps. According to Medicare.gov, Medicare covers colorectal cancer screening tests to help find pre-cancerous polyps. However, if a polyp or other tissue is found during the colonoscopy, you may have to pay 20 percent of the Medicare-approved amount for the doctor’s services and a copayment in a hospital outpatient setting.

Of course, it is important to discuss your testing options with a physician, who can provide you with more detailed information about each screening test, how often they should occur and what is best for you. Be sure to ask questions about how often Medicare covers each screening test so you know your potential out-of-pocket costs up front.

Again, because the symptoms of colon cancer are often unnoticed, us seniors must take charge of our own health and visit the doctor annually for a regular screening. Contact your doctor today to schedule a test for colorectal cancer in honor of National Colorectal Awareness Month.



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Protect and Preserve the Medicare Part D LIS Program

Sometimes there is a double meaning to the term “Medicare reform.” “Reform” can mean improve and strengthen or it can mean change and weaken.  One example is a proposed reform of the Medicare Part D Low-Income Subsidy (LIS) Program, also known as Extra Help. This program saves low-income beneficiaries close to $4000 per year in prescription drug costs according to the Centers for Medicare and Medicaid Services (CMS).

The proposed reform would change and weaken the program by requiring low-income Medicare beneficiaries to pay higher copays for brand name drugs while lowering copays for generic drugs. The reform, first proposed by the Medicare Payment Advisory Commission (MedPAC), aims to drive more seniors and individuals with disabilities to use generic drugs, which in theory could lower costs to Medicare.

However, this proposed reform is flawed for a number of reasons. It fails to take into account that many patients, including those at or below the poverty level, require access to brand name drugs because their doctor has determined these medications will produce more positive health outcomes than generic medications would provide. In these instances, patients must have affordable access to brand name drugs or their health and well-being could suffer as a result.

Unfortunately, the proposal would increase cost sharing for these patients.  According to analysis by the Leadership Council on Aging Organizations (LCAO), this would deter access to needed medicines which could in turn lead to much higher Medicare costs on other types of health care services.

Further, even if this change provided some exclusion for certain therapeutic classes of drugs, the exclusion may not be broad enough to address the treatment of chronic diseases for which there are often no generic substitutes.

The LIS program must be protected and preserved. This program works to keep cost sharing low for the most vulnerable beneficiaries to ensure patients can access the treatments they need. Adding to those costs could make health care unaffordable for them. The most inappropriate way to celebrate Medicare’s 50th anniversary in 2015 would be to adopt an LIS reform proposal that increases costs for low-income people instead of maintaining its commitment to improve their quality of life.



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Stand Alone or Take Advantage?

A very important question you should ask regarding Medicare prescription drug coverage is what type of plan you want.  There are two very different choices.

The first is to enroll in Medicare Part D. This is a stand-alone plan that covers just your medications. You use this coverage in conjunction with the medical coverage you receive with Medicare Parts A and B (hospitalization, provider visits, testing, etc.).

The other option is to opt for a Medicare Advantage Plan that provides all of the health care services under Part A and B as well as coverage for your medicines in one plan. Examples of Medicare Advantage Plans include Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), Medicare Medical Savings Account Plans, and Special Needs Plans.

Both types of plans have advantages, the right choice for you depends on many factors including where you live and your preferences regarding provider choice. Also, be sure to examine more than just the bottom line on premium costs when evaluating any program.

Some beneficiaries choose to enroll in traditional Medicare health coverage as wells as a stand-alone drug plan (Part D) because it gives them freedom to choose providers without having to coordinate within a network or get referrals. The Part D plans cover your medicines but do not include extra services or provide care. (Note: Some beneficiaries who have regular Medicare and Part D plans also purchase Medicare Supplemental Insurance to assist in copayments and deductibles for medical services.) Part D plans are available throughout the United States, so you have this option no matter where you live.

On the other hand, Medicare Advantage Plans provide health coverage through specific provider networks and facilities. Once you enroll, you are required to seek care within your network. In some cases, these plans also offer additional services not available to beneficiaries who aren’t in their program. Medicare Advantage Plans contract with Medicare to provide Medicare Parts A and B services as well as coverage for your medicines. If you choose to enroll in a Medicare Advantage Plan you do not need to purchase Medicare Supplemental Insurance. These plans are not available everywhere, so it’s important to check what is available in the region or area in which you live. You can check online using the plan finder at www.medicare.gov or use our tools to find a local office to assist you in your search.

