Health Reform & Seniors (04/08/2010 Web chat)


Uploaded by USHealthReform on 08.04.2010

Transcript:
HELLO, I'M JENNY BACKUS, ACTING ASSISTANT SECRETARY FOR PUBLIC
AFFAIRS HERE AT HHS, AND WELCOME TO OUR SECOND WEBCHAT ON HEALTH
REFORM. WE AT HHS ARE HERE TO ANSWER
YOUR QUESTIONS AS WE BEGIN TO IMPLEMENT HEALTH CARE REFORM,
AND TODAY I'M JOINED BY THREE OF OUR DEPARTMENT'S TOP OFFICIALS
TO DISCUSS HOW HEALTH REFORM WILL HELP AMERICA'S SENIORS.
SOME OF THE MOST IMPORTANT EARLY BENEFITS OF THE NEW HEALTH
REFORM LAW GO TO OLDER AMERICANS AND WE WILL BE DISCUSSING THOSE
TODAY BUT THERE HAS ALSO BEEN A GREAT DEAL OF MISINFORMATION OUT
THERE AND TODAY WE HOPE TO HELP YOU UNDERSTAND WHAT IS TRUE AND
WHAT IS FALSE. EARLIER THIS WEEK, WE ASKED AMERICANS TO SUBMIT
THEIR QUESTIONS ABOUT HEALTH REFORM'S IMPACT ON SENIOR
CITIZENS, AND TODAY WE'LL ADDRESS AS MANY QUESTIONS AS WE
CAN. WE WILL ALSO BE TAKING QUESTIONS
LIVE VIA TWITTER AND OUR HANDLE IS @H-H-S-G-O-V, @HHSGOV.
WE WILL BE HOLDING THESE CONVERSATIONS REGULARLY IN THE
MONTHS AHEAD, SO IF WE DO NOT GET TO YOUR QUESTION, WE WILL
MAKE EVERY EFFORT TO COVER IT NEXT TIME.
KEEP IN MIND THAT WE WILL ALSO BE ANSWERING SOME OF THE MOST
FREQUENTLY ASKED QUESTIONS EACH DAY ON OUR WEBSITE:
HEALTHREFORM.GOV, SO. CHECK THE SITE REGULARLY FOR
MORE INFORMATION AND UPDATES. JOINING ME TODAY TO HELP
DISTINGUISH FACT FROM FICTION IS HHS SECRETARY KATHLEEN SEBELIUS,
ASSISTANT SECRETARY FOR AGING KATHY GREENLEE, AND PRINCIPAL
DEPUTY ADMINISTRATOR FOR THE CENTERS FOR MEDICARE AND
MEDICAID MARILYN TAVENNER. SO SECRETARY SEBELIUS, LET'S BEGIN
THE PROGRAM WITH YOU -- WHAT ARE THE IMMEDIATE BENEFITS
FOR SENIORS IN THIS BILL? -- THE GOOD NEWS FOR SENIORS, IS THAT
CONGRESS AND THE PRESIDENT SPENT A LOT OF TIME AND ENERGY FIGURING OUT HOW
WE MAKE SURE WE KEEP THE PROMISE TO MEDICARE BENEFICIARIES 45 YEARS AGO.
MAKING SURE MEDICARE IS STRONGER IN THE FUTURE SO THE BILL IN AND
OF ITSELF OVER THE COURSE OF THE NEXT 10 YEARS STRENGTHENS
MEDICARE. IT MAKES THE TRUST FUND MORE
SOLVENT. THAT'S GOOD NEWS.
THERE IS HELP IMMEDIATELY AND OVER THE COURSE OF THE BILL FOR
MEDICARE SENIORS TO PAY OFF PRESCRIPTION DRUG BILLS.
TOO MANY FOLKS HIT THE GAP IN COVERAGE.
THE DOUGHNUT HOLE. THEY ARE GOING TO RECEIVE A
CHECK THIS YEAR TO TRY AND HELP CLOSE THAT COVERAGE GAP.
MEDICARE WILL BEGIN OFFERING ANNUAL CHECKUPS, PREVENTIVE CARE
CHECKUPS STARTING NEXT YEAR. AND THERE WON'T BE ANY LONGER A
COPAY. ANY FINANCIAL BARRIER TO GET
IMPORTANT SCREENINGS IN PREVENTIVE CARE. SO THERE ARE IMPORTANT STEPS ALONG
THE WAY DEALING WITH MEDICARE ITSELF.
THERE ARE OTHER FEATURES OF THE BILL AIMED AT SENIORS THAT SOME
OF OUR FRIENDS ARE GOING TO TALK ABOUT. THE ELDER JUSTICE ACT, CLASS ACT. AREA
THAT WE’VE BEEN MISSING IN THIS COUNTRY FOR A LONG TIME, BUT HELP IMPROVE
LAWS FOR SENIORS. -- I KNOW THERE IS A LOT OF
THESE THINGS IN THERE. KATHY GREENLEE AS THE ASSISTANT
SECRETARY OF AGING. YOU DO A LOT OF OUTREACH. WHAT
ARE SOME OF THE WAYS THAT THE ADMINISTRATION IS GOING ABOUT
EDUCATING SENIORS ABOUT ALL THE STUFF THAT’S IN THIS BILL?
