Keeping Medicare Affordable in 2012

By Kathleen Sebelius, Secretary of Health and Human Services. Crosspost from Healthcare.gov

Across the country, people with Medicare are now considering their options for 2012. Medicare’s annual Open Enrollment period opened on October 15 and closes December 7. While that seven-week period is longer than usual, it also ends on an earlier date. So seniors and people with disabilities along with their families and caregivers are examining their options and making their choices now.

The good news is there are better choices available and we’re controlling the cost of coverage. Earlier this year, we announced that premiums for Part D prescription drug coverage will remain virtually unchanged and average Medicare Advantage plan premiums will actually go down by 4 percent. That’s the second consecutive year of falling premiums for the millions of people who choose Medicare Advantage.

Today, we have more good news. Medicare’s Part B monthly premium, which helps pay for physicians’ services, outpatient hospital services, certain home health services, and other items, is rising by only $3.50 despite earlier projections of a much bigger jump.

For the last two years, the Part B premium has been frozen for most people with Medicare because their Social Security benefits were not increasing. But this year, Social Security benefits are rising 3.6 percent to cover inflation – the same percent increase as Medicare’s premium. For example, the typical retired worker will see a $39 per month increase in their Social Security check. This more than offsets the modest $3.50 change in Medicare premiums which will be the same percent of Social Security checks in 2012 as they were in 2008. In addition, Medicare’s Part B deductible will actually fall by over $20, from $161 to $140.

At the same time, Medicare is providing new benefits thanks to the Affordable Care Act. The health reform law reduces prescription drug costs for people who hit the donut hole and makes preventive benefits like cancer screenings and cholesterol tests free for everyone with Medicare. Through September 2011, nearly 20.5 million people in traditional Medicare received a free preventive service. Through August of this year, nearly 1.8 million people who hit the donut hole received these discounts, saving almost $1 billion – coming to an average of $530 per beneficiary.

Put simply, thanks to the Affordable Care Act, Medicare is providing better benefits at lower costs. Today’s announcement means seniors will have more money in their pocket. And seniors and people with disabilities are getting a Medicare program that’s stronger for today and tomorrow.

Lung Cancer Awareness Month

Medicare is ready to help you quit smoking.

About one out of every six cancer deaths in the U.S. comes from lung cancer. Each year, nearly 200,000 Americans are told they have lung cancer and more than 90,000 people die from this disease. Smoking causes 80 to 90 percent of lung cancer cases, so many of these lung cancer deaths can be prevented.

If you haven’t been diagnosed with an illness caused or complicated by tobacco use, you can get 8 face-to-face smoking cessation counseling sessions during a 12-month period. You pay nothing for these counseling sessions, as long as you get them from a qualified doctor or another Medicare provider.

Talk with your doctor about Medicare-covered smoking cessation programs near you, and visit our smoking cessation page to find more resources.

National Family Caregiver Month

Medicare Offers Information and Support to Caregivers.

More than 66 million Americans care for loved ones who have a chronic illness, disability, or frailties that come naturally with old age. Nobody is in a better position than family caregivers to help loved ones manage their health care when it comes to medicines, treatments, diets, and exercise.

Looking for assistance and information? We can help. Ask Medicare has tips sheets, videos and practical information for caregivers, including tips on what every caregiver should know and answers to your Medicare questions. As a caregiver we know you’re juggling a lot, so we put it all in one place to save you time.

For more information, check out the Administration on Aging’s Eldercare Locator and the National Family Caregivers Association.

BELIEVE in yourself… PROTECT your health… REACH OUT for help.

4 Ways to Protect Your Identity and Personal Information

Peter Budetti, Deputy Administrator for Program Integrity

  1. Guard your information.
  2. Be wary of giveaways.
  3. Don’t lend your identity.
  4. If you spot something, say something

These are 4 simple ways to protect your identity and personal information from Medicare fraud, but they can be difficult to do if you’re caught off guard. 

