News
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Fastest Growing Retiree Cost 2015 Hint Not Prescriptions
This week, progress stalled on a continuing resolution to fund the federal government past September 30th. In addition, one Senate committee held a hearing on maximizing Social Security benefits. .When there's a COLA as low as 1.3%, a provision of law known as "hold harmless" ensures that an individual's net Social Security benefit will not decrease from December of one year to January of the next, because of an increase in the Part B premium. That's an important protection, but it doesn't go far enough. .In the meantime, TSCL would like to remind you that many Senators and Representatives will attend local events or schedule town hall meetings while they are in their home states and districts, giving constituents an excellent opportunity to voice their concerns. We encourage you to approach your Members of Congress and request their support for fair cost-of-living adjustments, Notch fairness, a permanent "doc fix," and other key issues. … Continued
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Legislative Update For Week Ending June 1 2012
Should seniors with Medigap supplements that provide "first dollar coverage" be required to pay more up-front? Should Medicare continue to pay for services based on medical necessity, or should the government change to a system "based on evidence of the value of services?" Congress may be debating these questions this month when the Medicare Payment Advisory Commission (MedPAC) issues its June report to Congress. The idea is to make Medicare beneficiaries "think twice" before scheduling doctor, outpatient services, or hospital stays in order to reduce government spending on Medicare. .The uncertainty of Senate passage of the new legislation to waive the cuts to Medicare comes about because of the 2010 Statutory Pay-As-You-Go Act, which requires across-the-board cuts, known as sequestration, to "mandatory" programs if any new legislation increases the deficit. .While TSCL supports this first legislative step, more work will be needed in the years ahead to provide greater financial certainty for disabled Social Security recipients. What do you think about the recent legislation and fixes for Social Security disability? Take TSCL's 2016 Senior Survey. … Continued
Surprisingly, there was no discussion of slowing the growth of cost-of-living adjustments (COLAs) by switching to the more slowly-growing "chained" CPI. The proposal is getting increasing attention (mostly favorable) in media editorials. Switching to the more slowly-growing chained CPI would reduce cost-of-living-adjustments, and many policy experts view the option as a front-runner for reducing the deficit. .Where do you want to live and how will you get around? Do you plan to stay where you are, move to senior housing, or someday move in with family? Is it cheaper to rent or to buy? If you own a home, will your financial plan cover the annual maintenance and inevitable upkeep and repairs such as painting or replacing a roof? Will you have access to public transportation if you can no longer drive or afford a vehicle? Look for local workshops that review the types of housing options in your area for people over 60. .The fraudsters enlist unscrupulous doctors to approve the test and the doctor receives a kick back from the recruiting company for each prescription. Medicare receives a bill that can range from ,000 to ,000. Victims have later reported that they did not even know the doctor who prescribed the test. Law officials warn that health fairs, senior centers and even church events are magnets for the scam, where recruiters take cheek swabs for genetic testing and collect Medicare numbers. .Immigration Reform – Close a loophole that pays Social Security benefits based on illegal work, preventing a drain on the Social Security Trust Fund. .The move is a long time coming. Legislation passed in 1996 made illegal immigrants ineligible to receive federal benefits. But according to an audit performed by the Inspector General of the Department of Health and Human Services, more than 29,185 illegal immigrants had improperly received Medicare benefits from 2009 through 201A review of 133,541 claims revealed that Medicare had paid more than .6 million in claims on behalf of 2,575 unlawfully present individuals. .During the most recent years for which data are available (2000-2004), the total number of mismatched wage reports jumped from 217 million at the end of 1999 to 264 million by 2004, an average of more than 9.3 million per year—82% higher than during the 1990's and more than double the rate of the 1980's. . Find out which drug store has the lowest cost-sharing before you fill. Your cost sharing can be dramatically higher depending on where and how you fill your prescription (retail versus mail order). Make sure you are using a preferred vs. standard network pharmacy and compare the prices of retail pharmacies with getting a 90-day supply from your drug plan's mail order pharmacy. For example, if you are enrolled in the Wellcare Wellness Rx plan and get your Eliquis from a standard in-network pharmacy, your copay for Eliquis after the 5 deductible would be during the initial coverage phase, and 7.38 in the Part D coverage gap. However, if you get your Eliquis from a preferred in-network pharmacy the co-pay is .00 during the initial coverage phase and 3.36 in the coverage gap. Depending on where you live, and your drug plan's mail order pharmacy, sometimes you may save a little more using mail order. .Because you are over 65, you are subject to Medicare's Special Enrollment Period rules that apply to the loss of health insurance coverage through you or your spouse's former employer. You need to enroll in Medicare Part B during the 8-month period that begins the month after your husband's employment ends or the employer health coverage ends, whichever happens first. Coverage under COBRA, however, would NOT be more than a temporary option for you because you would NOT be eligible for a Special Enrollment Period when that coverage ends, so don't wait to enroll in Medicare. You have 8 months to sign up for Part B and Part D without penalty, starting after the loss of your husband's job. .Medicaid is popular with the public. When asked about their views on Medicaid, three-fourths (74 percent) of the public, including majorities of Democrats (84 percent), independents (76 percent), and Republicans (61 percent), hold a favorable view of Medicaid. Majorities also support increasing funding for Medicaid or keeping it the same, with 40% increasing funding, and 47% who support keeping funding at the same level.