-- WE'RE VERY GLAD TO BE PARTNERS WITH OUR FRIENDS AT HHS
TO REACH OUT TO SENIORS. THERE ARE 38 MILLION SENIORS AND
WE WANT TO MAKE SURE WE CAN DO A COUPLE OF THINGS: THAT WE CAN
EXPLAIN TO THEM THE BROAD PROVISIONS THAT WE SEE THAT WILL
IMPACT THEM AND THEN AT THE RIGHT TIME GIVE THEM THE RIGHT
INFORMATION. SO THAT WHEN THE CHANGES ARE MADE, CMS
WILL BE RIGHT THERE EXPLAINING THOSE CHANGES.
WE HAVE WONDERFUL PARTNERS IN THE FIELD.
WITH THE STATES, THE AGENCIES, ALL OF US WORK WITH TRIBAL
ORGANIZATIONS AS WELL AS THE PROVIDERS OUT THERE PROVIDING
EVERYTHING FROM MEALS TO MEDICAL CARE.
WE WILL WORK WITH EVERYONE TO PROVIDE THE RIGHT INFORMATION AT
THE RIGHT TIME TO SENIORS. -- SPEAKING OF THE RIGHT INFORMATION, THERE
IS -- ONE OF THE AREAS WE GOT A LOT OF QUESTIONS ABOUT
TODAY, THAT ARE OUT THERE, IS ALL THESE SUPPOSED CUTS TO
MEDICARE. WHAT'S TRUE AND WHAT'S FALSE?
-- I THINK IT'S IMPORTANT THAT INDIVIDUALS UNDERSTAND THERE ARE
NO CUTS IN MEDICARE. IN FACT, THERE ARE ACTUAL
IMPROVEMENTS AS THE SECRETARY MENTIONED;
THERE IS PREVENTIVE CARE THAT BEGINS IN 2011.
THIS SHOULD STRENGTHEN THE MEDICARE PROGRAM AND THE BILL
ITSELF ACTUALLY EXTENDS THE TRUST FUND.
ALL GOOD THINGS FOR MEDICARE POPULATION.
-- WE TALKED ABOUT A COUPLE OF THE BENEFITS.
WHAT ARE SOME STEPS THAT SENIORS SHOULD BE TAKING TO TAKE
ADVANTAGE OF SOME OF THE THINGS DESCRIBED, THE DOUGHNUT HOLE CHECK, SOME OF
THE PROVISIONS YOU TALKED ABOUT?
I KNOW CMS IS IN CHARGE OF SOME OF THIS.
-- LET'S TALK ABOUT THE DOUGHNUT HOLE FIRST.
MANY SENIORS, THEIR DRUG COSTS EXCEED THEIR COVERAGE.
SO BEGINNING IN JUNE WE WILL START A PROCESS OF WHEN YOU
REACH THE DOUGHNUT HOLE THERE WILL BE A 250-DOLLAR CHECK
ISSUED TO THE SENIOR. THAT WILL COME AUTOMATICALLY.
THERE IS NO NEED TO CONTACT US. YOU SHOULD NOT BE CONTACTED BY
OUTSIDE VENDORS. THIS WILL BE A STRAIGHT CONTACT
BETWEEN CMS AND THE INDIVIDUAL RECEIVING THE CHECK.
THAT IS A ROLLING ENROLLMENT. IF YOU DON'T REACH YOUR DOUGHNUT
HOLE UNTIL OCTOBER, NOVEMBER, YOU WOULD RECEIVE THE CHECK
AFTER THAT. -- WE'LL HAVE INFORMATION ON THE
WEBSITE. THIS BRINGS US A POINT.
KATHY, I'LL GO TO YOU AND THEN THE SECRETARY.
WE GOT A REPORT FOR SOMETHING CALLED THE SENIOR MEDICARE
PATROL ABOUT SOME OF THE SCAMS HAPPENING?
-- YES. SOME THINGS HAVE NOT CHANGED.
ONE OF THE BEST PIECES OF ADVICE, BE CAREFUL WITH YOUR
MEDICARE CARD. BE CAREFUL WHO GETS THAT INFORMATION AND
ALWAYS GIVE IT TO A TRUSTED SOURCE.
THE REASON FOR THAT IS VERY APPARENT RIGHT NOW.
WE GOT REPORTS THROUGH A PROGRAM OF OURS IN MISSOURI THAT SOMEONE HAD
GONE DOOR TO DOOR AT A SENIOR LIVING COMPLEX MISREPRESENTING
THAT THEY WERE FROM THE FEDERAL GOVERNMENT TRYING TO OBTAIN
MEDICARE INFORMATION FROM A SENIOR FOR BAD PURPOSES.
THIS WAS A SCAM ARTIST. WE WERE ABLE TO FIND OUT ABOUT
THAT AND REPORT THAT SO THAT WE CAN HAVE LOCAL LAW ENFORCEMENT
INTERVENE. BUT THE GOOD NEWS IS THAT
SENIORS SHOULD ALWAYS HAVE KNOWN THIS IS NOT SOMETHING THAT THEY
SHOULD TRUST AND CHECK IT OUT. THE PROGRAM THAT WE HAVE IS
CALLED SENIOR MEDICARE PATROL. WE TRAIN ACROSS THE COUNTRY
5,000 VOLUNTEERS TO HELP SENIORS LEARN HOW TO READ THEIR
BENEFITS, HOW MEDICARE WORKS. SENIORS DON'T WANT TO BE VICTIM
TO SCAMS. THEY DON'T WANT SOMEONE TO STEAL
THAT INFORMATION. THEY'RE THE BEST ADVOCATES THAT WE HAVE FOR
THEMSELVES TO GIVE THEM THE GOOD INFORMATION AND
STOP THESE ARTISTS. SENIORS SHOULD KNOW THAT THE
FEDERAL GOVERNMENT DOESN'T SELL INSURANCE DOOR TO DOOR.
