Saving money on health costs: Extra Help program

By: Jonathan Blum, Acting Principal Deputy Administrator and Director of the Center for Medicare

If you’ve ever found yourself skipping a day of your medication or cutting your pills in half to make your supply last a little longer, there’s help. Medicare has a special program called “Extra Help.” If you have limited income and resources you can sign up to get help paying things like monthly premiums, annual deductibles, and prescription copayments in your Medicare drug plan. Did you know that the Extra Help program is estimated to be worth about $4,000 dollars per person, per year? Even if you’re not sure you’d qualify, it’s worth filling out an application to see.

Estimates show that about 2 million people with Medicare may be eligible for the Extra Help program but don’t even know it. Are you or a family member one of these people?

It’s easy and free to apply for Extra Help. Here’s how:

Don’t wait – apply today to see if you qualify for some extra help with your health costs.

Stay up to date on the latest Medicare news and follow us on Twitter @MedicareGov.

Medicare Open Enrollment: find comfort in convenience

By Jonathan Blum, Acting Principal Deputy Administrator and Director of the Center for Medicare

Like most people, I take comfort in the things I’m familiar with. I choose to shop at the supermarket around the corner because I know exactly where to find the things I’m looking for. Sure, I might be able to save a little more money by shopping at a different store on the other side of town, but I choose to stick with what I’m most comfortable. We all like to get a good deal, but convenience is a big part of the value.

The same is true when it comes to choosing a health plan: convenience matters. So in addition to cost, coverage, and benefits, here are some other things you may want to consider as you compare Medicare options during Open Enrollment:

Doctor and hospital choice

You want to be comfortable with the people you’re working with, especially when it comes to something as private as your health. Will your doctors and hospitals accept your current coverage next year? If you’re thinking about changing plans, make sure you check which doctors and hospitals you’ll be able to use. Where are they located, and what are their hours?

Pharmacy access

Is the pharmacy you use included in your drug plan’s network? Do they prescribe electronically? Can you get refills by mail? Remember that plan networks can change from year to year. If it’s important to you to stay with the same pharmacy, it’s worth checking to make sure they’ll still be in your plan’s network.

Travel

Maybe you travel a lot, or spend part of the year in a different state. If you do, make sure you know whether your coverage will travel with you.

We’re working hard to make sure you have choices in the way you get the Medicare benefits you’ve earned – and we want you to be comfortable. Use the Medicare Plan Finder to look at all of the health and drug plan options in your area. If you still need help comparing, call 1‑800‑MEDICARE (1-800-633-4227).

2013 Medicare update

By: Marilyn Tavenner, Acting CMS Administrator

We’re now past the halfway point for Medicare’s annual Open Enrollment period, which opened on October 15 and closes December 7. As you and your loved ones with Medicare sit down to consider your options for 2013, we’d like to share the latest news about Medicare. 

Our Administration is committed to making Medicare stronger for you and future generations. Thanks to the health care law, everyone on Medicare can get preventive services like mammograms and other cancer screenings for free. The health care law also makes prescription drugs more affordable for seniors who hit the donut hole.

These new benefits are making a difference for millions of Americans. 5.6 million seniors and people with disabilities have saved $4.8 billion on prescription drugs since the law was enacted, and during the first nine months of 2012 over 20.7 million people with original Medicare got at least one preventive service at no cost to them. 

These and other parts of the law will result in significant savings. We estimate that the health care law will save the average person in traditional Medicare $5,000 through 2022Earlier this year we projected that the standard premium for Medicare Part B (which covers certain doctors’ services, outpatient care, medical supplies, and preventive services) would rise by more than $9.00 a month in 2013. Today we announced that the actual rise will be lower—$5.00—bringing 2013 Part B premiums to $104.90 a month. By law, the premium must cover a percent of Medicare’s expenses; premium increases are in line with projected cost increases.  Medicare Part B premiums have gone up slowly over the past five years – an average of less than 2 percent a year, or $8.50 total.

