Safer and More Effective Dialysis

Do you or a loved one get kidney disease treatments? Do you ever wonder if you’re getting quality care or what Medicare does to make sure you’re getting quality care? To make sure you’re getting the best quality care, Medicare has a new Value-Based Purchasing “Quality Incentive Program.” This program encourages facilities to provide excellent care, which is best for your health and safety.

Medicare is paying dialysis facilities for providing quality care

When Medicare pays a facility for your care, it expects that care to be of good quality. Starting this month, dialysis facilities that don’t meet treatment standards, or improve from their past results, will have their claims payments reduced. What this means is that facilities have an incentive to provide you with better quality care.

Look for a certificate in your dialysis facility

The next time you visit your dialysis facility, you should see a certificate posted showing how well the facility did in the Quality Incentive Program. Facilities are rated on measures important to your treatment, including:

• management of your low red blood cell count (anemia) by dialysis and medications
• effectiveness of your dialysis (how much waste, or urea, is removed from your blood)

You can view a facility’s certificate online using Dialysis Facility Compare, and also see other information including what services are offered, whether the facility has evening hours, and if they offer training. You can use this information to find a dialysis facility that meets your needs.

Learn More

The Quality Incentive Program will improve care for all patients. Talk to your dialysis care team about what these results mean for your care. Read about Medicare’s coverage for dialysis and kidney disease education, and find a dialysis facility near you.

Medicare Covers Hospice and Comfort Care

Do you care for someone who is terminally ill? It isn’t always easy to care for a loved one in difficult times, but Medicare can help – you don’t have to do it alone. Medicare covers care for people who are terminally ill, and we have resources to help you.

Hospice is a program of care and support for people who are terminally ill. The focus is on comfort, or “palliative” care, not on curing an illness. Hospice care can include doctor and nursing services, counseling, medical supplies, pain medications, and other services.

If your doctor has certified that your loved one is terminally ill, Medicare covers hospice care, which is usually provided in the home. Medicare will still pay for covered benefits for any health problems that aren’t related to your loved one’s terminal illness. Get more details about Medicare’s coverage.

Remember, you’re not alone – Medicare is here to help. You can also get information about long-term planning, managing stress, and much more.

Diabetes Screenings, Supplies, and Training – Medicare Has You Covered

Diabetes affects millions of people – are you one of them? Medicare covers supplies and self-management training 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 this test. You may be at high risk for diabetes if you have high blood pressure, high cholesterol, obesity, 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.

As Open Enrollment Ends, People with Medicare save $1.5 billion on prescriptions

by Kathleen Sebelius

If you’ve had a Medicare Advantage or Prescription Drug Plan for a few years, you’ll know that December is the end of Medicare Open Enrollment.  This year, the last day for you to choose new Medicare health or prescription drug coverage for 2012 is December 7, earlier than it’s been in previous years.

December 7 is tomorrow.  But you still have until midnight tomorrow if you want to make a change  to your medical or prescription drug coverage.

And as you are reviewing your plan, remember that Medicare is only getting stronger. New data released today shows how millions of seniors have gotten cheaper prescription drugs and free preventive services, all thanks to the President’s health reform law.

Thanks to the Affordable Care Act, the Medicare prescription drug coverage gap known as the donut hole is starting to close. Through the end of October, 2.65 million people with Medicare have received discounts on brand name drugs in the donut hole.  These discounts have saved seniors and people with disabilities a total of $1.5 billion on prescriptions – averaging about $569 per person.  For State-by-State information on the number of people who are benefiting from this discount in 2011, visit this page.

Over the coming years, the Affordable Care Act will help close the coverage gap completely. Each year from now to 2020, you’ll pay less for brand name and generic drugs in the coverage gap.  And in 2020, the coverage gap will be eliminated and the donut hole will be closed for good.

In addition to cheaper prescription drugs, the Affordable Care Act also made preventive services available to people with Medicare for free. Preventive care helps people stay healthy and live longer lives. Through the end of November nearly 24.2 million people with Medicare have received one or more free preventive services, including Medicare’s new free Annual Wellness Visit.  For State-by-State information on the numbers of people who are utilizing preventive services in 2011, visit this page.

These new benefits are just two ways the Affordable Care Act is making Medicare and our health care system stronger and giving hardworking families the security they deserve. It has helped lower your Part B premium in 2012 by $22.  And, on average, Medicare Advantage premiums will be lower in 2012 as enrollment continues to rise.

And if you haven’t reviewed your Medicare coverage, take time now to compare your current coverage with other options to make sure your plan will meet your health care needs for the coming year.  Medicare now offers better choices, more benefits, and lower costs thanks to the Affordable Care Act. Visit www.Medicare.gov/open-enrollment/ for more information.

Medicare Open Enrollment: Last Week to Review and Compare Medicare Plans

by Kathleen Sebelius, Secretary of Health and Human Services

With housework, doctor appointments, time with family, and job responsibilities, there are always tasks that get left until the last minute. But whether I’m choosing an insurance plan or planning a vacation, I still want to make sure my “I”s are dotted and my “T”s crossed. I want to know that everything’s taken care of – without worry and confusion.

Speaking of insurance, time is running out! If you’ve been thinking about changing your Medicare coverage, the time to act is now. The dates for Medicare Open Enrollment are early this year to allow for a smoother transition to a new plan.  Not only did Open Enrollment start earlier, but it also ends earlier – the last day for you to change your Medicare plan is now December 7.  This gives Medicare enough time to process any change you may make and have you linked correctly to the plan you choose as soon as your coverage starts. That way you can go to the doctor or your pharmacy on January 1 without having to worry about your coverage.   

If you’re like me, you might use the December holidays to discuss health care options with family or friends. I use the time to talk to my father, who is on Medicare. This year, because Medicare Open Enrollment ends early, the time to have that important conversation is now.

This year, thanks to the Affordable Care Act, you have better  choices, more benefits and lower costs, and it’s worth it to review them. Our counselors worked with a man in Oregon who has saved more than $600 a month on his prescription drugs between benefits from the health care law and lowering his doses.  $600 a month makes a huge difference in helping him pay other bills, and still put some money into savings.

I know that sorting through your health and drug coverage choices during Open Enrollment can be confusing but you don’t have to do it alone. 

Look around for all the Medicare information out there. We have plenty of resources to help you think about cost, coverage, extra benefits, and convenience when evaluating your plan choices. And visit our Open Enrollment center, where we’ve gathered everything you need online, including a video on how the Medicare Plan Finder works, to walk through your options. 

Medicare’s here to help you, stronger than ever. Take the time this week to review and compare plans. It’s worth it – you can relax later.