Health screenings save men’s lives

Did you ever put off doing a task or getting a test and later wished you’d just gotten it over with? If you’re a man with Medicare, now’s the time to talk with your doctor about whether you should get screened for prostate cancer, for colorectal cancer, or for both. Screening tests can find cancer early, when treatment works best.

Don’t worry about the cost—if you’re a man 50 or over, Medicare covers a digital rectal exam and Prostate Specific Antigen (PSA) test once every 12 month. Also, Medicare covers a variety of colorectal cancer screenings, and you pay nothing for most tests.

Prostate cancer is the most common cancer in men, second only to lung cancer in the number of cancer deaths. Not sure you should get screened? You’re at a higher risk for getting prostate cancer if you’re a man 50 or older, are African-American, or have a father, brother, or son who has had prostate cancer.

Colorectal cancer is also common among men—in fact, it’s the second leading cause of cancer-related deaths in the United States among cancers that affect both men and women. If everyone 50 or older got screened regularly, we could avoid as many as 60% of deaths from this cancer.

In most cases, colorectal cancer develops from precancerous polyps (abnormal growths) in the colon or rectum. Fortunately, screening tests can find these polyps, so you can get them removed before they turn into cancer. If you’re 50 or older, or have a personal or family history of colorectal issues, make sure you get screened regularly for colorectal cancer.

June is Men’s Health Month, a perfect time for you (and the men in your life) to take the steps to live a safer, healthier life. Watch our videos on how Medicare has you covered on prostate cancer and colorectal cancer screenings, and visit the Centers for Disease Control for more information on men’s health.

Get ready for your summer trip

If you’re planning a vacation this summer, you know there’s a lot to do before your leave – like buy sunscreen, book your flight, and renew your passport. Don’t forget to include 2 very important items on your travel to-do list if you plan to leave the country on your trip:

  1. Look into Medicare coverage outside the United States.
  2. Think about getting additional health care coverage.

You have Medicare, so your health care services and supplies are covered when you’re in the U.S., which includes Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. But, if you plan to travel overseas or outside the U.S. (including to Canada or Mexico), it’s important to know if your Medicare coverage will be different.

In most cases, Medicare won’t pay for health care services or supplies you get outside the U.S. Medicare may pay for health care and services you get outside the U.S. in these rare cases.

Because Medicare coverage outside the U.S. is limited, you may want to buy a travel insurance policy. To find out more about these policies, talk to an insurance or travel agent. Not all travel policies include health insurance, so ask questions and read the terms and conditions carefully.

Figuring out your health care coverage will help you be prepared so you can have a stress-free trip. To be even more prepared for your vacation, visit the Centers for Disease Control’s Traveler’s Health page for more information on how to stay healthy abroad.

Say “no” to tobacco!

This year include tobacco in your annual spring cleaning, and kick those cigarette butts in the, well, butt!  Why? Because tobacco use is the second leading cause of death worldwide, responsible for 1 in every 10 adult deaths. If you or someone you love is ready to quit smoking, we can help.

Medicare can help you quit smoking

Part B covers free counseling sessions as a preventive service to help you quit smoking. If you haven’t been diagnosed with an illness caused or complicated by tobacco use, and if the doctor or other health care provider accepts assignment, then you pay nothing for the counseling sessions.

If you’ve already been diagnosed with an illness that was caused or made worse by tobacco use, or you take a medicine affected by tobacco, you can still get up to 8 counseling sessions every 12 months. In this case, you pay your Part B deductible and 20% of the Medicare-approved amount. (If you get counseling in a hospital outpatient setting, you’ll also need to pay the hospital a copayment.)

Let’s get started!

Bring out the trash bags and the brooms – it’s time for a clean start this spring. Visit the Centers for Disease Control and the National Cancer Institute to learn more about how you can quit smoking.

CMS Promotes Value for Seniors and Persons with Disabilities in Medicare Plans

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

With today’s regulation limiting overhead and profits for Medicare Advantage and prescription drug plans, the Affordable Care Act continues to promote value for consumers’ and taxpayers’ health care spending. These new requirements apply to Medicare health and drug plans offered by private insurance companies serving over 37 million seniors and persons with disabilities, and build on a similar regulation we issued last year requiring a minimum medical loss ratio for health plans serving consumers in the private insurance market. Medicare health and drug plans, beginning next year, must meet a minimum medical loss ratio, limiting their spending on non-health related items such as administrative costs, profit, or overhead. More specifically, this means that the plans must spend at least 85 percent of their revenue on direct benefits to Medicare enrollees such as clinical services, prescription drugs and quality improving activities.

The new Medicare MLR requirements will also give people with Medicare and their caregivers more information about Medicare plans when comparing their health care options during enrollment periods. They will be able to consider a plan’s medical loss ratio, along with quality ratings, coverage, premiums and other factors that influence their health care decisions.

