Category Archives: Medicaid / Medicare

Medicare: A Quick Overview

Medicare is a Federal health insurance program. It covers most people 65 years old and over, some people younger than 65 with disabilities, people diagnosed with amyotrophic lateral sclerosis (ALS), and those with end-stage renal disease (ESRD).

Medicare is divided into several parts. This fact sheet discusses: Part A, Hospital Insurance and Part B, Medical Insurance. For more information on Medicare Part C (Medicare Advantage Plans) and Part D (the prescription drug benefit), please see our fact sheets Medicare Advantage Overview and Part D Overview at cahealthadvocates.org.

Part A: Hospital Insurance
Part A covers most in-patient hospital care, some in-patient skilled nursing facility care, some home health care, and hospice care.

There is no monthly Part A premium for people who have 40 or more quarters of Social Security credits (about 10 years of full-time work with four quarters per year) and who are eligible for Social Security or Railroad Retirement benefits. People insufficient Security quarters may buy Part A and pay a monthly premium of $451.00 (for 2012).

Part B: Medical Insurance
Part B covers a portion of the Medicare approved costs for out-patient medical services such as doctors’ services, out-patient hospital care, laboratory tests, out-patient physical and speech therapy, some home health care, ambulance services, and some medical equipment and supplies.

Part B coverage is optional. If you or your spouse are still working and you are covered by your employer group health plan, you may not need this part of Medicare until you or your spouse retire. (See our fact sheet Coverage After 65 if You or Your Spouse Works). For people who enroll in Part B and receive Social Security, the Part B monthly premium ($99.90 in 2012, for beneficiaries with individual incomes of $85,000 or less) is automatically deducted from their Social Security check every month. For people who do not receive Social Security, they will be billed quarterly for Part B. Medicare does not offer comprehensive coverage. Even though it pays for some preventive services and covers most medically necessary services, Medicare pays for less than half of what it typically costs beneficiaries for all of their health care expenses. Some examples of items that Medicare will not pay for are: hearing aids, eyeglasses, dental care and long term care at home or in a nursing home, when the care you need is primarily personal care services/custodial care.

The 2013 Annual Enrollment Period (AEP) Is Here!!

From now (October 15th) to December 7th, the annual enrollment period for Medicare health insurance plans is here. If you would like to review what is available in Arizona contact us at Arizona Senior Health Insurance Solutions. We will help you find the plan that will help you live your life to the fullest.

Medicare Part D Drug Plans Will Have Large Price Fluctuations in 2013

Avalere Analysis Reveals Significant Fluctuations in Medicare Prescription Drug Plan Premiums for 2013

Take a look at the link and read the findings.

http://www.avalerehealth.net/wm/show.php?c=1&id=902

Avalere Health analyzed the premium increases submitted to the Center for Medicare Services (CMS) for the 2013 calendar year and noticed quite a bit of changes. Several of the highly advertised and marketed drug plans have double digit percentage increase over last year.

Contact us at Arizona Senior Health Insurance Solutions and let us help you find a Medicare health insurance plan that will help you enjoy your life to the fullest.

 

Brewer Signs 2012 Budget, touts Medicaid Reforms

Arizona’s $8.3 billion budget for the next fiscal year is now law.

April 8, 2012 – Story by Mary Jo Pitzl / The Arizona Republic

Gov. Jan Brewer on Thursday announced that she had signed the budget package late Wednesday, calling the plan “a milestone on the road to recovery.”
In late 2008, Arizona’s budget tumbled into red ink along with the overall economy, and throughout her tenure, the Republican governor has been battling budget deficits.
The fiscal year that begins July 1 is projected to end with a modest $5 million surplus. Brewer and GOP legislative leaders believe they’ll be able to keep the budget in balance throughout the coming year, instead of seeing it slip almost immediately into deficit, because they have balanced it structurally. That means they have matched state spending to the revenue the state is expected to generate in the next year.

To do that, they cut programs by $1.1 billion and reduced some of the gimmicks used to balance past budgets. However, the plan also relies on shifting costs to local governments and continuing to defer $1.3 billion in payments to various state programs.

There are no tax increases and no new borrowing, although debt remains from previous years of borrowing.

Brewer said the budget represents a state government that is “cost-effective, efficient and fiscally stable.”

Critics, though, have likened it to a “tea party” budget, with its reliance on spending cuts, especially to human- and social-service programs. The reductions equal the amount cut over the previous two years.

Many of those cuts make permanent changes to state law, meaning the programs they support will not return when state coffers are again flush with cash.

Andrei Cherny, chairman of the Arizona Democratic Party, labeled the budget a product of “the Russell Pearce Republicans.” Pearce, R-Mesa, has called the state Senate, over which he presides, the “tea-party Senate.”

The budget’s main appropriations bill takes effect immediately; the 12 policy-related bills in the package will become law 90 days after the Legislature adjourns its session. Adjournment is expected later this month.

Nearly half of the budget reductions come from the state’s health-care program for low-income Arizonans.

“This budget recognizes the need to comprehensively reform our state Medicaid program,” Brewer wrote in a signing statement sent to Pearce and House Speaker Kirk Adams, R-Mesa.

She proposes to freeze enrollment in the Arizona Health Care Cost Containment System, require co-pays from patients, and cut reimbursement rates for doctors, hospitals and other health-care providers. The budget cuts $500 million from AHCCCS, although many of the savings are contingent on federal approval of a reform package Brewer submitted to Washington, D.C., last week.