THEY NEVER HAVE, THAT’S NOT PART OF THIS PROGRAM SO
THEY SHOULD BE VERY WEARY WHEN SOMEONE POSES AS THEM
-- YOU’VE BEEN WORKING IN FRAUD FOR A LONG TIME – IN FRAUD & ABUSE,
WHAT ELSE IS IN THIS BILL IN YOUR SORT OF STRATEGY?
ADDRESS THIS? -- WELL, PRESIDENT OBAMA SAID
FROM THE OUTSET, WE REALLY HAVE TO GO AFTER THIEVES WHO ARE
STEALING OUR MEDICARE DOLLARS. STEALING FROM BENEFICIARIES. STEALING FROM
THE NEXT GENERATION OF BENEFICIARIES. WE KNOW IT GOES ON.
WE HAVE TO CRACK DOWN. WE ASKED THE ATTORNEY GENERAL
AND ME TO WORK TOGETHER AS 2 CABINET SECRETARIES TO REALLY BE
MUCH MORE AGGRESSIVE GOING AFTER THIS CROOKS.
AND WE'VE DONE JUST THAT. WE NOW HAVE POLICE AND
INVESTIGATORS IN 7 CITIES AROUND THE COUNTRY WHERE THERE HAS BEEN
EVIDENCE THAT HIGH FRAUD HAS OCCURRED.
WE HOPE TO EXPAND THAT TO 11 MORE CITIES OVER THE COURSE OF
THE NEXT YEAR. REAL BOOTS ON THE GROUND GOING
AFTER FOLKS WHO ARE SELLING PHONY EQUIPMENT, STEALING
MEDICARE CARDS, SIGNING PEOPLE UP FOR BENEFITS THAT DON'T
EXIST, TRYING TO REALLY RIP OFF THE MEDICARE TRUST FUND.
SO GOING AFTER FRAUD AND ABUSE AND MAKING SURE THOSE DOLLARS
STAY SAFE AND SECURE IS PART OF THE EFFORT.
WE JUST HAD A HUGE HISTORIC SETTLEMENT CASE WITH A MAJOR
DRUG COMPANY WHO WAS MISREPRESENTING -- MISMARKETING
THE DRUG. ONCE THE LAWSUIT WAS SETTLED,
OVER $2 BILLION WAS RETURNED TO THE MEDICARE TRUST FUND FOR THE
MONEY THAT HAD BEEN SPENT BUYING THE DRUG FOR PURPOSES THAT WERE
POTENTIALLY DANGEROUS TO FOLKS. SO WE'RE LOOKING AT THE WHOLE
ARRAY OF PEOPLE WHO STEAL, PEOPLE WHO ABUSE THE SYSTEM,
PROVIDERS WHO ARE NOT ON THE UP AND UP.
EQUIPMENT PROVIDERS WHO ARE NOT PROVIDING REAL SERVICES TO
SENIORS. WE REALLY WANT TO GET MUCH
TOUGHER, MUCH MORE AGGRESSIVE AND KEEP THAT MONEY GOING TO THE MEDICARE
BENEFICIARIES WHERE IT BELONGS.
-- WE HAVE A WEBSITE WHICH LINKS UP HEALTHCARE REFORM, LINKS UP
THE CMS, STOPMEDICAREFRAUD.GOV. THERE IS GOOD INFORMATION THAT
YOU CAN DOWNLOAD FOR YOUR PARENTS IF YOU'RE A CAREGIVER TO
TELL THEM ABOUT WHAT YOU WERE JUST TALKING ABOUT.
NOW WE'RE GOING TO VIEWER QUESTIONS WHICH IS THE BEST PART OF THE 7
SHOW. AND WE ARE GOING TO TAKE AS MANY
OF YOUR QUESTIONS IN AS WE CAN. WE'VE RECEIVED, AGAIN, 600
QUESTIONS IN ADVANCE OF THIS WEB CHAT WHICH IS A GREAT SIGN.
WE SORTED THEM INTO CATEGORIES. WE WANT TO TRY TO COVER AS MUCH GROUND
AS POSSIBLE IN THE SHORT TIME THAT WE HAVE. SO I MAY PARAPHRASE YOUR
QUESTION A LITTLE BIT WHEN I READ IT.
BUT LET'S GO TO THE QUESTIONS. I THINK MARILYN, THIS MAY BE FOR
YOU. SHERRY FROM NORTH CAROLINA.
MY HUSBAND (AGE 59) WAS FORCED INTO EARLY RETIREMENT DUE TO A
LAYOFF. HIS FIRM HAS NEVER OFFERED
HEALTH INSURANCE TO RETIREES. IS THERE ANYTHING IN THE HEALTH
CARE BILL FOR HIM? RIGHT NOW THE ONLY WORK HE CAN
FIND IS ON CONTRACT AND WITHOUT BENEFITS.