Here are a few questions to consider when determining what is right for you:

  • Does my current doctor or other care provider participate in the Medicare Advantage Plan?
  • If not, am I willing to change doctors/providers?
  • Are the care providers and other facilities in Medicare Advantage Plans convenient to me?
  • Are my medicines covered?

One last thing: Medicare provides a rating of 1 to 5 stars for Medicare prescription stand-alone plans and Medicare Advantage Plans. These ratings are based on both Medicare quality standards and beneficiary experience. For a full explanation of the star rating system, go to www.medicare.gov and don’t forget to look for and consider the rating as you select a plan.

Remember that a Medicare is open 24/7 at 1-800-633-4227.



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Thanksgiving Plans???

Thanksgiving weekend has been a traditional time for discussion and consideration of Medicare Part D plans. This year, as families gather, both Medicare beneficiaries and younger family members may be considering their various healthcare coverage options. It’s a great thing to do because plans and coverage needs can and do change from year to year!

The tools Medicare has provided on its website, www.medicare.gov, have become even more streamlined and user friendly over the years, and surveys consistently show that those of us who use them appreciate that convenience as well as the coverage we receive.

Happy Thanksgiving!

So, if you haven’t already done so, take a break from that post-turkey-dinner nap, non-stop football, or Black Friday shopping and go over your Part D coverage!   Don’t forget to also check out all of the resources that are available at www.SeniorsSpeakOut.org!  They will get you prepared for the tasks at hand.

Remember, www.medicare.gov is ready and waiting all the time, and though Medicare’s call center is closed of Thanksgiving Day, you call them bright and early Friday morning or any other time including the weekend at 1-800-633-4227.

Have a safe and wonderful Thanksgiving!



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Shopping for Plans In-Person or Via the Phone

Earlier this week on the blog, we laid out the simple steps you can take to compare plans and shop for coverage using the online tools, such as the Plan Finder, available at www.medicare.gov. Of course, there are people of all ages who are not comfortable putting all their information into a computer – or at least trying to do it without help. Fortunately, Medicare understands this. If you would rather have an in-person discussion or talk to a specialist on the phone, those resources are available as well.

The initial steps to shopping for coverage are the same whether with a representative or online. Begin by making a list of the medicines you take and the dosage. Next, decide whether you want to get most of your medicines, especially the ones you take regularly, by mail or at a local pharmacy. You’ll also need your Medicare card available which will have key information like your Medicare number and the date you became enrolled in Medicare.

If you don’t use a computer or have one available, you can call your local Area Agency on Aging and make an appointment to meet with the SHIIP Counselor who can help you compare available plans. You can find information on local agencies using our online mapping tool. When you go, remember to bring your medication information and your Medicare card with you when you go.

Additionally, you can speak to a Medicare counselor over the phone any day of the week by calling 1-800-MEDICARE or 1-800-633-4227. A live person will walk you through any questions or concerns you have along the way. They are available 7 days a week excluding federal holidays.

How long will this process take? Probably about an hour or so.  Not long, but enough time to maybe save you money or at least confirm that you are getting the best coverage you can for the medicines you take.

Finally, you can always get information directly from the plan you are interested in. To do this, go to the Plan Finder on the Medicare website, follow the directions, and you will get a list of plans in your area. Click on the name of the plan in order to obtain the contact information. You can also call a local SHIIP Counselor to get plan contact information.

Have you gone through the paper enrollment process? Any guidance you would share with fellow seniors? We’d love for you to sound off in the comment section or through our Facebook page to let us know about your personal experience.



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Online Tools to Shop for Part D Coverage

It is interesting to hear younger people talk about how hard it is to choose health insurance plans. They’re right. Evaluating all the intricacies of multiple plans can at times be a significant challenge. That’s why Medicare beneficiaries are incredibly fortunate. We have easy-to-use tools and real people to help us compare choices and select the Part D plan that’s right for us.

A quick visit to the Medicare Plan Finder website is all you need to get started using the tools that are available to compare plans. So, if you are thinking about reviewing your Medicare Part D plan options now that it is open season – and you really should be thinking about it – here are some easy steps to follow.