During Medicare Open Enrollment – between now and December 7 – you can expect to hear a lot about the choices, benefits, and lower costs you have when it comes to Medicare.

Open Enrollment is a great time for you to review and compare your Medicare choices and make you have the coverage that fits your needs. Unfortunately, it’s also a popular time for Medicare fraud schemes. 

During Open Enrollment, you’ll find Medicare information all around you – in the mail, on TV, in the paper, and on your computer.  Here are a few reminders to keep you safe from those who might not have your best interests in mind:    

1.    Guard your Medicare and Social Security numbers – treat them like you’d treat your credit cards.

You’ll be hearing so much about Medicare during Open Enrollment, that it may not surprise you to get phone calls or visits to your house from people selling Medicare plans. 

It’s illegal for someone to call and ask for your Medicare number, Social Security number, or bank or credit card information.  A Medicare representative or a private insurance plan working with Medicare will never call and ask for this information, and we will never call you or come to your home uninvited to sell Medicare products.  If a sales agent does call or visit you uninvited they are violating the Medicare marketing rules.

2.    Be suspicious of people offering free medical equipment or services.

 Anyone who offers you free medical equipment or services and then requests your Medicare number is tricking you – if it’s really free, they don’t need your Medicare number. It’s illegal, and it’s not worth it!

3.    Don’t let anyone borrow or pay you to use your Medicare card or your personal information.

If someone asks you for your Medicare number, stop and think. If you wouldn’t feel comfortable giving that person your credit card number, don’t give them your Medicare number. 

4.   Most importantly, if you suspect Medicare fraud, let us know! Call 1-800-MEDICARE (1-800-633-4227).

Medicare is stronger than ever, and we need your help to keep it that way. The health care law is doing a lot to help us fight Medicare fraud and make America stronger, safer, and healthier. 

Want to help? You can get tips on protecting yourself from identity theft at stopmedicarefraud.gov. Learn more about spotting and reporting fraud, and learn about our Senior Medicare Patrol volunteers who are teaching people like you how to spot, report, and stop fraud, and protect themselves from identity theft.

Remember, a little preparation goes a long way. If you experience a Medicare fraud scheme – walk away, hang up, close the door, or say “no thanks.”

Get the Care You Need, When You Need It

By Don Berwick, CMS Administrator

Cross-posted from HealthCare.gov.

Posted October 20, 2011

Your doctors try hard to give you the best care possible, but it can be a challenge to get all the information they need to protect your health.  For people with Medicare, this is particularly important because a significant number of people over age 65 and those with disabilities live with one or more chronic conditions. That is why I’m so pleased with the work we are doing with doctors and hospitals to find ways to improve care and reduce costs.

When doctors, hospitals, and other health care providers are able to work together they provide better, more coordinated health care. Thanks to the Affordable Care Act, they can do that by becoming an Accountable Care Organization (ACO).

By taking this step, providers will be able to communicate closely with each other about your health with the goal of delivering better and more coordinated care while meeting your needs and preferences. Doctors will be able to spend more time with patients. And specialists and primary care doctors will communicate more to ensure that you get the care you need.

Medicare will help doctors and hospitals that choose to participate ensure you are getting the right care, in the right place, at the right time.  And if that care coordination lowers costs, doctors and hospitals as well as Medicare can share in the savings – shifting payments toward value rather than volume of care.

Your Medicare benefits will stay the same. You can see still see any doctor or healthcare provider who accepts Medicare – even if your doctor chooses to participate in this program. Nobody – not your doctor, not anyone – can limit your choice on who you see.

If your provider decides to participate, you will be notified. For more information, talk to your doctor or call 1-800-MEDICARE (1-800-633-8227). TTY users should call 1-877-486-2048.

This is just one of many ways the Affordable Care Act is helping your doctors spend more time with you to help you to stay healthy and to get better.  Learn more here.

