Need help with your health care costs?

Susan, a woman in her mid-80’s, went to her local SHIP for help with her finances and healthcare decisions. Susan hasn’t had prescription drug coverage since 2011, and she currently isn’t getting any help to pay her prescription drug costs. Susan spoke with a SHIP counselor about her situation and learned she could get Extra Help with paying her prescription drug costs. Susan’s now enrolled in a plan where she can afford her medications.

If you have limited income and resources, like Susan, you may be eligible for “Extra Help” or one of Medicare’s savings programs. These programs may help you save on premiums, deductibles, copayments, or prescription costs.

Get help with one of our 4 savings programs

Medicare offers 4 kinds of programs that may help with your costs.

1.     Qualified Medicare Beneficiary (QMB) Program

2.     Specified Low-Income Medicare Beneficiary (SLMB)

3.     Qualified Individual (QI) Program

4.     Qualified Disabled and Working Individuals (QDWI)

Applying for Extra Help is simple and free.

Don’t go without your prescriptions even if you’re having trouble paying for them. If you have limited income or resources, you may be eligible for Extra Help to help pay Medicare prescription drug costs, like premiums, deductibles and copayments.

Take a minute to see if you qualify to get help with your health care costs – it could mean money in your pocket.

Bundled payments, DMEPOS, regulatory reform, and ESRD

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

In the past few days, the Centers for Medicare and Medicaid (CMS) announced four critical initiatives that are designed to enhance health care delivery for millions of Medicare beneficiaries by improving care or lowering costs, or both.  Taken together the announcements illustrate the breadth and diversity of efforts underway to ensure a better, stronger, more patient-centered Medicare program.

Last week, we announced a new health care delivery system reform, made possible by the Affordable Care Act, to test how bundling of payments for episodes of care, for example a heart attack or stroke, instead of paying for each test or procedure or physician’s visit, can result in more coordinated, higher quality care for beneficiaries.  By bundling payments for services that beneficiaries receive during an episode of care, CMS hopes to encourage doctors, hospitals, and others  to work together to improve care and health outcomes, while also lowering Medicare costs.  Over 500 organizations, nationwide, have already signed-on to participate.

We also announced a major expansion of the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program.  In its first year of operation, competitive bidding, where prices are based on suppliers’ bids, saved the Medicare program, and taxpayers, over $202 million, while maintaining access to quality products for Medicare beneficiaries in the nine areas of the country where the program launched.   It’s a great example of the Administration’s determination to put the brakes on runaway healthcare costs.  With this expansion in the program, Medicare beneficiaries in 91 major metropolitan areas will save an average of 45 percent on certain DMEPOS items beginning in July.  Between 2013 and 2022, we estimate that the expansion of the DMEPOS program will save Medicare $25.7 billion, while saving beneficiaries, who pay a percentage for medical equipment and supplies, $17.1 billion through lower prices.

This week, we issued a proposed rule which will help health care providers and hospitals to operate more efficiently by getting rid of regulations that are outdated, obsolete, or excessively burdensome.  Many of the rule’s provisions streamline requirements that health care providers must meet in order to participate in the Medicare and Medicaid programs, without jeopardizing patient safety, and they will save providers nearly $676 million annually.  Just as important, by eliminating burdensome requirements, health care providers can improve the quality of health care delivery for Medicare beneficiaries by spending more time focusing on patient care and less time filling out forms.

Finally this week, we announced the Comprehensive End-Stage Renal Disease (ESRD) Care Initiative.  It will help identify, test and evaluate new ways to improve care for Medicare beneficiaries living with ESRD.  We’ll be working with the health care provider community to care for a population that significant and complex health care needs.  Through better care coordination, beneficiaries can more easily navigate the multiple providers involved in their care, ultimately improving their health outcomes.

These four initiatives demonstrate that CMS is employing new and novel tools and programs, thinking outside the box and beyond the usual way of doing things, in order to improve health care delivery for people with Medicare and, in the process, strengthen the Medicare program for current and future beneficiaries.

This Valentine’s Day give your heart some love

Although popular love songs might tell you otherwise, a broken heart can’t kill you – but heart disease can.  Heart disease is the leading cause of death in the United States. 

You might not be able to avoid Cupid’s arrow, but you can take steps to lower your risks and prevent heart disease.  Start by scheduling an appointment with your doctor to discuss whether you’re at risk for heart disease. 

Medicare will cover a cardiovascular screening at no cost to you every 5 years.  The screening includes tests to help detect heart disease early and measures cholesterol, blood fat (lipids), and triglyceride levels. 

If you and your doctor discover that you’re at risk for a heart attack or stroke, there are steps you can take to help prevent these conditions.  You might be able to make lifestyle changes (like changing your diet and increasing your activity level or exercising more often) to lower your cholesterol and stay healthy.

Luckily, you don’t have to face these challenges alone. The national Million Hearts campaign has pledged to help prevent 1 million heart attacks and strokes over the next 5 years. You can join them, and get information and resources you need to learn how to take care of your heart and live a healthy life.

February is American Heart Month, and a healthy heart is the best Valentine’s Day gift you could ever give yourself, or the people who love you.