New information on Medicare, and a call to action

News and Views from Rita

The Medicaid Expansion bill, which our Governor is opposing, would be a great benefit to the state for one simple reason. The Affordable Care Act is now a fact of life. It is not going away and not participating in it means that indigent patients enter the health care system through emergency rooms, which is far more expensive, and not through doctor’s offices. If these people were allowed to be on Medicaid, they could see a doctor and have access to preventive care and not become a high cost patient.

If you agree, please contact the governor and tell him to join the rest of the United States in agreeing to the Medicaid Expansion bill. He has until 2014 to make his decision.

Gov. Sean Parnell, P.O. Box 11001, Juneau, AK 99811-0001.

Just some facts about Medicare

In a recent poll, 89 percent of Americans oppose cuts to Medicare to reduce the nation’s budget deficit.

Half of all people with Medicare live on incomes of less than $22,500 per year; the median income for older women amounts to just $15,000 per year

A nursing home room can cost up to $84,000 per year – an expense not covered by Medicare

In 2010, people with Medicare paid 15 percent of household expenses toward health care costs compared with only 5 percent for those not yet on Medicare.

Among the future generation of retirees, half will have incomes below $27,000.

Rising health care costs are the real problem. Medicare does a better job of controlling health care costs than any private health plans. Medicare will be able to fully pay on claims until 2024.

Improvements passed in the Affordable Care Act (Obama Care) that address waste, fraud and abuse bought the Medicare Part A trust fund an additional eight years of solvency.

Changes to coverage for equipment, supplies

If you are on original Medicare and you get certain durable medical equipment and supplies such as oxygen, walkers or wheelchairs, you should know about the Medicare program called the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS). The competitive bidding program saves money for taxpayers and people with Medicare and may change the suppliers people with Medicare will need to use.

(Editor’s note: See Jeanne Larson’s article for more details about this program.)

The program replaces the outdated, inflated fee-schedule prices Medicare is currently paying with lower, more accurate prices. Under this program, suppliers submit bids to provide certain medical equipment and supplies at a lower price than what Medicare now pays for these items. Medicare uses these bids to set the amount it will pay for those equipment and supplies under the competitive bidding program.

Qualified, accredited suppliers with winning bids are chosen as Medicare contract suppliers. The program:

• helps you and Medicare save money

• ensures that you have access to quality medical equipment, supplies and services from suppliers you can trust

• helps limit fraud and abuse in the Medicare program.

If you have original Medicare, live in one of the competitive bidding areas, and use equipment or supplies included under the program (or get the items while visiting a competitive bidding area), you generally must use Medicare contract suppliers if you want Medicare to help pay for the item.

If you live in one of the areas where the program is expanding and you’re renting oxygen or certain other durable medical equipment at the time the program starts, you’ll be able to continue renting these items from your current supplier if that supplier becomes a contract supplier or decides to participate in the program as a “grandfathered” supplier.

If you live in (or get these items while visiting) these areas and don’t use a Medicare contract or a grandfathered supplier, Medicare won’t pay for the item and you may have to pay full price.

Rita Hatch volunteers for Older Persons Action Group’s Medicare Counseling and Assistance program. Call her at 276-1059 in Anchorage or 1-800-478-1059 toll-free statewide. Her e-mail address is ritaopag@gci.net.

 
 
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