-- THANK YOU, JENNY. SHERRY, IT'S IMPORTANT THAT WE
TALK TO YOU ABOUT THIS TYPE OF PROGRAM.
WE HAVE WHAT'S CALLED A HIGH RISK POOL THAT WILL BE AVAILABLE
FOR INDIVIDUALS. THERE ALSO AN EARLY
RETIREE INSURANCE POOL THAT COMES ABOUT THIS SUMMER.
SO THERE ARE MORE THAN 1 OPPORTUNITY FOR YOUR HUSBAND AND
YOU TO HAVE COVERAGE UNDER THE BILL THAT WAS NOT AVAILABLE TO
YOU BEFORE. -- ANYTHING ELSE?
-- WELL, I WOULD SAY THAT MARILYN IS TALKING ABOUT, I
THINK, THE SORT OF BRIDGE STRATEGY.
WHAT WILL BE AVAILABLE STARTING IN 2014 IN EVERY MARKET IN THE
COUNTRY IS A NEW INSURANCE POOL. WHAT HAPPENS TOO OFTEN TO
59-YEAR-OLDS IS THAT INSURANCE COMPANIES DECIDE THEY DON'T WANT
TO TAKE THEIR COVERAGE, WRITE THEIR POLICY OR THEY CHARGE 4,
5, 6, 7 TIMES AS MUCH TO AN OLDER INSURANCE BENEFICIARY AS
TO SOMEBODY WHO IS YOUNGER. THOSE RULES WILL CHANGE.
COMPANIES WILL HAVE TO WRITE POLICIES THAT DON'T HAVE THAT
KIND OF HUGE AGE DIFFERENTIAL. BUT ALSO WE'RE GOING TO PUT EARLY
RETIREES, SINGLE WORKERS, ENTREPRENEURS, SMALL BUSINESS
OWNERS IN MUCH BIGGER POOLS SO THEY'LL HAVE NEGOTIATING POWER.
THEY'LL HAVE THE SAME KIND OF POWER THAT FORTUNATE 500
COMPANIES HAVE, THAT MEMBERS OF CONGRESS MUCH IN BIGGER POOLS
WITH A PLAN THAT WILL HAVE TO PROVIDE THEM COVERAGE.
THEY'LL HAVE SOME CHOICES AND OPTIONS GOING FORWARD.
MARILYN HAS DESCRIBED BRIDGE STRATEGY OF PROGRAMS THAT ARE RELATIVELY
TEMPORARY OVER THE NEXT COUPLE YEARS TO PROVIDE COVERAGE.
THEN WE WILL A NEW MARKETPLACE.
-- THAT'S IMPORTANT TO REMEMBER. THIS BILL JUST DOESN'T GO INTO
EFFECT OVERNIGHT. IT'S A STEPPING STONE TO GET
THERE. AGAIN, THIS IS ABOUT HOW THE LAW GOES
INTO EFFECT. MARILYN I'M GOING TO START WITH YOU
AGAIN. NOT ALL THE QUESTIONS ARE GOING
TO MARILYN. DON'T WORRY.
THIS IS LEONARD FROM CALIFORNIA. HOW WILL THE NEW HEALTH CARE LAW
AFFECT THOSE OF US WHO ARE UNDER AGE 65 BUT STILL DISABLED AND ON
MEDICARE? IS THERE ANYTHING THAT IS
DIFFERENT FOR US THAN THOSE ON MEDICARE DUE TO AGE?
PEOPLE ARE DISABLED. HOW DOES THE NEW LAW IMPACT
THEM? -- IF YOU'RE ON MEDICARE,
NOTHING WILL CHANGE FOR YOU. YOU WILL CONTINUE WITH YOUR
MEDICARE BENEFITS. I THINK THAT'S VERY IMPORTANT TO
UNDERSTAND. MANY PEOPLE ARE CONFUSED THAT
THEIR CURRENT MEDICARE BENEFIT MAY CHANGE.
IT WILL NOT CHANGE. THERE ARE SOME STRENGTHENING
PROVISIONS IN THE BILL SUCH AS WE DISCUSSED EARLIER ABOUT
PREVENTIVE CARE BEGINNING NEXT YEAR WHERE THERE WILL BE NO
COPAY OR NO DEDUCTIBLE FOR YOU. THERE ARE ALSO SOME QUALITY PROGRAMS
FOR PEOPLE WITH CHRONIC DISEASE OR DISABILITY WHERE WE'LL BE
ABLE TO DO MORE INHOME CARE, MORE COORDINATED CARE PROGRAMS.
IT SHOULD STRENGTHEN. YOU SHOULD SEE IMPROVEMENTS AS TIME GOES ON.
IT WILL TAKE NOT AWAY YOUR BENEFITS.
-- ONE ISSUE THAT'S BIG, THE RETIREE DRUG PLANS.
DAVID WANTS TO KNOW, WHAT'S GOING TO HAPPEN TO THEM,
WILL THEY BE FULLY PROTECTED IN THE NEW LAW? -- ABSOLUTELY.
THE GOVERNMENT WILL CONTINUE TO PROVIDE A TAX BREAK TO COMPANIES
FOR OFFERING RETIREE DRUG PLANS. WILL STILL PAY A Y PORTION OF IT.
