Implications of the 2003 Medicare law for older adults and people with disabilities Translating “Legislative Sausage” into Understandable Choices Diane.

Slides:

Advertisements

Similar presentations

Improving the lives of older Americans Using Technology to Screen and Enroll People in Benefits: An Overview of BenefitsCheckUp Marlene Schneider AIRS.

Advertisements

Health Insurance, Health Care Reform and Resources in Chicago Dancers’ Health Insurance Resource Center A program of The Actors Fund with support from.

Challenges of Serving Low-income Medicare Beneficiaries: Impact of Cost Sharing Cindy Parks Thomas Brandeis University Schneider Institute for Health Policy.

The Medicare Drug Discount Card: A public-private partnership July 28, 2004 Grace-Marie Turner Galen Institute.

Healthy Indiana Plan Hoosier Innovation: Health Savings Accounts 1992: Hoosier pioneers medical savings accounts 2003: Tax advantaged HSAs authorized.

The Sandwich Generation

North Carolina AIDS Drug Assistance Program (ADAP) State Pharmaceutical Assistance Program (SPAP)

Ideas for People Losing Illinois Cares Rx Benefits July 2011.

The Health Law: It’s Working! About 10 million more people have insurance this year as a result of the Affordable Care Act The biggest winners from the.

Benefits & Transition Overview of SSI vs. SSDI & Medicaid vs. Medicare For transition aged beneficiaries.

Commonwealth Coordinated Care

Deciphering Medicare Part D Susan Miller, Patient Education Douglas A. Magenheim, MD, MBA, FACP.

The New Health Care Law: Temporary Insurance for People with Pre-Existing Conditions.

Medicare Supplemental Insurance 101 A brief overview of Medicare Supplemental Insurance and how it works. Agentlink Senior Brokerage Created 4/14/2014.

Presented by Donald Rickenbaugh Direct Service Supervisor Center for Independence of the Disabled, NY.

© 2014 Medicare Rights Center Let’s Learn Medicare Programs that Help Pay Your Medicare Costs.

Welcome to our meeting! Thank you all for coming today. This is an Educational Presentation only. No specific company premiums or benefits will be reviewed.

“Serving the senior market since 1982”. Source: CMS National Training Program Medicare 101 Introduction to Medicare Original Medicare Plan Medicare Supplement.

© 2005 National Mental Health Association The Medicare Drug Benefit: What Is It and What Does it Mean for Mental Health? Get Educated, Get Enrolled An.

Medicare 101 Christian Reformed Church. June, Medicare 101 Introduction to Medicare Original Medicare Plan Medicare Supplement Insurance (Medigap)

Healthy Kids in the CAP or Welfare Office Covering The Basics.

Return to KaiserEDU Tutorials

1 Medicare and Prescription Drugs Rescuing Medicare Step 1 in Saving U.S. Health Care Diane Archer Founder and Special Counsel Medicare.

Medicare and the New Prescription Drug Benefit Presented by Tricia Neuman, Sc.D. Vice President and Director, Medicare Policy Project The Henry J. Kaiser.

Understanding the Healthy Michigan Plan. About 10 million more people have insurance this year as a result of the Affordable Care Act The biggest winners.

Medicare Prescription Drug Coverage Extra Help with Medicare Prescription Drug Costs for Those Who Need it Most.

Medicare Prescription Drug Coverage. What’s Different About Prescription Drug Information? One size does not fit all, more than ever before Distinct messages.

History of Medicare 1948  Harry Truman 1950 Social Security officials  realized older Americans were facing a health care crisis =

REACH National Medicare Training Program Speaker Name Group Name Date.

Harris County Area Agency on Aging Aging and Disability Resource Center.

94 Adult Systems of Care. 95 General Healthcare for Adults There are fewer healthcare programs for adults than for children Most are for adults with disabilities.

Benefits and Services for Seniors in New York City NEW YORK CITY DEPARTMENT FOR THE AGING Diane Rose, September 17, 2008.

Presented by Deb Polun Director of Government Affairs/Media Relations Community Health Center Association of Connecticut.

1 State Perspectives on Medicare Part D: Lessons from Pharmacy Plus Programs Cindy Parks Thomas Donald Shepard Christine E. Bishop Daniel M. Gilden Brandeis.

© 2005 National Mental Health Association The Medicare Drug Benefit: What Is It and What Does it Mean for Mental Health?

