Disability Issues

By Silvia Cernea

People enrolled in Medicare’s Part D drug benefit will face higher drug premiums next year and fewer plans offering so-called gap coverage. The Part D program, introduced in 2006, allows Medicare recipients to choose from insurer and company-sponsored drug-coverage plans that are approved by Medicare. Consumers pay a monthly premium, co-payment and deductible.

Gap coverage kicks in once consumers and their plan have $2,510 of drug costs. Consumers are then responsible for 100 percent of drug costs until they have paid $4,050, including what they paid as part of the $2,510. When that amount has been paid, Medicare’s “catastrophic” coverage assumes most of the cost. Next year, the $2,510 amount set by Medicare’s Part D will increase to $2,700; the $4,050 amount climbs to $4,350.

Before Part D, beneficiaries who didn’t have other types of drug coverage paid the entire cost of their prescriptions. There are now about 25.6 million people enrolled. These days, however, fewer plans offer gap coverage, and premiums and co-payment charges have gone up, said Michael Burgess, director of the New York State Office for the Aging.

Open enrollment for the Medicare Part D lasts until Dec. 31 and Medicare users can change plan providers. Unless they sign up before Dec. 31, some recipients may have no drug benefit for 2009.

http://www.bloomberg.com/apps/news?pid=20601213&sid=a.cUsxy3Aajc&refer=home

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* I am in the process of comparing which Medicare Part D provider to switch from my current provider. A provider was offering a lower copayment if the drugs are mail ordered. The mail order pharmacy Medco costs for one of my drugs would be $244 while the cost through my current pharmacy is $126. The double mail order cost would get me to the doughtnut hole which would result in paying the full cost of $244 later in the year.

*A red flag is to compare the drug costs which go towards the doughnut hole versus a smaller copayment.

May 6, 2008 - The Dallas Morning News

By Jason Roberson

May 6, 2008 (McClatchy-Tribune Regional News delivered by Newstex) –

Wal-Mart Stores Inc. updated its $4 drug program Monday to include orders for 90-day supplies, additional drugs to treat osteoporosis and breast cancer and more than 1,000 popular over-the-counter drugs at less than 50 percent of the cost.

Wal-Mart said that Texans have saved $149 million since Wal-Mart (NYSE:WMT) started its $4 drug program in September 2006 and that Dallas-Fort Worth customers have saved nearly $46 million.

The changes to Wal-Mart’s drug program include:

Enhanced $4 Prescription Program — Wal-Mart, Neighborhood Market and Sam’s Club pharmacies will fill prescriptions for up to 350 generic medications at $10 for a 90-day supply. There is no need to sign up for a pharmacy discount card.

Additional women’s health medicines — such as Alendronate, a new generic version of Fosamax used to treat osteoporosis, and tamoxifen and estrogen/methyltestosterone to treat breast cancer, menopause and hormone deficiency — will cost $9 for up to a 30-day supply and $24 for a 90-day supply.

New $4 over-the-counter offerings include commonly used medicines such as the Equate brand of popular drugs like Zantac, Pepcid and Claritin.

http://bulletin.aarp.org/yourhealth/medications/
articles/walmart_adds_to_its__drug_program.html

Modest Needs exists

To prevent otherwise financially self-sufficient individuals and families from entering the cycle of poverty, when this might be avoided with a small amount of well-timed financial assistance;

To restore the financial self-sufficiency of individuals who are willing to work but are temporarily unable to do so because they do not have the means to remit payment for a work-related expense;

To empower permanently disadvantaged individuals who otherwise live within their limited means to continue to live independently, despite a temporary, unexpected financial set-back; and

To strengthen small non-profit organizations by providing a forum whereby such organizations can apply directly to the general public for the help they need to complete the relatively inexpensive projects that will allow them to better serve their clients and the communities they exist to serve.

In keeping with its mission, Modest Needs offers the following four types of grants

Independent Living Grants

Modest Needs makes Independent Living Grants by remitting payment to a creditor for an expense on behalf of persons who are permanently unable to work but who nevertheless are living independently on the limited income to which they are entitled - their retirement income, or their permanent disability income, for example.

In making an Independent Living Grant, our goal is to empower financially responsible persons who cannot work to continue to live independently on their limited incomes, despite an unexpected expense which no conventional agency is prepared to address.

For example, we might make an Independent Living Grant to cover the cost of maintenance on a piece of accessibility equipment not covered by Medicaid, to cover an unexpectedly large prescription medication co-pay, or to assist with a large summer cooling bill.

http://www.modestneeds.org/

By Lisa Girion and Andrea Chang - October 31, 2008 - Los Angeles Times

One of the nation’s largest drugstore chains ratcheted up a price war Thursday, offering deep discounts on generic prescriptions amid national concern about the spiraling cost of healthcare.

Drugstore giant CVS Caremark Corp. announced it would sell 90-day supplies ofmore than 400 medications for $9.99 and offer discounts for cash-paying patients at its in-store medical clinics.

The price war was unleashed by Wal-Mart Stores Inc., the country’s largest retailer, a few years ago. Since then, many grocery stores have followed suit.

The price competition makes generic drugs just about the only healthcare bill that isn’t escalating. The lower prices provide a measure of relief to consumers who are struggling with rising health insurance premiums and other out-of-pocket expenses or have lost coverage altogether.

“Generics used to generate a significant amount of profit, and that’s all been changed by Wal-Mart,” said Joel W. Hay, an associate professor of pharmaceutical economics at USC. “That’s really squeezed the rest of the retail pharmacy industry. And now they are getting the price down to where there is no profit left, or very little.”

In order to get the $9.99 generic deal, customers must enroll in the program by paying an annual fee of $10. Members paying cash can save 10% on visits to the retailer’s in-store MinuteClinics.

The $9.99 CVS offer is just a penny less than Wal-Mart’s $10 charge for a 90-day supply.

http://bulletin.aarp.org/yourhealth/medications/
articles/cvs_slashes_generic.html

We partner with government agencies, commercial customers and a network of over 1,100 local  transportation providers to ensure access to essential health care for millions of Americans every year. With innovative programs and cutting edge technology, we enhance transportation service quality while helping to contain health care program costs.

LogistiCare is a go-between for getting between your house and the doctor’s office. The company brokers non-emergency transportation services for commercial health plans, government entities (such as state Medicaid agencies), and hospitals throughout the US. Using its call centers and a network of some 900 independent, contracted transportation providers, the company coordinates the medical-related travel arrangements of its clients’ members. In addition, it contracts with local school boards to coordinate transportation for special needs students. The company provides more than 14 million trips each year for clients in more than a dozen states. Logisticare was acquired by Providence Service in late 2007.

http://www.logisticare.com/

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Foundation Overview

The mission of The LogistiCare Foundation (LGTCF) is to increase access to transportation for senior citizens, persons with disabilities and persons living in poverty, in order to improve the quality of life of these individuals.

The LGTCF gives funding priority to projects in transportation, but will not exclude from consideration funding requests that further the twin goals of improving independent living and quality of life of the target populations.

http://www.logisticare.com/foundation.asp?id=178