WE THINK IT'S A GREAT IDEA IF EMPLOYEES HELP STABILIZE RETIREE
MARKET PLACE. THE ONLY CHANGE, AND IT IS A
CHANGE THAT WAS MADE BY CONGRESS, IS THAT EMPLOYERS --
WE'VE CLOSED A LOOPHOLE WHERE EMPLOYEES NOW CAN RECEIVE A
SUBSIDY FROM THE GOVERNMENT THAT WILL GO ON -- WHAT THEY CAN'T DO
IS TAKE A TAX DEDUCTION ON THAT SUBSIDY.
IT ISN'T THEIR MONEY IN THE FIRST PLACE.
THEY WERE PREVIOUSLY ALLOWED TO DEDUCT NOT ONLY THEIR OWN
CONTRIBUTION BUT THE GOVERNMENT'S CONTRIBUTION AND
CONGRESS SAID PROBABLY SHOULDN'T HAPPEN, TAXPAYER MONEY IN THE
FIRST PLACE, SO WE DIDN'T WANT TO DOUBLE DEDUCT IT.
BUT GOVERNMENT WILL STILL PAY A SHARE.
EMPLOYERS WILL STILL BE ENCOURAGED TO KEEP THAT IN PLACE AND STILL
HAVE A SUBSIDY. -- ANYTHING ELSE?
-- I THINK THAT'S A PRETTY GOOD ANSWER.
JAN FROM ILLINOIS. I WILL BE 64 ON FRIDAY, HAPPY
EARLY BIRTHDAY, AND PLAN ON CONTINUING TO WORK UNTIL JUNE
2011. I HAVE A PRE-EXISTING
CONDITIONS, SARCOIDOSIS & PULMONARY FIBROSIS AND I USE
OXYGEN ON A DAILY BASIS. I'M AFRAID I WON'T BE ABLE TO
GET SUPPLEMENTAL INSURANCE (OR WON'T BE ABLE TO AFFORD IT) WHEN
I RETIRE. WILL HEALTH CARE REFORM HELP ME
OR DO I HAVE TO WAIT UNTIL 2014 ?
-- SHE HAS TO WAIT TO TURN 65. SHE'S WORRIED ABOUT WHEN SHE
RETIRES THAT SHE WILL GET MEDICARE, WHICH IS A GOOD THING.
HOW CAN SHE GET -- USED TO BE CALLED MEDIGAP INSURANCE.
SHE COULD SHOP FOR IT WHEN SHE TURNS 65.
THE OLDER YOU GET, THE MORE EXPENSIVE IT CAN BE. YOU DON’T WANT
TO BUY IT WHEN YOU ARE 90. BUY IT WHEN YOU'RE 65.
IT'S GUARANTEED ISSUE SO SHE SHOULDN'T HAVE A PROBLEM WITH
HER MEDICAL CONDITIONS. SHE NEEDS TO MAKE THE DECISION
EARLY. THERE ARE PEOPLE WHO CAN HELP
HER WITH THAT. WE HAVE, THROUGH 1-800 MEDICARE,
MEDICARE.GOV, AN ENTIRE NETWORK OF PEOPLE WHO SPECIALIZING IN HELPING PEOPLE
JUST LIKE HER. BUT IT'S IMPORTANT TO SHOP WHEN
SHE TURNS 65. -- SHE'S BE 65 BEFORE SHE PLANS
TO RETIRE. SO THERE WILL BE NO GAP.
IT SOUNDS LIKE SHE'S ON EMPLOYER COVERAGE RIGHT NOW.
SHE DOESN'T RETIRE UNTIL JUNE 2011.
SHE WILL HAVE HAD HER 65th BIRTHDAY BEFORE SHE RETIRES.
THERE SHOULD BE NO GAP THAT SHE HAS TO WORRY ABOUT.
-- THE OTHER IMPORTANT POINT -- WE'RE GETTING SPECIFIC QUESTIONS
WHICH IS GREAT. WE WANT TO BE HERE AS A
RESOURCE. BUT ADMINISTRATION, AGING, HHS,
WE ARE ALL LOOKING TO GET MORE RESOURCES THAT YOU CAN GET HELP
NAVIGATING THIS. AND MARILYN, DO YOU WANT TO TALK ABOUT
YOUR CALL NUMBER AND I KNOW YOU'RE GETTING SOME NEW
IMPROVEMENTS TO THE WEBSITE. -- WE ARE.
FIRST OF ALL, I THINK MANY OF THE READERS MAY -- VIEWERS MAY
BE FAMILIAR BUT IT'S 1-800-MEDICARE. LAST YEAR WE RECEIVED MORE THAN
26 MILLION CALLS ON THIS NUMBER. AND IT'S A NUMBER AVAILABLE
THROUGHOUT THE UNITED STATES. ANYONE CAN CALL THE NUMBER.
AND WE WILL TRY TO ANSWER ANYTHING FROM YOUR SIMPLE
QUESTIONS TO THE MOST COMPLICATED QUESTIONS AND GET
YOU HELP. AND WE TRY TO DO THAT IN A SINGLE CALL.
THERE IS ALSO A WEBSITE THAT WE IMPROVENED RECENTLY,
MEDICARE.GOV THAT HAS A LOT OF NEW ADDITIONAL INFORMATION
THAT'S USER FRIENDLY. WHETHER YOU OR THE PERSON ON
MEDICARE OR MAYBE YOU'RE A CAREGIVER FOR SOMEONE, WE
ENCOURAGE YOU TO USE THE WEBSITE AND THE PHONE NUMBER.
