Disability Issues

Dec. 31 (Bloomberg) — The Mayo Clinic, praised by President Barack Obama as a national model for efficient health care, will stop accepting Medicare patients as of tomorrow at one of its primary-care clinics in Arizona, saying the U.S. government pays too little.

“Many physicians have said, ‘I simply cannot afford to keep taking care of Medicare patients,’” said Heim, a family doctor who practices in Laurinburg, North Carolina. “If you truly know your business costs and you are losing money, it doesn’t make sense to do more of it.”

The Mayo organization had 3,700 staff physicians and scientists and treated 526,000 patients in 2008. It lost $840 million last year on Medicare, the government’s health program for the disabled and those 65 and older, Mayo spokeswoman Lynn Closway said.

http://www.bloomberg.com/apps/news?pid=20601087&sid=aHoYSI84VdL0

By Bob Moos - November 2, 2008 - The Dallas Morning News

Social Security beneficiaries will get an average of $63 more each month, but part of that increase may be claimed by higher premiums and out-of-pocket costs in their drug coverage.

Plans change premiums, deductibles, co-payments and the drugs they cover each year, he said, so the best choice for someone one year may not be the best the next year.

Insurers were required to notify their customers by last week of any changes planned for 2009.

The financial crisis has made it especially important for seniors to check the cost and coverage of their drug plans during this year’s six-week enrollment period beginning Nov. 15, he said.

Consumer advocates say the motto for this fall’s enrollment period should be “Shop till your drug costs drop.”

Texas seniors will be able to choose from 53 prescription plans for 2009, with monthly premiums ranging from $13.70 for a plan by First Health to $97.10 for a plan by Scott and White.

The highest-priced plans offer the broadest coverage, such as help with generic drugs in the “doughnut hole,” where beneficiaries with standard coverage bear the full cost of their prescriptions.

Thirteen plans in Texas will help pay for some or all generic drugs through the coverage gap. As in 2008, no plan in Texas will cover brand-name drugs in the doughnut hole.

The hole will be larger in 2009. Seniors without gap protection will pay the full price of their prescriptions after their total drug expenses reach $2,700 next year, up from $2,510 this year.

They are then on their own until their out-of-pocket expenses hit $4,350, compared with $4,050 in 2008. At that point, catastrophic coverage kicks in, and Medicare pays 95 percent of the bills.

Eligible seniors can get help paying for their drug plan’s monthly premiums, annual deductibles, co-payments and any costs they may have in the doughnut hole.

The amount of extra assistance depends on your income and assets. Single people can qualify with annual incomes below $15,600 and resources under $11,990. Couples must have incomes below $21,000 and resources under $23,970.

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

The Consortium for Citizens with Disabilities website at http://www.c-c-d.org/

The following is a copy and paste from an online document at

http://www.c-c-d.org/task_forces/fiscal_policy/CCD-FY-08Appr-Recom.pdf

The Consortium for Citizens with Disabilities Fiscal Year 2009 Appropriations Recommendations for Selected Federal Programs of Importance to Individuals with Disabilities

DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD)

Section 811 Supportive Housing for Persons with Disabilities – $237.0 million – The Section 811 Supportive Housing for Persons with Disabilities program provides affordable and accessible housing for people with severe disabilities, including physical disabilities, developmental disabilities, and chronic mental illnesses as well as for all people with disabilities who currently live in institutions, nursing homes, homeless shelters, or who remain at home with aging parents because there is no housing available for them. Section 811 is the only federal program that funds the production of affordable and accessible units for persons with severe disabilities. The Administration’s FY 2009 budget proposes a mere $160 million, slashing the program for a second consecutive year. This cut would virtually end the program’s production component. This proposed funding level will only support renewal of existing tenant-based and project-based subsidy commitments and minimal new units.

Vouchers Targeting Non-Elderly Persons with Disabilities- $50 million - Section 8 vouchers, which are administered by Public Housing Agencies, are designed to bridge the gap between income and rent by paying the difference between what a very low-income household can afford (e.g., 30 percent of income) and modest rental housing costs. In FY 2008 Congress appropriated $30 million for approximately 4,000 new vouchers targeted to non-elderly people with disabilities. This was the first time since 2002 that Congress has provided such funding. The Administration’s FY 2009 budget contains no funding for additional new vouchers.

MEDICARE

Approximately 6.5 million people with disabilities under age 65 receive Medicare benefits. To qualify, an individual must meet the Social Security Administration’s standard for long-term, serious disability. Most Medicare beneficiaries with disabilities under age 65 have worked but have become disabled and now receive Social Security Disability Insurance (SSDI) payments. Most people with disabilities under age 65 must wait two years from when they are determined to be eligible before their Medicare coverage becomes effective. Other Medicare beneficiaries with disabilities become eligible as Disabled Adult Children. (i.e. they receive Social Security benefits and Medicare due to the retirement, death, or disability of a parent.)  Dual Eligibles. are those who receive both Medicare and Medicaid benefits. The President’s budget proposes to significantly reduce Medicare spending by $178.2 billion over five years. Much of the Medicare savings, approximately $117 billion, would come from reducing scheduled reimbursement increases in provider payments over the next five years. For example, inpatient rehabilitation facilities would be cut by $4.8 billion. CCD believes that with so many major improvements critically needed in the Medicare program, these proposals are misplaced. Congress should be focused on fixing the problems with implementation of the Part D drug benefit; extending reasonable treatment of Medicare beneficiaries whose outpatient therapy needs exceed the caps set to apply in full force next year; averting a significant decrease in the physician fee schedule; modifying the “in the home” restriction under the durable medical equipment benefit so that people requiring wheelchairs are not confined to the four walls of their homes; and eliminating Medicare’s 2-year waiting period. CCD believes that further restrictions in funding to the Medicare program would be ill-advised at this time.