Begin by making a list of the medicines you take and the dosage. Next, decide whether you want to get most of your medicines, especially the ones you take regularly, by mail or at a local pharmacy. With that information, a laptop or tablet computer, a phone, and your Medicare card, you are ready to go.

Once on the Medicare Plan Finder website, you will be asked if you want to look broadly at all of the plans available in your area or do a more personalized search which requires providing your name, Zip Code, Medicare Number, date of birth, and the year your Medicare coverage became effective. All of that information can be found on your Medicare card. If you or someone searching for you has never put in your information before, you should use the General Search option.

Continuing with the General Search, you next have to provide some information about yourself and your income and Medicare status as well as the list medicines you take and their dosage. All of this is necessary to help narrow down the list to plans that are right for you.

If you have searched for coverage before, it’s even easier. Simply choose the Personalized Search option and it will automatically reflect the information you provided the last time you compared plans. It will also give you the chance to update the information with any changes or additions.

From that point on, just follow the directions on the screen until you have a number of choices that you are comfortable working with, or in some cases, a single choice that best meets your needs. You can always go back and change the search data to get more or fewer choices.

But the best news is that if you need help or have questions, — day or night, weekday or weekends — you can call 1-800-MEDICARE or 1-800-633-4227 and speak to a live person. They’re available anytime except federal holidays.

Watch the blog for more information this week about the resources available to you if you’d rather not search for a plan online. In the meantime, let me know what your experience has been like with the online tools – both good and bad.



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The Benefits of Part D Coverage for America’s Veterans

This week, we celebrate Veteran’s Day, a time of thanks and appreciation for the sacrifices and service given to all of us by the men and women who are or have been in our armed forces. Providing the highest quality healthcare to our veterans is a national priority, so we wanted to review some important considerations for veterans who are eligible for Medicare.

There is a common but mistaken assumption that all veterans and their families receive health care services through The Department of Veterans Affairs (VA) or The Department of Defense. In fact, though millions of veterans use the VA system, not all veterans receive care that way. Moreover, except in very limited circumstances, spouses of veterans are not eligible to receive care through the VA system at all. Actually, millions of veterans are enrolled both in Medicare and in the VA Health system and thus receive different but very essential health benefits from each one.

VA encourages veterans who are eligible for Medicare to opt to enroll in Medicare Parts A and B so that they have coverage for medical services received outside the VA system. That is because VA only pays for services provided at a VA facility or a pre-approved non-VA provider. It’s easy then to see then why Medicare coverage may be particularly important, for example, if a beneficiary doesn’t live near a VA facility.

Another fact to keep in mind is that by enrolling in Medicare Part B when a veteran is first eligible, there is protection should VA benefits ever be lost or if any gaps in coverage occur. (More specifics on this are available at www.medicare.gov and www.va.gov.)

Medicare Part D is optional as well, but many veterans choose to supplement their VA coverage with a Medicare Part D plan.  Here are some reasons why:

  1. VA will not fill prescriptions written by providers outside the VA system. If a veteran enrolled in the VA Health System also takes medicine prescribed by a private clinician, Part D provides coverage for the medicine but VA will not. This situation can also arise if a veteran enters a non-VA nursing home or care facility and needs to use their pharmacy; VA will not cover this but Part D will.
  2. Only the veteran (except for CHAMPVA beneficiaries) can use the VA Health system pharmacy, so spouses definitely need to have coverage through Part D or another creditable plan. Creditable coverage means that the plan has been evaluated and found to provide coverage equal to or better than the basic Part D benefit plan.
  3. VA coverage only applies to VA pharmacies and mail order services. If a veteran lives far from a VA facility and needs new medicines suddenly and/or quickly, a local pharmacy would be an important option. Medicare Part D would cover the medicines but VA would not.
  4. Finally, for low income persons, Medicare provides financial help for Medicare Part D beneficiaries through its low-income subsidy (LIS) program. Some veterans who are eligible for this program may find that enrollment in Part D will reduce their drug costs even more.

If you have questions about VA benefits and coverage, contact the VA Health Administration Center at 1-877-222-8387.  If you have questions about Medicare, contact them at 1-800- 633-4227.