-- WE'RE GOING TO HAVE THE SECRETARY DEMO IT.
-- IF I COULD JUMP IN FOR A MINUTE. IN THE LAST
SEVERAL YEARS WITH THE PRESCRIPTION DRUG BENEFITS,
SENIORS HAVE GONE THROUGH AN OPEN ENROLLMENT PERIOD.
MANY, MANY SENIORS FIND SOMEONE IN THE SENIOR HEALTH INSURANCE
PROGRAM TO CALL FOR HELP. THEY WILL HAVE GOOD INFORMATION
FOR THEM NOW WITH REGARD TO HEALTH REFORM.
THAT'S A BROAD NETWORK, THOSE ARE THE PEOPLE THAT WE'RE
WORKING WITH THAT WE MENTIONED EARLIER.
THAT'S WHERE SENIORS SHOULD CALL.
THE SAME PLACE THEY'VE ALWAYS GONE FOR TRUST AND INFORMATION.
-- YOU JUST TALKED ABOUT THE MEDICARE ADVANTAGE IN THE OPEN
ENROLLMENT. AA HAS A QUESTION.
I'M COVERED BY A MEDICARE HMO WHICH SERVED MY HEALTH VERY
WELL. WILL BE ABLE TO MAINTAIN THE
SAME COVERAGE I HAVE AFTER THE HEALTHCARE REFORM IS
IMPLEMENTED? -- ABSOLUTELY.
THIS IS A VERY IMPORTANT QUESTION.
UNFORTUNATELY, THERE HAS BEEN A LOT OF MISINFORMATION ABOUT THE
SO-CALLED MEDICARE ADVANTAGE PLANS.
SENIORS HAVE A CHOICE. WHEN THEY TURN 65 AND BEYOND,
TO EITHER ENROLL IN THE TRADITIONAL MEDICARE PLAN OR ENROLL IN A
MEDICARE HMO OR MEDICARE ADVANTAGE PLAN.
FROM ARE MANY PARTS OF THE COMPANY WHERE THERE ARE 3 OR 4
CHOICES. WE HAVE OVER 200 PLANS IN THE
MARKET PLACE RIGHT NOW. COMPANIES IN THE MARKET, OVER
1400 PLANS CHOSEN BY SENIORS. NOTHING IN THAT SCHEME WILL
CHANGE. MEDICARE ADVANTAGE PLANS WILL
CONTINUE TO OFFER SERVICES TO BENEFICIARIES.
COMPANIES RIGHT NOW CHOOSE WHETHER TO CONTINUE OR GET OUT
OF THE MARKET. SO THERE MAY BE SOME PLANS TO
DROP OUT NEXT YEAR, THE FOLLOWING YEAR.
IT'S NOT BECAUSE ANYBODY AT THE FEDERAL GOVERNMENT LEVEL OR THE
BILL ORDERED THEM OUT. IT'S BECAUSE THE COMPANY DECIDED
TO MAKE A CHANGE. WE WANT CURRENT BENEFICIARIES,
FUTURE BENEFICIARIES TO UNDERSTAND THAT ONE OF THE
THINGS OVER TIME THAT WILL HAPPEN IS THE OVERPAYMENT TO THE
INSURANCE COMPANY WILL GRADUALLY DECREASE. SO THE PAYMENT WILL LOOK MORE LIKE FEE FOR
SERVICE. BUT MEDICARE ADVANTAGE WILL BE A
SOLID CHOICE FOR ABOUT 11 MILLION AMERICANS. WE WANT
TO MAKE SURE THEY HAVE THAT CHOICE.
-- I WANT TO REPEAT SOMETHING YOU SAID.
IT'S NOT WHEN YOU HEAR ABOUT CUTS, IT'S NOT TO THE BENEFIT
THAT SENIORS ARE RECEIVING, IT'S TO COMPANIES BECAUSE THERE HAVE
BEEN A DISCREPANCY. -- INSURANCE COMPANIES GET PAID
14-15% MORE TO OFFER THE SAME KIND OF BENEFITS THAT THE
GOVERNMENT GETS PAID BASICALLY TO PROVIDE THE FEE FOR SERVICE
MEDICARE. ABOUT 80% OF AMERICANS ARE IN FEE FOR SERVICE.
ABOUT 20% ARE IN SOME KIND OF MEDICARE ADVANTAGE PLAN.
WHAT CONGRESS SAID IS OVER TIME, WE GRADUALLY WANT TO REDUCE THAT
SUBSIDY TO INSURANCE COMPANIES. WE WANT THE PLANS TO STAY.
WE WANT THEM TO COMPETE. WE THINK A LOT OF SENIORS WANT
TO MAKE A CHOICE, WANT SOME COMPETITION IN THE MARKETPLACE.
THAT'S GREAT. NEXT YEAR THERE WILL BE
ABSOLUTELY NO CUT IN MEDICARE ADVANTAGE PLAN.
WE’VE ALREADY TOLD THEM THAT. THE PAYMENT WILL BE EXACTLY THE SAME AS IT
IS THIS YEAR.
SO MEDICARE ADVANTAGE PLANS WILL BE PART OF THE FUTURE.