Several other changes in 2013 include:

  • Medicare Part A Premium: Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Only about 1 percent of people with Medicare pay a premium for Part A services—you need to have paid Medicare payroll taxes for 40 quarters of employment or be married to someone who did. For those few affected, the 2013 Part A premium is decreasing to $441, down from $451 in 2012.
  • Medicare Part A Deductible: This deductible is the cost to people with Medicare for up to 60 days of Medicare-covered inpatient services in the hospitals for each benefit period (a benefit period starts the day a patient is admitted and ends when the patient has been out of the hospital for 60 days in a row.)  This will increase to $1,184 in 2013, up from $1156 this year (an increase of 2.4%).
  • Medicare Part B Deductible: The deductible will increase to $147 in 2013, from $140. This is still $15 below the deductible in 2011.  
  • Income-related Adjustments: People with Medicare who report 2011income above $85,000 a year ($170,000 filing jointly) are legally responsible to cover a larger portion of the cost of their coverage.  These premium adjustments range from $42.00 to $230.80 a month for Medicare Part B.

As Open Enrollment finishes up and we approach a new year, people with Medicare can be assured they are part of a program that strives to deliver better benefits while curbing costs. And we will continue to do all we can to make Medicare even stronger.

Are you a smoker? Today’s a great day to quit.

Have you tried to quit smoking, but failed in the past? Do you have a loved one who needs a little extra support to quit? If so, today’s 37th annual Great American Smokeout might give you or your loved one the motivation you need to quit the habit for good.

Quitting is hard, but Medicare can help. Check out BeTobaccoFree.gov, a comprehensive website with up-to-date tobacco-related information. Also, watch our short video about Medicare’s smoking cessation counseling sessions, and talk to your doctor about strategies to help you quit. Take the first step toward a healthier life – make a plan to quit today!

Medicare Open Enrollment: More is better

By Jonathan Blum, Acting Principal Deputy Administrator and Director of the Center for Medicare

In this season of Open Enrollment, people with Medicare have the opportunity to choose the Medicare plan that best serves their unique health needs and provides them with the greatest value. In determining the value of a plan choice, you should look not only at premiums and cost-sharing but also at what benefits and quality of care that money will buy. This year, I am proud to say that while costs, by and large, have remained relatively stable, the benefits that people with Medicare will get for their premiums continues to grow.

For those choosing Original Medicare, the benefit package continues to grow stronger and provide greater value. For example, EVERYONE with Medicare has access to a variety of preventive services and screenings, most at no cost to them when furnished by qualified and participating health care professionals. This includes things like diabetes and cancer screenings, and a yearly “wellness” visit. During the first 9 months of this year, over 20 million people with Original Medicare received at least one preventive service at no cost.

Beneficiaries may also explore their options beyond Original Medicare, as virtually all people with Medicare have access to Medicare Advantage Plans in 2013, and many of these plans offer extra benefits beyond the comprehensive package offered by Original Medicare. Medicare Advantage Plans may offer vision, hearing, or dental coverage, or extend coverage while you travel. And most Medicare Advantage Plans also include prescription drug coverage.

Use this time to decide what benefits are most important in helping you meet your unique health care needs. Use the Medicare Plan Finder to look at all of the health and drug plan options in your area for what will provide you with the greatest value. If you still need help comparing, call 1 800 MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

Only you know what extra benefits and services are most important for you. Just know that no matter how you choose to get your Medicare benefits, you’ll be getting more.

Stay up to date on the latest Medicare news and follow us on Twitter @Medicaregov.

Medicare is ready to help you quit smoking

Every year, more people die from lung cancer than any other type of cancer and smoking is the leading cause. Don’t become a statistic – Medicare is ready to help you quit smoking. Talk to your doctor today and cross one thing off your list.

Besides being famous for Thanksgiving, November is also Lung Cancer Awareness Month. While you’re making lists for the upcoming holiday season, make a note to talk with your doctor about quitting if you smoke. Medicare covers 8 face-to-face smoking cessation counseling sessions during a 12-month period. If you haven’t been diagnosed with an illness caused or complicated by tobacco use, you pay nothing for these counseling sessions, as long as you get them from a qualified doctor or another Medicare provider.

