PLEASE HELP US IN FLORIDA!!

[Guest guest]

This is the story that Bob LaMendola has been working on from

Saturday's Ft Lauderdale Sun-Sentinel. Do you think that the rest of

you that are " dual eligible " can NOW start to write your letters to

the Legislators, Newspaper Editors, US Congress Members and Senators,

and any other concerned persons? Or, after being in this fight to stay

alive all these last few years, have you all given up and just want to

hope that this doesn't happen, or won't affect YOU on January 1, 2007?

Trust me, if YOU are one of the " dual eligibles " from Medically Needy

Share of Cost that got pushed over to Medicare D last December in

order to obtain medications on January 1, 2006.....THIS WILL AFFECT YOU!

WAKE UP........IT'S PAST TIME TO START FIGHTING AGAIN!!!!!!!!!!!!!!!

Bill Rettinger, Co-Founder

MedicaidAdvocates.Com

http://www.sun-sentinel.com/features/health/sfl-rxbneedy11nov11,0,4200367.story?\

coll=sfla-news-health

Rule change to drug subsidies could be costly

Drug subsidies worth hundreds to some people

By Bob LaMendola

South Florida Sun-Sentinel Health Writer

November 11, 2006

Because of tangled government eligibility rules, up to 37,000

Floridians with chronic and costly illnesses are at risk of losing

low-cost Medicare and Medicaid prescription coverage. As a result,

they will face sharply higher medical bills.

Patients and advocacy groups fear the big bills will drain thousands

of dollars every month from people who can afford it least, possibly

forcing some to skimp on medicine and doctor visits -- for at least a

few months.

" I'm figuring out which bridge I'm going to live under, " said Bill

Rettinger, a Fort Lauderdale patient and activist who is disabled by

severe arthritis and chronic pain from an auto accident, as well as

asthma and diabetes.

The problem springs from complex eligibility rules. These patients --

including about 2,000 in Broward County and 1,000 in Palm Beach County

-- earn too much to qualify for regular state Medicaid available to

low-income people, but because of large medical bills, they were

eligible for a state " medically needy " program that paid all their costs.

This year, medically needy patients were moved into Medicare's new

drug program and pay subsidized prices of $0 to $5 per prescription.

But because Medicare now covers the bulk of their drugs, most of them

no longer will qualify as medically needy Jan. 1. That's the Catch-22.

As a result, these patients will also lose eligibility for those

Medicare discounts and must pay regular drug co-pays.

If that happens, Rettinger said his out-of-pocket costs for drugs and

doctor visits will drain $1,100 out of his monthly disability check of

$1,300, leaving him $200 to pay other bills. Now, under Medicare,

Rettinger pays about $300 a month. In 2005, while medically needy, he

paid nothing.

Those affected by the change are among the sickest people in the

state, with chronic conditions such as organ transplants, HIV/AIDS,

cancer and heart disease. Some need more than $3,000 of medication

monthly.

State and federal officials said some medically needy people do not

realize their special coverage could end Dec. 31, even though agencies

are sending letters and activists are spreading the word.

" There are going to be some very, very upset people, and some are

going to be clueless, " said Miriam Harmatz, an attorney at Florida

Legal Services in Miami. " They're going to go to the drugstore on Jan.

2 to pick up their prescriptions expecting to pay $2 and it's going to

be hundreds of dollars. "

Florida officials said they do not know how many medically needy

patients will be affected or how much they will spend. Some will be

able to remain on the medically needy plan because they still have

high bills, and others will re-qualify for subsidized Medicare drug

prices because their annual incomes fall below $14,700 ($19,800 for a

couple).

But those who do not qualify will lose part or all of their present

coverage and will have to hunt for Medicare health plans or drug plans

with low premiums and co-pays, said Sybil , assistant secretary

for Medicaid operations.

" Some will have problems, but we feel there are options to keep people

in good health-care coverage, " said.

On a positive note, said, those patients who have to pay very

large medical costs in 2007 can requalify for Medicaid's medically

needy program the next month.

Once that happens, they will also requalify for the subsidized drug

coverage from Medicare, restoring their present status, said Renard

Murray, an associate regional administrator for Medicare.

" It's not dire straits for these folks, " said.

But health-care advocates remain concerned. Applying and getting

reapproved for two government programs could take at least two months,

during which time the patients would be paying thousands of dollars

out of pocket.

Bruce Bernstein, a Boynton Beach heart transplant recipient, said he

would have to pay about $1,000 a month for drug co-pays through his

HMO if he lost the low-cost coverage.

" I'm just able to scrape by now. If I had to pay more, I don't know

what I would do, " Bernstein said.

Advocacy groups led by the Florida Coalition for Transplant Survivors

have started a petition asking state legislators to make it easier to

qualify as medically needy. Now, patients do not qualify until their

medical bills absorb all but $200 of their monthly incomes.

In addition to Medicaid's medically needy group, other low-income

patients are at risk of losing subsidized prescriptions next year.

Medicare sent letters to 46,000 Floridians -- 623,000 across the

nation -- warning people they will not be automatically renewed for

subsidies and must reapply.

Although a large number of them could easily requalify, officials and

advocates worry that some people will fail to reapply and lose out,

because they will mistakenly think they are supposed to be dropped,

fail to notice the letter or are among hard-to-reach groups such the

mentally ill and homeless.

Bob LaMendola can be reached at blamendola@... or

or , ext. 4526.