WE THINK THEY'RE A SOLID CHOICE. WE WANT TO MAKE SURE SENIORS ARE
GETTING THEIR BANG FOR THE BUCK. -- I'M GOING TO A TWITTER
QUESTION WHICH IS ACTUALLY A GREAT QUESTION.
CAN YOU DEFINE THE DOUGHNUT HOLE?
-- THE DOUGHNUT HOLE IS AN EXPRESSION THAT WE USE
CURRENTLY. THERE IS COVERAGE OF PRESCRIPTION DRUGS
UP TO A CERTAIN AMOUNT. BEYOND THAT THE INDIVIDUAL
MEDICARE RECIPIENT STARTS TO PAY OUT OF THEIR POCKET.
WE CALL THAT THE DOUGHNUT HOLE. WHAT HAPPENED THIS YEAR, UNDER THE
NEW LAW, WHEN YOU REACH THAT CERTAIN AMOUNT WHERE YOU’VE PAID A CERTAIN AMOUNT
OUT OF YOUR POCKET THEN YOU WILL RECEIVE A $250
REBATE CHECK. THAT WILL OCCUR AT THE TIME THAT
YOU EXCEEDED THE EXPENSES. THAT DOUGHNUT HOLE AS IT'S
DESCRIBED WILL START TO CHANGE NEXT YEAR.
IT WILL BE GONE BY 2020. IT WILL REDUCE OVERTIME OVER THE
NEXT 10 YEARS. THE DOUGHNUT HOLE WILL GO AWAY.
THAT WILL BE COVERED BY YOUR COVERED BY YOUR REGULAR
INSURANCE COMPANY. -- HOW WILL THE 250-DOLLAR
BENEFIT TOWARD COVERAGE GAP COST BE RECEIVED BY BENEFICIARIES?
WHAT'S THE ELIGIBILITY? -- THE ELIGIBILITY HAS TO DO
WITH CERTAIN DOLLAR THRESHOLD. ONCE YOU'VE PAID A CERTAIN
EXPENDITURE OUT OF POCKET YOU'RE ELIGIBLE FOR WHAT IS CALLED THE
DOUGHNUT HOLE REBATE AND THAT CHECK WILL BE WRITTEN TO
YOU. IT WILL COME FROM MEDICARE, FROM
CMS. IT'S NOT ANYTHING YOU HAVE TO
APPLY FOR. THERE IS NOT AN APPLICATION
PROCESS. WE WILL MONITOR THE EXPENSES AND WE WILL
SEND YOU THE CHECK ONCE YOU QUALIFY.
-- YOU DON'T HAVE TO GIVE YOU SOCIAL SECURITY NUMBER, YOU
DON'T HAVE TO -- -- AND THERE SHOULD NOT BE ANY
PRIVATE COMPANY CONTACTING YOU ABOUT THIS. ONLY THROUGH YOUR
REGULAR MEDICARE ROUTES. -- OKAY.
TOM AND JANET HAD A QUESTION. I THINK YOU ANSWERED THE FIRST
PART OF IT. HOW WILL THE NEW HEALTH REFORM
BILL AFFECT THE SENIOR CITIZENS AND THEIR HMO'S.
THEN THEY SAY WE UNDERSTAND THAT THE SENIORS
IN THE STATE OF FLORIDA WILL BE EXEMPT FROM THE MEDICARE
ADVANTAGE. IS THIS TRUE?
WE'RE AFRAID OF LOSING OUR DOCTOR.
-- I THINK AGAIN WHAT HAPPENED IS THE BILLS WENT THROUGH
CONGRESS. A LOT OF THE GOOD IDEAS ABOUT
ONE STATE WERE BROADENED TO A LOT OF STATES.
THERE AREN'T A LOT OF STATE SPECIFIC ISSUES BUT THEY HAVE
REALLY BEEN EXTENDED TO THE COUNTRY.
AGAIN, MEDICARE ADVANTAGE PLANS WILL CONTINUE TO FUNCTION THE
WAY THEY DO NOW IN THE MARKETPLACE.
SENIORS WILL CONTINUE TO HAVE MEDICARE ADVANTAGE PLANS AS A
CHOICE. FEE FOR SERVICE IS ONE CHOICE.
MEDICARE ADVANTAGE PLANS ARE ANOTHER CHOICE. THAT WILL
CONTINUE ON INTO THE FUTURE. WHAT WE HAVE JUST DONE IS TELL
COMPANIES THAT FOR CALENDAR YEAR 2011, WE'RE NOT EVEN HALFWAY
THROUGH 2010. BUT FOR CALENDAR YEAR 2011 THERE
WILL BE NO CUTS BY THE FEDERAL GOVERNMENT TO THE
MEDICARE ADVANTAGE PLAN. SO THEY KNOW ALREADY WHAT THEIR
PAYMENTS WILL BE, WHAT THEIR PACKAGE WILL BE.
THEY NEED TO COME BACK TO US AS THE YEAR PROGRESSES IN TERMS OF
WHAT BENEFITS THEY INTEND TO OFFER, WHAT THE MAILINGS WILL BE.
THERE WILL BE ANOTHER OPEN ENROLLMENT IN FALL.
MEDICARE WILL CONTINUE TO OPERATE VERY MUCH THE WAY THEY
HAVE IN THE PAST. THERE SHOULDN'T BE ANY CHANGE IN
PROVIDERS. PROVIDERS WILL BE COMPENSATED
THE SAME WAY. THE COMPANY WON'T GET A CUT SO
HOPEFULLY THEY WON'T IMMOWS ANY ADDITIONAL CUTS ON DOCTORS.
