Asclepios
Save More Lives
April 24, 2008 • Volume 8, Issue 17
For those who qualify, the Extra Help program under
Medicare’s prescription drug benefit can be a life saver.
Extra Help pays
premiums, sets more affordable copayments and provides coverage through the
doughnut hole—the gap in coverage that is built into Part D.
For a person
with Medicare trying to afford their prescription drugs on less than $1,300 per
month—the maximum allowed—Extra Help means prescriptions can be refilled on
time, pills no longer have to be split and money does not have to be diverted
from the grocery budget.
Unfortunately, millions of older adults and
people with disabilities in or near poverty are not getting the help they need.
The Extra Help program is not reaching the people it was designed to help. It
needs to be fixed.
The problem is the asset test. Over half of those
rejected by the Social Security Administration for Extra Help were denied simply
because the value of their bank accounts, life insurance policies and retirement
accounts were above the low ceilings set by law. A widow with just $7,800 saved
for her retirement is ineligible for Extra Help, no matter how low her monthly
income.
The problem is worse in the Medicare Savings Programs, which have
maximum asset thresholds frozen at $4,000 for an individual and $6,000 for a
married couple—levels established two decades ago. Only 20 percent of eligible
people with Medicare are enrolled in the Medicare Savings Programs that pay the
Part B premium, now nearly $100 per month.
Congress has the opportunity
this year to raise and align the asset levels for both Extra Help and the
Medicare Savings Programs. Please ask your senator to take
action to help low-income people with Medicare.
Medical
Record
“We urge you to . . . increase the asset allowance for the Part
D low income subsidy [Extra Help] so that those with very limited incomes but
modest retirement savings, can obtain the assistance that the Medicare
Modernization Act was intended to deliver in paying premiums and coninsurance
under the drug benefit” (Letter to
Congressional Health Leaders from 33 Senators, December 2007).
“The Congress should raise Medicare Savings Program income and
asset criteria to conform to low-income drug subsidy criteria”
(Unanimous
Recommendation by the Medicare Payment Advisory Commission, March
2008).
“I am a medical social
worker who has discovered that many of the pharmaceutical companies’ patient
assistance programs that I previously used to help my patients have now excluded
those with Part D, both seniors and the disabled. Those who have low incomes but
are a little over the limit for Extra Help are now prevented from getting their
meds from the programs that used to provide them” (Story
submitted to the Medicare Part D Monitoring Project, Medicare Rights Center,
January 2007).
* * * *
Medicare Part D Appeals Help for Advocates Is
Here!
MRC’s new Medicare Part D Appeals: An advocate’s manual to navigating the
Medicare private drug plan appeals process offers an easy-to-understand,
comprehensive overview of the entire appeals process, including real-life case
examples, a glossary of important appeals terms, a sample protocol for
advocates, and links to important resources.
Register for a FREE copy of this great
resource.
* * * *
Medicare Part D Monitoring
Project
The Medicare Rights Center (MRC) would like to hear about your experience, or
that of someone you know, enrolled in a private health plan. With information
about what the issues are with Medicare Advantage plans, we will be able to
demand that those problems be fixed.
Submit your story at http://www.medicarerights.org/partdstories.html.
* * * *
The Louder Our Voice, the Stronger Our
Message
Asclepios—named for the Greek and Roman
god of medicine who, acclaimed for his healing abilities, was at one point the
most worshipped god in Greece—is a weekly e-newsletter designed to keep you
up-to-date with Medicare program and policy issues, and advance advocacy
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* * * *
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