Carol Schmitkons, Amherst Township Senior Service (ATTSO) Director

Medicare Modernization Act of 2003

In 2003, President Bush and Congress passed a new law to bring people with Medicare more choices in health care coverage and better health care benefits.  The new law will strengthen the current program, add new prescription drug and preventive benefits, and provide extra help to people with low incomes.  You will still be able to choose doctors, hospitals and pharmacies.  Here is a timeline of what will be happening in the next year and a half.

• 2004 – Discount Drug Cards start
• 2005 – New and improved Preventive
                Benefits start
• 2006 – Prescription Drug Plans start

In this issue we will discuss the changes that will take place in 2004.  Future issues of the Senior Gazette will cover the planned Medicare changes of 2005 and 2006 in more detail.

NEW NAME

“Medicare + Choice” plans will now be called “Medicare Advantage” plans.  More Preferred Providers Organization plans (PPO’s) will be included, which will give you more choices of doctors and service providers.  This is particularly nice if you travel to other states or live out of the state for part of the year.  A referral is usually not required as long as the new doctor is on the PPO’s list.

WHAT’S NEW WITH MEDICARE

Part A

– Hospital Deductible per benefit period
   (60 days beginning the first night you are hospitalized)
    …….…………………………………………$876

– Hospital Co-Pay (for inpatient hospital days 61-90)
    …….…………………………………….$219/day

– Lifetime Reserve Day Co-Pay
    ….……………………………………….$438/day

– Skilled Nursing Facility Co-Pay
   (for days 21-100 inpatient rehab)………$109.50/day

 

Part B

– Monthly Premium (up 13%)………………$66.60

– Annual deductible remains………………….$100

– Co-insurance amount for most Part B services
    …..…………………………………..remains 20%

Medicaid eligibility

	Single	Married
Monthly income:	$510	$866
Total resources:	$1500	$2250

	Single	Married
Monthly income:	$796	$1061
Total resources:	$4000	$6000

	Single	Married
Monthly income:	$951	$1269
Total resources:	$4000	$6000

	Single	Married
Monthly income:	$1068	$1426
Total resources:	$4000	$6000

DRUG DISCOUNT CARDS

Drug Discount Cards will offer partial relief to high prescription drug costs from June 1, 2004 until the full Medicare drug benefits begin in January 2006.  Registration for the drug discount cards that include Medicare’s seal of approval will begin in May, with benefits starting in June.

Medicare will contract with private companies to offer the new drug discount cards until Medicare prescription drug benefits start in 2006.  A discount card with Medicare’s seal of approval can save you 10 – 25% on prescription drugs. You may qualify for a $600 credit on your discount card to help pay for your prescription drugs if your individual income for 2004 is no more than $12,569 (married couples no more than $16,862) and you are not on Medicaid or an employer’s group health plan.

The list of nationwide companies who will have discount cards is continually growing.  Check Medicare’s website (www.Medicare.gov) for a complete, updated list.  The following is a list of several of the companies:

• Aetna Health Management, LLC
• Caremark Advantage, Inc.
• Catalyst Rx
• Medco Health Solutions, Inc.
• PBM Plus, Inc.
• PharmaCare Management Services, Inc.
• Pharmacy Care Alliance, Inc.
• Scrip Solutions, LLC
• SXC Health Solutions, Inc.
• United Healthcare Insurance Co.
• WellPoint Pharmacy Management
• Express Scripts, Inc.
• Argus Health Systems, Inc.
• Computer Sciences Corporation (National & OH)
• First Health Services Corporation (OH & several other states)
• Golden Buckeye’s Medicare-approved card ($20 charge will work best for the low income)

Medical Health Plan Card sponsors in Ohio that are also participating are:

• Community Insurance Company (2 plans)
• Health Plan of the Upper Ohio Valley
• Hometown Health Plan
• SummaCare Inc.
• United Healthcare of Ohio