Get smart: know when antibiotics work

By: Patrick Conway, M.D., Director and Chief Medical Officer, CMS Center for Clinical Standards and Quality

As we enter flu season, you may seek fast relief when illness strikes, but think twice before asking your doctor for antibiotics. Did you know that if you have a cold or flu, antibiotics won’t work for you? That’s because antibiotics cure bacterial infections, not viral infections. Every time someone takes antibiotics, sensitive bacteria are killed, but resistant germs may survive to grow and multiply.

Antibiotic resistance, caused by overuse and misuse of antibiotics, is one of the world’s most pressing public health problems. These drug-resistant bacteria—which were once easily treatable—can now cause significant harm and suffering. When antibiotics fail to work, we get longer-lasting illnesses, need more doctor visits or extended hospital stays, and more expensive medications.

If you or a loved one lives in a nursing home, pay close attention to when antibiotics are prescribed. Roughly  2 out of 3 nursing home residents get at least one course of antibiotics each year, yet nearly 27,000 residents end up with antibiotic-resistant infections each year. These infections are often severe, difficult to treat, and lead to more hospitalizations and deaths among people over 65.  If you have questions, please ask your health care provider.

The CDC has marked November 12—18 as Get Smart About Antibiotics Week. You can take several steps to make certain you’re using antibiotics properly:

  • Take antibiotics only to treat a true bacterial infection. It should be for only as long as your doctor prescribed to treat the infection, to reduce your risk of getting the infection again, or to reduce the risk to those around you.
  • Always talk to your doctor before taking an antibiotic to be sure it will treat the infection you have.
  • Never take antibiotics for a viral infection, such as a cold, cough, or the flu. Antibiotics won’t cure your virus, they won’t keep those around you from getting the illness, and they won’t help you feel better. In fact, taking antibiotics when you have a virus may do you more harm than good, because you increase your risk of getting an antibiotic-resistant infection later.
  • Not sure if you have a virus, which can’t be treated by antibiotics? Get smart—read this chart!

Antibiotics won’t help you recover from the flu, but keep yourself from catching the major flu viruses in the first place by getting your flu shot! It’s free for people with Medicare, once per flu season in the fall or winter, when given by doctors or other health care providers (such as senior centers and pharmacies) that take Medicare.

Medicare covers hospice & comfort care

Do you care for someone who’s terminally ill? It can be hard taking care of everyday activities while trying to care for someone who’s sick. The comforting news is you don’t have to do it alone. Medicare can help.

Medicare covers care for people who are terminally ill, and we have resources to help you. As part of hospice coverage, your loved one can get the care and support they need. This can include doctor and nursing services, counseling, medical supplies, pain medications, and other services. And, most importantly, hospice can provide much needed comfort while at home.

Remember, you’re not alone – Medicare is here to help. There are resources to help you plan for the future, take care of yourself, and much more.

You can also contact these organizations for additional support:

Diabetes screenings, supplies, and training – Medicare has you covered

Diabetes affects millions of people – are you one of them? November is American Diabetes Month and a perfect time to find out about the supplies and self-management training that Medicare covers to help you manage your diabetes. Many people with diabetes don’t know that they have it – and Medicare covers screening tests so you can find out if you do.

If you’re at high risk for developing diabetes, Medicare covers up to two fasting blood glucose (blood sugar) tests each year. If your doctor accepts assignment, you pay nothing for these tests. You may be at high risk for diabetes if you’re obese, have high blood pressure, high cholesterol, or a family history of diabetes. Talk to your doctor to find out when you should get your free screening test.

If you have diabetes, Medicare covers many of your supplies, including test strips, monitors, and control solutions. In some cases, Medicare also covers therapeutic shoes if you have diabetic foot problems. You pay 20% of the Medicare-approved amount for these supplies.

Medicare also covers diabetes self-management training to help you learn how to better manage your diabetes. You can learn how to monitor your blood sugar, control your diet, exercise, and manage your prescriptions. Talk to your doctor about how this training can help you stay healthy and avoid serious complications.

Take control of your health – talk to your doctor today about screening tests and what supplies and training you may need for your health.

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