By ensuring that plan payments are spent on health care and activities that improve the quality of care received, seniors and persons with disabilities will have more opportunities to work with their doctors and other health care professionals to stay healthy. With Medicare spending already growing at a slower pace, the new requirements are just one more way the Affordable Care Act is creating more value for seniors and persons with disabilities. We are excited about new initiatives and projects that are improving the health of people with Medicare and are committed to making a stronger Medicare program.

Older Americans Month 2013: Unleash the Power of Age!

For 50 years, May has been the month we celebrate older adults across the nation. You could say that Older Americans Month is coming of age. This year’s theme—“Unleash the Power of Age!”—emphasizes older Americans’ potential for energy and activism and urges them to embrace it.

There’s no age limit on achievement—and older Americans are doing incredible things. They make a difference in their communities by continuing their careers, pursuing new business ventures, and volunteering in their retirement years.  To find ways to get involved in your community, visit Serve.gov.

Staying active, engaged, and healthy is good advice for everyone, but it’s especially important for older people. The U.S Administration on Aging (AoA), supports older adults through programs and resources to encourage healthy living. In addition, the Affordable Care Act is making certain vital preventive services, such as mammograms, diabetes screening, and an annual wellness visit, available for seniors with Medicare.  Also, check out Go4Life, an exercise and physical activity campaign from the National Institute on Aging at NIH.

Throughout the year, and especially during Older Americans Month in May, we urge all Americans to appreciate and celebrate the vitality, aspirations, and achievements of elders and their contributions to society.

Get your blood pressure checked regularly

Do you or does someone you know have high blood pressure? Most likely, your answer is yes. More than one-third of adults in the United States have high blood pressure, and many don’t even know it. High blood pressure increases your risk of heart disease, the #1 killer worldwide, and many other diseases. That’s why it’s important to get your blood pressure checked regularly.

Medicare helps make checking your blood pressure easy. A blood pressure screening is covered in your “Welcome to Medicare” visit and your Yearly Wellness visit at no cost to you.

There are also many ways to prevent and help treat high blood pressure. Eating a healthy diet and avoiding sodium are easy ways to lower blood pressure. Maintaining a healthy weight and being physically active are also important. The surgeon general recommends at least 30 minutes of moderate physical activity most days of the week. You can also check your blood pressure between your yearly visits for free at many pharmacies, senior centers, and health fairs.

May is National High Blood Pressure Education Month, watch our video to learn more.

Protect yourself from Hepatitis B

Did you know that 1.2 million people in the U.S. have chronic Hepatitis B, but many more people don’t know they’re infected because they have no symptoms? Hepatitis B is a contagious liver disease that can range in severity from a mild illness lasting a few weeks to a serious illness that can lead to liver disease or liver cancer.

Medicare can help keep you protected from Hepatitis B. The best way to prevent Hepatitis B is by getting the Hepatitis B vaccine, which is usually given as 3 shots over a 6-month period. You need to get all 3 shots for complete coverage. If you’re at high or medium risk for Hepatitis B, Medicare Part B will cover Hepatitis B shots for free.

Are you at risk for getting Hepatitis B? If you have hemophilia, End-Stage Renal Disease (ESRD), diabetes, or certain conditions that lower your resistance to infection, you have a higher risk for getting Hepatitis B increases.  Additionally, if you have a profession that puts you in frequent contact with blood or bodily fluids, you may be at a higher risk.

May is Hepatitis Awareness month. To find out more about preventing and treating Hepatitis B, visit the Centers for Disease Control.

Protect your bones—Medicare can help

Do you keep putting off exercise? You may be hurting your bones. Lack of exercise is one of the risk factors that can lead to osteoporosis. When people have osteoporosis their bones become less dense. You may not know that you have osteoporosis until your bones are so weak that a sudden strain, bump, or fall causes your wrist to break or your hip to fracture.

Medicare can help you prevent or detect osteoporosis at an early stage, when treatment works best. Talk to your doctor about getting a bone mass measurement—it may be free.

May is National Osteoporosis Awareness and Prevention Month. Learn more about what puts you at risk for osteoporosis and how to prevent or treat it at the National Osteoporosis Foundation or the Centers for Disease Control. Watch our short video to learn more about how Medicare can help you protect your bones.

Making complaints less complex

We hope every healthcare experience you have is a positive one. That’s why we offer you a variety of tools to express your concerns. One of those tools is the ability to file a complaint (sometimes called a “grievance”).

Do you have a complaint?

If you have a concern or a problem that isn’t a request for coverage or reimbursement, you have the right to file a complaint. Not sure if you need to file a complaint or an appeal? Read some examples of situations where you might need to file a complaint.