Medicare Open Enrollment: Things to Think About When Comparing Plans

By Jonathan Blum, Deputy Administrator for Medicare

Every day we are faced with choices.  We check the weather forecast to help us decide what to wear.  We might look over the supermarket sale ad to help us figure out what to have for dinner.  I’ll bet that sometime today, without even realizing it, you’re going to gather some information and use it to help you make a decision.  Some of those choices might be harder than others.

In my work with the Medicare program, I know that choices are a good thing.  But I’m also aware – because some of you have told me — that sorting through your health and drug coverage choices during Open Enrollment can be confusing — especially when many Medicare plans seem to offer similar benefits.

That’s why making Medicare easier to access has been one of our top priorities. The Affordable Care Act is helping us do this, in addition to delivering better choices, more benefits, and lower overall costs to the Medicare program.

We’ve been working to make Medicare less confusing by steadily phasing out duplicative plans, and shoring up our website, toll-free call center and community programs to make it easier for people to find Medicare coverage that works for them.

This year, when you sit down to review your Medicare health and drug plan choices, here are some things I hope you think about:

Are the services you need covered?

We know future health care needs can be hard to predict, but changes happen. Maybe your family situation is different this year, or you have different health concerns. Make sure you understand what services and benefits you’re likely to use in the coming year.

Remember that no matter what plan you pick, you’ll have access to a variety of preventive tests and screenings, at no cost to you, thanks to the health care law.

Do you have any other coverage?

You may have other health insurance from a current or past job, or through a family member.  If you do, you’ll want to understand exactly how that other coverage works with Medicare. You may want to just keep what you have.

Costs

How much are your premiums and deductibles? How much do you pay for hospital stays and doctor visits? Is it important for you to have expenses balanced throughout the year?  Just like with everything else, the lowest-cost health plan option might not be the best choice for you.

Doctor and hospital choice

We understand the relationships you have with your doctors and providers are important. Do your doctors accept your coverage? Do you have to choose your hospital from a network? Do you need to get referrals?  With Original Medicare, you can always go to any doctor or hospital that accepts new Medicare patients.

Drug coverage

Do you need to join a Medicare drug plan? Will you pay a penalty if you join a drug plan later? How much will your prescriptions cost under each plan? Even if you don’t take many drugs now, you might want the peace of mind of knowing you’re covered.

Quality of care

Ask yourself whether you’re truly satisfied with your medical care. Not all health care is created equal, and the doctors, hospitals and facilities you choose can impact your health. Look for plans with a 5‑star performance rating — the right expertise and care may help speed your recovery and improve your outcomes.

Convenience

Your time is valuable, too. Where are the doctors’ offices? What are their hours? Which pharmacies can you use? Can you get prescriptions by mail? Do the doctors use electronic health records or prescribe electronically? Remember that even if you are happy with your current plan, these answers might change from year to year.

Travel plans

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.

Only you know what’s most important to you and your family – that’s why we want to make sure you have all the information you need to make the best decision for you.  Look around for all the Medicare information out there [link to second blog in series]. And visit our Open Enrollment center, where we’ve gathered everything you need to walk through your options.  Now, what’s for dinner?

Medicare Open Enrollment: 4 Places to Look for Medicare Information

By Julie Green Bataille, Director of Communications

Whether it’s apple picking or Sunday afternoon football, there’s a comfort in things that happen every fall. Shorter days and cooler nights also mark the start of Medicare Open Enrollment. Between now and December 7, you can expect to hear about the choices, benefits, and lower overall costs you have when it comes to Medicare – many of them thanks to the health care law.

Open Enrollment is your chance to review your health care coverage and see if you need to make any changes, or if you are happy sticking with the plan you have.  The health care law extended the Open Enrollment period and made it earlier – giving you more time to make choices and giving Medicare time to process everything so your coverage starts without a hitch on January 1st.This year, you can make any changes as early as October 15.