Her signing letter made no reference to the transplant program, which was cut in October. Brewer spokesman Matthew Benson said Thursday that, with the budget now signed into law, that coverage is reinstated. That should put 96 people who need bone-marrow and lung transplants, among others, back under state coverage for now.

Democrats have questioned whether the budget truly restores funding.

Brewer said the budget, rife with “difficult choices,” struck a balance between the need to make state spending line up with state revenue and Arizona’s obligation to education, public safety and vulnerable citizens.

She said she did her best to protect K-12 education, the main beneficiary of the temporary 1-cent-per-dollar sales-tax hike she promoted last year.

“The adopted state budget keeps that promise, limiting K-12 cuts to roughly 2 percent of total education funding from all sources,” she wrote.

Legislative analysts said the cuts equal 3.6 percent of state general-fund spending on education, the only pot of money over which lawmakers have control.

Brewer said she protected base funding for Arizona’s public-school system from deeper cuts that lawmakers wanted by aiming reductions at specific programs, such as eliminating vocational-education programs for high-school freshmen.

Critics have charged the governor with reneging on her promise to protect education, even though they acknowledge Brewer’s proposals were less harmful than those of legislative Republicans.

The Arizona Education Network, a Tucson-based group of education advocates, said Brewer and the Legislature “have violated the public’s trust with these deep cuts.”

In addition to about $150 million in cuts to K-12, the budget reduces university funding by $198 million and takes $70 million from the community-college system.

Cherny, of the Democratic Party, said that the budget decimates Arizona education and that Democrats will remind voters of that in next year’s elections.

The budget also cuts $50 million from the Department of Economic Security, which provides the state’s safety-net programs, and $53 million from the Department of Health Services.

The budget reduces funds that have kept the state’s parks system on life support; advocates say the cuts mean some parks will have to close.

Brewer and lawmakers turned their focus to provisions of the budget they say will make fundamental changes in how government operates, mostly by erasing a structural deficit. That kind of fiscal stability, they said, will boost business and investor confidence in Arizona and help speed economic recovery.

AZ Health Care Cost Containment System

U.S. Supreme Court Ruling and Future of Health Care in AZ

August 2, 2012
The recent Supreme Court ruling provides states multiple and complex opportunities with respect to the future of their Medicaid programs. Governor Brewer has started a deliberate and thoughtful process to review these options and engage with stakeholders for their valuable input. The slides below have been included to start the discussion during meetings with stakeholders in the healthcare and business sectors. Additional meetings are being scheduled with healthcare providers and community organizations. AHCCCS will also host public meetings across the state toward the end of August and into September. Information about these community forums will be posted here once available.

This article is posted on the AZHCCCS website here

People with Medicare save more than $4.1 billion on prescription drugs

People with Medicare save more than $4.1 billion on prescription drugs

18 million with Medicare also receive free preventive services in the first seven months of 2012

Nearly 5.4 million seniors and people with disabilities have saved more than $4.1 billion on prescription drugs as a result of the Affordable Care Act, Health and Human Services (HHS) Secretary Kathleen Sebelius announced today.  Seniors in the Medicare prescription drug coverage gap known as the “donut hole” have saved an average of $768. During the first seven months of 2012, the new health care law has helped nearly 18 million people with original Medicare get at least one preventive service at no cost to them.

“The health care law has saved people with Medicare over $4.1 billion on prescription drugs, and given millions of beneficiaries access to cancer screenings, mammograms and other preventive services for free,” said Secretary Sebelius.  “Medicare is stronger thanks to the health care law, saving people money and offering new benefits at no cost to seniors.”

The health care law includes benefits to make Medicare prescription drug coverage more affordable. In 2010, anyone with Medicare who hit the prescription drug donut hole received a $250 rebate. In 2011, people with Medicare who hit the donut hole began receiving a 50 percent discount on covered brand-name drugs and a discount on generic drugs. These discounts and Medicare coverage gradually increase until 2020 when the donut hole is fully closed.

The health care law also makes it easier for people with Medicare to stay healthy. Prior to 2011, people with Medicare had to pay extra for many preventive health services. These costs made it difficult for people to get the health care they needed. For example, before the health care law passed, a person with Medicare could pay as much as $160 for a colorectal cancer screening.  Now, many preventive services are offered free of charge to beneficiaries, with no deductible or co-pay, so that cost is no longer a barrier for seniors who want to stay healthy and treat problems early.

In 2012 alone, 18 million people with traditional Medicare have received at least one preventive service at no cost to them.  This includes 1.65 million who have taken advantage of the Annual Wellness Visit provided by the Affordable Care Act – over 500,000 more than had used this service by this point in the year in 2011.  In 2011, an estimated 32.5 million people with traditional Medicare or Medicare Advantage received one or more preventive benefits free of charge.

For state-by-state information on savings in the donut hole, please visit: http://www.cms.gov/apps/files/donut-hole-data-chart.pdf (PDF – 206 KB)

For state-by-state information on utilization of free preventive services, please visit: http://www.cms.gov/apps/files/preventive-data-chart-first-seven-months-2012.pdf (PDF – 281 KB)

 

Read the original article here: http://www.hhs.gov/news/press/2012pres/08/20120820a.html