Medicare Help Center

Understanding Medicare’s Drug Plan

webmaster — Sun, 08 Oct 2006 22:14:31 +0000

The Daily Press has an article that helps explain the often confusing Medicare Drug Plan. Some important quotes from the article are below:

In January 2006, Medicare began offering prescription drug coverage to all beneficiaries. The creation of this program led to an increase in the number of elderly and disabled Virginians who have drug coverage. In 2005, 570,220 or 58.7 percent of all Virginia’s Medicare beneficiaries had comprehensive prescription drug coverage, most often through Medicaid or through a previous employer. In 2006, with the inception of the Medicare prescription drug benefit, the number of Virginia’s beneficiaries with comprehensive prescription drug coverage rose to 924,616. More than 90 percent of all Medicare recipients in Virginia now have comprehensive prescription drug coverage, according to the Centers for Medicare & Medicaid Services (CMS).

The coverage gap is a part of some Medicare prescription drug plans, but it is not a part of all plans and does not affect all who have enrolled in a plan. Many beneficiaries do not realize that they are likely a part of the 92 percent of all Medicare beneficiaries who will not be subject to the gap at all because:

They are in a plan that provides gap coverage;
They are receiving a subsidy that eliminates the gap;
They have drug coverage other than through Medicare; or
They do not spend enough on prescription drugs to reach the gap in the first place.

The Daily Press notes that patients who do have a gap are still going to pay less for their prescriptions than a general cash paying customer, and that patients in the gap have the option to change to an insurance plan that covers the gap during their next enrollment period (November 15th to December 31, 2006). Seniors who can not afford the gap-covered insurance plans are encouraged to investigate low-income subsidies to eliminate the gap.

Security Gaps in Medicare and Medicaid

webmaster — Sun, 08 Oct 2006 21:50:08 +0000

Federal investigators say they have found serious computer-security flaws that could lead to the improper disclosure of medical information on people enrolled in Medicare and Medicaid. The investigators, from the Government Accountability Office, said “key information security controls were missing” from a huge communication network used by the federal Centers for Medicare and Medicaid Services, the New York Times reported today.

As a result, they said, personally identifiable information “could be improperly modified, disclosed or deleted.” Moreover, the report said, “these weaknesses could lead to disruptions in services” to millions of beneficiaries.

The network is used to pay claims and to communicate with state Medicaid agencies, health care providers and many private contractors.

Dr. Mark McClellan, administrator of the Centers for Medicare and Medicaid Services, said none of the flaws had led to “actual security breaches.” He said he is taking steps to fix the problems.

But the GAO said Medicare officials would not necessarily know whether a security breach had occurred because they had no “audit trail” to document use of the computer network or a reliable way to detect intrusions into their computers.

Without an audit trail to track past accesses, it’s unclear whether or not a breech has occurred in the past. Medicare and Medicaid patients should be especially cautious with sharing personal information, and should review their credit reports regularly for signs of identify theft or possible abuse.

Medicare Changes - Brief 2006 Changes Explained

webmaster — Sun, 08 Oct 2006 21:30:14 +0000

If Medicare coverage weren’t already confusing enough, new legislation passed last year to upgrade the program has many recipients scratching their heads. But not to worry, said Andrew Crocker, Texas Cooperative Extension gerontology health specialist. Clarification is just a click away, thanks to the World WideWeb.Medicare is the federal health care program designed for people age 65 and older and those who are disabled. That hasn’t changed.

What has changed are some of the benefits included in Medicare coverage, Crocker said. For instance, new drug discount cards for Medicare beneficiaries will be available this year. These cards will provide discounts of 10 percent to 25 percent for prescription drugs until the newly authorized Medicare prescription drug benefit starts in 2006. Beneficiaries should be aware that prescription drug card scams are already operating, even though there are currently no approved drug discount cards from Medicare. If you are approached by someone selling cards and asking for personal information, you are encouraged to call local authorities to verify their identity prior to providing any personal information.

Other changes expected in 2006 include:

Health Savings Accounts, in which participants are allowed to divert their savings for later health care expenses.
More Medicare Advantage plan choices including preferred provider organization (PPO) plans that allow a wide choice in medical care providers
Prescription drug benefit plans that will include monthly permiums and a $250 deductible. Other options may be available, such as extra help for those with higher financial need. Depending on income, some patients will pay only a co-payment for each prescription, while others may receive help paying either the premiums or the deductible.
A new one-time, preventative wellness exam, blood screening tests to check for heart disease, and diabetes screening for those considered to be at risk.