Things to know before you file a complaint:

Each plan has specific rules you’ll need to know and follow when filing a complaint.  If, after filing a complaint, your plan doesn’t address the issue, call 1-800-MEDICARE for assistance. You can also call your State Health Insurance Assistance Program (SHIP) for free, personalized help filing a complaint.

Information you’ll need to have ready when you file a complaint: 

Basic information about you 

  • First and last name
  • Date of birth
  • State you live in
  • Zip code
  • Email address
  • Preferred call back time, phone number, and response language

Medicare card information 

  • Medicare number
  • Effective date

Health or drug plan information

  • Your health or drug plan name
  • Your health or drug plan contract ID

Complaint topic

  • Benefits
  • Prescription drugs
  • Services
  • Something else

 

2 tools Medicare offers that can help…

1. A Personal Health Record (PHR) is a record with information about your health that you, or someone helping you, can keep for easy reference using a computer. You control the health information in your PHR and can get to it anywhere, at any time, with Internet access.

2. The Blue Button tool provides you an easy way to download your personal health information to a file. You can download the file of your personal data and save the file on your own personal computer.  You can access the Blue Button through your account on MyMedicare.gov.

Nearly 3.5 million people saved more than $706 on prescriptions in 2012

By Kathleen Sebelius, Secretary of Health and Human Services

Posted March 21, 2013, Crossposted from healthcare.gov

In the three years since the Affordable Care Act became law, the slower growth of health care costs is saving money in Medicare and the private insurance market, helping to curb previously skyrocketing premiums and making Medicare stronger.

The nonpartisan Congressional Budget Office recently estimated that Medicare and Medicaid spending would be 15 percent less — or about $200 billion— in 2020 than was previously projected, thanks to this slower growth. Medicare spending per beneficiary rose by just 0.4% in 2012, while Medicaid spending per beneficiary actually dropped by 1.9% last year. We are making Medicare stronger, too, by spending smarter, promoting coordinated care, and fighting fraud. Not only does this ensure that taxpayer dollars are spent wisely.  It means that those who count on Medicare — our grandparents, parents, our friends, and neighbors – will have it for years to come.

Today, we are announcing that thanks to the Affordable Care Act, more than 6.3 million seniors and people with disabilities on Medicare have saved more than $6.1 billion on prescription drugs since the health care law was enacted three years ago. This is the result of the law’s closing of the prescription coverage gap known as “the donut hole.”

Nearly 3.5 million people with Medicare saved an average of more than $706 each on their prescriptions in 2012.

In the case of Helen Rayon of Pennsylvania, the savings on her medications is enough to help her contribute to the education of her grandson. She says: “I take seven different medications. Getting the donut hole closed … gives me a little more money in my pocket.” Watch a video to learn more about Helen.

David Lutz, a community pharmacist from Hummelstown, PA, described his elderly customers, “splitting pills, taking doses every other day, missing doses, stretching their medications.”  But he says this has begun to change with the savings resulting from the Affordable Care Act, and that’s good for their health as well as their budgets.

After the law was passed, the Affordable Care Act provided a one-time $250 check for people with Medicare who reached the Part D prescription drug coverage gap in 2010. Since then, individuals in the donut hole have continued to receive savings on prescription drugs. In 2013 individuals in the donut hole are saving over 50% off of the cost of branded drugs. The savings on both brand name and generic drugs will continue to increase until the coverage gap is closed in 2020.

Along with savings on their medications, American seniors have also benefited from access to vital preventive services — such as mammograms, cholesterol checks, cancer screenings, and annual wellness visits — with no Part B coinsurance or deductibles. In 2012, more than 34 million seniors and people with disabilities with Medicare received at least one free preventive service. Having easier access to preventive services without worrying about the cost helps seniors stay healthier and identify health conditions before they become more serious and costly.

Helen works as a health-and-wellness coordinator at a senior center, arranging for health and fitness activities for seniors older than herself.  She knows they struggle with the costs of staying healthy. “If it weren’t for the health care reform, many of our seniors would not get to a doctor,” to get a check up, Helen says. “It is expensive for us to keep good health.”

Affordable Care Act initiatives are also ensuring that if Medicare beneficiaries do end up in the hospital that their care is coordinated and they stay out of the hospital once they’re discharged. This also gives Medicare beneficiaries – and other taxpayers – more value for their health care dollars. In fact, hospital readmissions in Medicare have fallen for the first time on record, resulting in 70,000 fewer readmissions in the last half of 2012.

The Affordable Care Act is helping us keep our moral commitment to ensure that our grandparents and other seniors get the high-quality, affordable health care and security they need and deserve.

To learn more about how the Affordable Care Act is saving seniors on prescription drug costs by closing the donut hole coverage gap, visit www.hhs.gov/news/press/2013pres/03/20130321a.html

Follow Secretary Sebelius on Twitter at @Sebelius.