Guest guest Posted January 5, 2006 Report Share Posted January 5, 2006 Asclepios Your Weekly Medicare Consumer Advocacy Update Never Again January 5, 2006 • Volume 6, Issue 1 It’s a familiar refrain on New Year’s Day—but this year it may not just be the revelers who wake up to a headache and a heart full of regrets. The politicians who concocted this private drug benefit, with wasteful handouts to the pharmaceutical and health insurance industries at taxpayers’ expense, may also be having second thoughts. Are they wincing every time the phone rings, expecting another angry constituent to accuse them of taking away their Medicaid coverage and sticking them in a drug plan that does not cover their medicines? Does their stomach churn when a frail grandmother at a town hall meeting berates them for thinking more of their drug company donors than their hometown constituents, who even with the drug benefit cannot afford their brand-name medicines? Can they remember what exactly the insurance companies promised they would deliver if they got the chance to sell subsidized drug coverage to people with Medicare? Low drug prices? Comprehensive coverage? Health security? It’s all a blur. And this year the headache doesn’t clear up by noon. It goes on. On Monday, the politicians find out that some nursing home residents who switched plans in December got out of the plan they were randomly assigned—it did not cover the drugs they take—but not in to the new plan they picked. On Tuesday, they find out that the drug plans are not providing temporary coverage of drugs that are off-formulary, something they promised to do in order to win contracts as Medicare drug plans. On Wednesday, they find out that people who had Medicaid coverage a week ago are getting stuck with a $250 deductible because their plan will not recognize their Medicaid eligibility. Couldn’t all these problems have been avoided? Yes, senator, but you have to take the pledge. “I recognize that a drug benefit delivered through the Medicare program with negotiated drug prices would deliver a simpler and more equitable, cost-effective and comprehensive benefit than a system of profit-seeking insurance companies. “Every day, I promise to help make a real Medicare drug benefit a reality. “I will not take another dime in campaign contributions from drug manufacturers or insurance companies.” Angry? Inspired? Click here to send the Medicare Rights Center your best slogan for our campaign to replace this privatized drug benefit with real Medicare drug coverage. Medical Record The amount of time allocated for the switch from Medicaid drug coverage to Medicare drug coverage for dual eligible individuals was determined back in June 2004 to be not enough time to ensure a smooth transition. The Medicare Payment Advisory Commission (MedPAC), an independent federal body that advises Congress on Medicare issues, notes that accomplishing the tasks of transitioning people from one drug plan to another in the private sector takes a minimum of six, and preferably, nine months (“Report to the Congress: New Approaches in Medicare,” Medicare Payment Advisory Commission, June 2004). Comparing the top 20 drugs prescribed to older Americans in 2004, one report found that the lowest price offered by any Medicare prescription drug plan was at least 48.2 percent higher than the lowest price available through the Department of Veterans Affairs (VA). The report found that the lowest price negotiated by the VA was, in every case but one, lower—often substantially so—than the lowest drug price available through any Medicare prescription drug plan operating in either Region 5, which covers the District of Columbia, land and Delaware, or Region 14, which covers Ohio (“Falling Short: Medicare Prescription Drug Plans Offer Meager Savings,” Families USA, December 2005). Pharmacists struggled with billing glitches and missing drug cards as they tried to fill prescriptions on January 3 under Medicare's new drug benefit. On the first full business day the benefit was available, pharmacists said some customers came in without cards or letters showing their eligibility and others were surprised that they had to pay full cost until meeting a deductible (“Pharmacists Deal with Medicare Confusion,” USA TODAY, January 4 2006). Fast Relief: Medicare Part D Monitoring Project The Medicare Rights Center (MRC) needs to hear about all the problems with the Medicare Part D benefit, whether they happen to you or someone in your community. With this information, we will be armed with the needed evidence to push for a decent Medicare drug benefit. Submit your story at www.medicarerights.org/partdstories.html. ***** Help Us Eliminate the 24-Month Waiting Period for Medicare Many people know that Medicare serves both older adults and people with disabilities. Few are aware that Americans with disabilities must wait 24 months from their first Social Security disability income payment, which is five months after Social Security deems them disabled, before their Medicare coverage begins. Medicare provides an invaluable safety net for Americans with disabilities, providing good, affordable health coverage when the private insurance market turns its back. Let us work together to make this health coverage available as soon as people need it, rather than 24 months later. Help us eliminate the 24-month Medicare waiting period. The Medicare Rights Center is committed to eliminating the Medicare coverage waiting period and we have recently embarked on a national media project to do so. Our goal is to focus attention on the personal experiences of people who are currently in the 24-month Medicare waiting period; or finally got Medicare coverage after having gone through the two-year wait. These individuals would have to be comfortable talking to the press about their health care experiences during the Medicare waiting period. If you know of individuals with a compelling story who are willing to participate in this project, please contact Heidi Kreamer at 800-333-4114, ext. 33 or hkreamer@.... 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 action alert designed to keep you up-to-date with Medicare program and policy issues, and advance advocacy strategies to address them. Please help build awareness of key Medicare consumer issues by forwarding this action alert to your friends and encouraging them to subscribe today. The Medicare Rights Center (MRC) is the largest independent source of Medicare information and assistance in the United States. Founded in 1989, MRC helps older adults and people with disabilities get good, affordable health care. Visit our online subscription form to sign up for Asclepios at http://www medicarerights.org/subscribeframeset.html. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 4, 2007 Report Share Posted July 4, 2007 I say this every time we have an episode which is often--I say it to myself. I will never XYZ again ever. And then turn around and do. Parades. Every parade besides ONE so far I have said it. The one she was fine in was the one she was actually walking with the GS in. She did really well. Besdies being afraid of the dogs around. So I thought hey they are asking for kids in the parade, she will do well again. But this time on her bicycle. I dreaded it, worried, and panicked about it--what if I had to carry HER kicking and screaming and HER bicycle all the way back to the car to leave? Well she did great riding to the wait-in-line for the parade to start spot on her bicycle. Then she couldn't wait. I told her upfront the rules are listen closely to me, stay by me, wait in line or we leave. She started taking off on her bike so that was it--we left. She was fine as she got to ride back to the car. So I asked her do you want to watch the parade now? She said ok. So big sigh of relief--that was over and no meltdown yet. We normally have issues as the other kids are running in the road for treats and I have to keep ahold of dd at all times so she doesn't take off and leave. Or get run over! Today she was calm--knew that we didn't want the candy so left it for other kids, shared what candy landed at her feet. She was wonderful! Until the beach ball incident. I had picked up comics and other toys for dd so had my hands pretty full and had hold of dd's hand. The beach balls were thrown and dd got one and then dropped it--the wind blew it to the other side of us....when dd leapt forward and started running, she caught me offguard. We BOTh fell down HARD. Thank goodness we had on our Autism Awareness buttons as she was fighting me to let her go to get to the ball that was blown way way off. She is having a meltdown, I am trying to calm her. Finally she calmed a little, then someone gave her a beach ball. Bad idea. she kept dropping it, mommy needed more hands. It kept being an issue. Everyone around us were so kind and didn't seem bothered as people usually do. Even when the noises of the parade made her "hum" loudly. We seemed to draw the campaigning senators in the parade with our Autism Awareness buttons too. LOL WE are going to find a spot tonight to watch fireworks IN the car. Next time maybe we can for parades too! Off to put ice on my knee and elbow. The life of a hermit looks better after every outting like this. J/K!!! Get the toolbar and be alerted to new email wherever you're surfing. Quote Link to comment Share on other sites More sharing options...
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