Medicare in Minnesota 2012 Your Medicare: Making the Best Possible Decisions October 2011 Presented by Stephanie Minor Senior LinkAge Line® Program Consultant.

MEDICARE PART D Are We Ready? Are We Ready?. Medicare Part D Overview Medicare Part A and B covers individuals Age 65 and older Age 65 and older Those.

Medicare 101 Module 1B. Medicare 101 9/6/20152 Medicare 101 Introduction to Medicare Original Medicare Medicare Supplement Insurance (Medigap) Medicare.

Q&A Public Benefits. What is Circuit Breaker? How does it work? Circuit Breaker is a program run through the Illinois Department on Aging that provides.

Getting Started Version 12.  This training can help you make important Medicare decisions  Choosing health and prescription drug coverage  Timing your.

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 Presented by Tricia Neuman, Sc.D. Vice President and Director, Medicare Policy.

Medicare 101 Module 1B. Medicare 101 9/18/20152 Medicare 101 Introduction to Medicare Original Medicare Medicare Supplement Insurance (Medigap) Medicare.

January National Medicare & You Training Program Amy Larrick, CMS NAACP April 27, 2006.

Policy Changes for Older Persons. Elderly Status in 1960 Little interest in expansion of programs for aged after initial passage of SS Act in 1935 First.

BB SS County Health Plan Model EMET The County Health Plan Model: Expanding Basic Health Coverage to Low Income Adults Expansion Model Evaluation.

The New Medicare Prescription Drug Benefit: An Overview Prepared by: Michelle Kitchman, M.H.S. Kaiser Family Foundation For the: California Senate Health.

40,000 volunteers staffed more than 50,000 enrollment events across the country 90 percent of people with Medicare have drug coverage More than 80 percent.

Carmen Mead MEDICARE.  “Medicare is a health insurance program for:  People age 65 or older,  People under age 65 with certain disabilities, and 

DataBrief: Did you know… DataBrief Series ● February 2011 ● No. 11 Eligibility Pathways for Dual Eligibles In FY 2008, over 9 million Medicare beneficiaries.

Healthy Alaska Plan Alaska Medicaid Redesign Initiative North Star Council on Aging Senior Center presented by Denise.

"Helping Seniors Make Smart Decisions about their Drug Coverage Options" Hal Prink, FHFMA, Medicare Patient Advocate, Senior’s Voice for Healthcare Rights.

Avalere Health LLC | The intersection of business strategy and public policy The Medicare Modernization Act: The Impact on States and Low-Income Beneficiaries.

1 State Options for Supplementing Medicare Part D Drug Coverage Invitational Summit on Medicare Part D Implementation Issues Jack Hoadley Georgetown University.

A Social Innovator for Healthcare, Economic Security, and Personal Dignity. Update on Medicare for Youth & Adults with Disabilities Health & Disability.

Let’s Learn Medicare Medicare for People with End-Stage Renal Disease (ESRD)

Welcome to America's 1st Choice!  We want to thank you for considering America's 1st Choice for your Medicare coverage.  America’s 1 st Choice is a.

Medicare Prescription Drug Congress MMA and Medicaid Gale Arden Director, Disabled & Elderly Health Programs Group CMSO CMS October 2005.

Your Local State Health Insurance Assistance Program (SHIP) office: Tom Everett ex. 104 This presentation may.

June 12, 2016 Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 Cost savings program available to many Medicare beneficiaries.

Medicare Prescription Drug Coverage Tim Cutler, PharmD Marilyn Stebbins, PharmD Clinical Pharmacists Mercy Medical Group - a service of CHW Medical Foundation.

Introducing the Medicare Prescription Drug Benefit This is a presentation created by GeorgiaCares. This is not an official document. The official Medicare.

CL This material has been created or produced by CLAIM with financial assistance, in whole or part, through a grant from the Administration for.

2018 Medicare Prescription Drug Benefit

Director, Pennsylvania PACE Program National Medicare Congress

MIPPA Programs Programs supported through the Medicare Improvements for Patients and Providers Act.

Health Coverage Enrollment in Michigan

Medicare and You John Williams SHIP Medicare Specialist

The Part D Benefit: Casualties Coming?

Presented by Tricia Neuman, Sc.D.

SOCIAL SECURITY CARD APPLICATION Medicare Benefits KnowYourBenefitsToday!