Over the next few months, look around – you’ll find a wealth of information about your Medicare benefits.  Our Medicare Open Enrollment calendar tells you what to look for this fall, especially in these 4 everyday places:

  1. Your mailbox
    Look through your mail carefully — you may get important notices from your current plan, Medicare, or Social Security about changes to your coverage or any extra help you may get paying for prescription drugs.Also look for your Medicare & You handbook.  Like an old friend, it shows up around the same time every year. This year, it may be in your email inbox instead – if you decide to “go green” and asked to get it electronically. But whether it’s on your computer or on your bookshelf, now is the time to take it out and find out what’s new in Medicare.

    You’ll also start to see brochures from companies that offer Medicare health and drug plans. Just remember, be smart about protecting your personal information and your identity — plans aren’t allowed to call or come to your home without an invitation from you.

  2. On your computer
    Comparing your plan choices is important –and our Medicare Plan Finder makes it as simple as possible. Soon, you’ll be able to watch a video about how the Plan Finder works. Enter the drugs you take to find out how you can lower your costs, review a the plan’s star ratings to compare plans based on quality, and join a plan right online if you find one that meets your needs.
  3. In newspaper, newsletters, and magazines
    Take a moment as you enjoy that morning coffee to read the Medicare information that’s out there.  You may find a local event — somewhere right around the corner with counselors to help you, like your State Health Insurance Assistance Program. Don’t miss the chance to get personalized help if you need it.
  4. On television and radio
    At the end of one of those shorter days, as you relax in front of the television, you may see some advertisements or programming about Medicare plans and your new choices.  You might also hear some advertisements on your way to or from work as you listen to the radio.Now is the time to enjoy the choice and control you have over your health care coverage. Just like fall, Medicare Open Enrollment only comes once a year.

Medicare Open Enrollment: Medicare Is Stronger Than Ever

By Don Berwick, Administrator, Centers for Medicare & Medicaid Services

With the start of this year’s Medicare Open Enrollment less than two weeks away, I can’t stress one point enough: Medicare is stronger than ever. Consumers have more and better Medicare options than ever before.

Seniors this year can expect more choices, more benefits, and lower overall costs. 

Because it’s a fact:  99% of you have at least one Medicare Advantage plan in your area. And everyone with Medicare can get a host of preventive tests and screenings —more than ever before — at absolutely no cost to you.  Medicare also continues to cover an Annual Wellness Visit – a great chance to talk with your doctor or other health provider about treating small problems and concerns before they become big ones.

Here’s the best part: even with these improved benefits, people won’t be feeling it in their pocketbooks.  Average premiums for Part D drug coverage are holding steady in 2012, and premiums for Medicare Advantage plans are actually dropping an average of 4%. And people who reach the Part D coverage gap will get a 50% discount on brand name drugs. 

This is all great news for the 47 million American seniors and people with disabilities who rely on Medicare.

We know that more choices can make decisions challenging, but we’ve expanded the Medicare safety net to make sure folks can get the help they need to sift through their options.  You can even get an early start — we’ve already made sure the Medicare Plan Finder is fully updated with all new 2012 cost and benefit information for health and drug plans.  If you’re the kind of person who likes to get online yourself and sort through the details, you can use this online tool right now.  Start by entering your drugs and checking on the doctors and pharmacies you want to use.  A few steps will get you to a personalized list of your plan choices and help you compare.   

If you’d rather get a personal hand walking through your choices, we’ve got help for you, too. You can call or visit one of the thousands of wonderful volunteers staffing the State Health Insurance Assistance Programs across the country. 

One more way we’re going to help – every week during Open Enrollment, we’re going to have some of our top health care experts adding tips and advice to this blog, to give you some important things to consider as you weigh your choices.  When Medicare Open Enrollment ends on December 7, we want every single American with Medicare to have health and drug coverage that meets their needs.   Are you ready?