Presentation transcript:

Implications of the 2003 Medicare law for older adults and people with disabilities Translating “Legislative Sausage” into Understandable Choices Diane Archer, Founder & Special Counsel Medicare Rights Center Academy Health, June 28, 2005

2 Overview of Today’s Talk 1.Back to the Basics: Medicare as we know it and the 42 million Americans it serves. 2.“But it’s good for you:” Challenges enrolling people in benefits programs. 3.Lessons learned the hard way: Key ingredients to a successful enrollment campaign. 4.New program, new challenges: The Medicare prescription drug benefit. 5.Tried and true: Ensuring access to benefits for America’s most vulnerable.

3 Back to the Basics: Medicare as we know it  Automatic enrollment: Medicare Part B has a 95.5% participation rate.  No need to choose a plan: Medicare covers services that are “reasonable and necessary”  Nationwide and open access to doctors: People with Original Medicare can see doctors and use facilities across the country. Currently, over 90% of doctors accept Medicare.

4 42 million Americans  Health: Currently, 78% of the Medicare population suffer from one or more chronic conditions that require ongoing medical management.  Income: Many on Medicare live with modest incomes and assets; 51% have incomes below 200% of poverty ($19,140/single and $25,660/couple in 2005); and 48% have countable assets (savings accounts, stocks, bonds, etc.) below $10,000.  Health Literacy: One-third of men and women with Medicare are unable to properly understand basic health-care information 70% of people over 85 have low health literacy. 23% of the Medicare population have cognitive impairments

5 “But it’s good for you”  Only one-third of eligible persons are enrolled in a Medicare Savings Programs (MSP) after 15 years.  Only twenty five percent of people eligible for “transitional assistance” under the Medicare drug discount card program have been enrolled. The program expires in six months. Most were enrolled automatically by their state or private health plan. Little data is available on actual usage of discounts cards.  Even with a one-page application and few documentation requirements, New York State’s pharmaceutical assistance program (“EPIC”) has a 50 percent enrollment rate for all eligible residents. Medicare Savings Programs

6 Lessons learned the hard way  Simplify, simplify, simplify: The simpler the program, the more likely people will access and benefit from it.  Tailored answers: Federal message is only a piece of the message, need to integrate state and local messages.  Repeat interventions: People need to hear messages several times to act on information. SSA’s one-time outreach to over 20 million people likely eligible for a Medicare Savings Program yielded less than 3 percent enrollment.  Adequate professional support network: Current State Health Insurance Assistance Program (SHIP) funding inadequate to meet consumer needs.

7 New Program, New Challenge: The Medicare Prescription Drug Benefit  New Program Design Process for securing drug benefit different from  Medicare Part B (which is automatic)  Other low-income assistance programs (MSPs) “Extra Help” requires two steps: enrolling in program, picking plan.  New Coordination Issues What will happen to existing State Rx programs? Will they wraparound? If people are happy with their SPAP, will they still need to enroll in Medicare’s drug benefit? People with Medicaid likely to fall through cracks. How will “extra help” affect eligibility for other public benefits such as Food Stamps and housing assistance?

8 New Program, New Challenge: The Medicare Prescription Drug Benefit  New Coverage Issues Formularies: How to know what drugs are covered when formularies can be changed monthly? Pharmacy networks: Will people know where to go to get their prescriptions filled?  New Cost Issues Copays for people with Medicaid Tradeoffs for people with incomes under 300% of FPL who don’t qualify for “extra help.” Premiums and penalties: Will people delay enrolling because of high premium?

9 What works? Tried & True Strategies for Increasing Enrollment  Hotline follow up: One call generally will not get people to act; continued follow up to track client through application process helps ensure enrollment.  Seniors Out Speaking on Medicare (SOS Medicare): Keep it short: brief, focused messages keep audience engaged Empower people with information: Emphasis on understanding health benefits, rights and options before being confronted with a crisis. Create relationships: Peer counselors have become trusted source of information and audience members now turn to them with questions.

10 New Challenges, New Strategies: Linking Individuals in Need to Care and Services (LINCS):  The LINCS program will create a network of remotely trained and remotely operating volunteer counselors who help older adults complete and submit the application for the new Medicare drug benefits “extra help” for people with low incomes.  Volunteers will also maintain a supportive relationship with prospective enrollees by following up with timely health care messages and referring them as necessary to other resources.

11 How Do I Stay Informed?  Sign up for regular updates from MRC:  Medicare Interactive (MI) web tool Visit to stay in the loop about health care benefits, rights and options.