-- EULA IS 60, RETIRED ON SOCIAL SECURITY DISABILITY.
SHE SAYS I CANNOT GET MEDICARE UNTIL I AM
62. I DO NOT HAVE HEALTH COVERAGE.
I CANNOT GET HEALTH COVERAGE BECAUSE I HAVE A PREEXISTING
CONDITION. WHEN, WHERE, AND HOW CAN I SIGN UP?
-- DO I GET A PIECE OF THIS NEW HEALTHCARE PLAN?
-- YOU HAVE ONE OF THE OF THE AMERICANS THAT ESSENTIAL WAS ON
THE MIND OF THE PRESIDENT IN CONGRESS PUTTING TOGETHER THIS
NEW STRATEGY. UNFORTUNATELY, EVERYTHING WON'T
HIT OVERNIGHT. BUT WE JUST SENT A LETTER TO
GOVERNORS IN STATES AROUND THE COUNTRY TO SET UP A HIGH RISK
POOL FOR ADULTS WITH PREEXISTING CONDITIONS SO THAT THERE WILL BE
SOME IMMEDIATE HELP IN THE MARKETPLACE.
THE PREMIUMS WILL BE CAPPED. AND THERE WILL BE AN
OPPORTUNITY. TOO MANY INSURANCE COMPANIES
RIGHT NOW SAY WE DON'T WANT ANYBODY WITH A PREEXISTING
CONDITION. WE'RE NOT GOING TO WRITE THE
POLICY AT ALL. OR WE'RE GOING TO CHARGE 400%
HIGHER THAN ANYBODY ELSE IN THE MARKET.
THAT WILL STOP THIS YEAR. THERE WILL BE A HIGH RISK PLAN
AVAILABLE. IN 2014 THERE WILL BE A NEW
MARKET THAT WILL PREVENT INSURANCE COMPANIES FROM ELIMINATING ANYONE WITH PREEXISTING
CONDITIONS AND PUT PEOPLE IN LARGER POOLS. IT'S STEP BY STEP.
WE WANT TO MAKE SURE THE NEW MARKETS RUN CORRECTLY, THAT WE
GET THEM SET UP WELL, THAT WE WORK WITH STATES TO DO THAT.
WE HAVE A HIGH RISK POOL AS THE BRIDGE AND A NEW MARKET AT LEAST
BY 2014. -- THERE IS A COUPLE GOOD
QUESTIONS I WANT TO GET TO. I THINK YOU MENTIONED EARLIER,
SECRETARY, BUT MAYBE MARILYN YOU CAN TALK A LITTLE BIT MORE IN DETAIL.
SAL SAYS, WILL MEDICARE COVER YEARLY PHYSICALS?
IF, SO WHEN. IT'S IRONIC WITH
ALL THE TALK THIS YEAR ABOUT PREVENTIVE MEDICINE THAT
MEDICARE HAS NEVER COVERED THESE SERVICES.
-- I THINK SAL MAKES A GOOD POINT.
BEGINNING IN 2011, WE WILL COVER PREVENTIVE CARE, ROUTINE
PHYSICALS, AND THERE WILL NOT BE A DEDUCTIBLE.
DEPENDING ON THE PLAN THEY HAVE TODAY, PARTICULARLY IN ONE OF
THE MEDICARE ADVANTAGE PLANS, THEY MAY HAVE SOME OF THESE
SERVICES NOW. WE WILL EXTEND THAT SERVICE TO
ALL TYPES OF MEDICARE PLANS. SO IF YOU ARE IN NEED OF
PREVENTIVE CARE, YOU CAN ACCESS -- YOU CAN GO TO YOUR
PHYSICIAN, YOU DO NOT HAVE TO WORRY ABOUT A COPAY OR A DEDUCTABLE.
THAT BEGINS IN 2011. WE THINK THAT'S A VERY GOOD
THING. WE'RE ABOUT PREVENTIVE CARE AND GETTING IN FRONT OF THE ILLNESS. WE THINK
THAT’S IMPORTANT -- YOU’VE BEEN DOING A LOT OF WORK
ON THAT AT THE ADMINISTRATION ON AGING, PREVENTION AND GETTING
AHEAD OF IT. I KNOW YOU HAVE TALKING TO A LOT
OF FOLKS. DO YOU HAVE YOU WANT TO ADD.
-- WE HAVE PROGRAMS AROUND THE COUNTRY THAT WE CAN PUT IN LOCAL
COMMUNITY ORGANIZES, THE BASEMENT OF A CHURCH, AT THE
YMCA. TO HELP SENIORS MANAGE THEIR OWN CHRONIC CONDITIONS.
WE CAN WORK WITH PARTNERS. IF YOU HAVE A CONDITION AND
YOU'RE STRUGGLING TO TAKE CARE OF YOURSELF OR SOMEONE ELSE, WE
CAN HELP YOU LEARN TO MANAGE THAT CONDITION SO YOU HAVE A
BETTER QUALITY OF LIFE AND FEWER EPISODES WHERE YOU NEED TO
ACCESS THE EMERGENCY ROOM OR THE HOSPITAL.
-- I'D SAY THE OTHER PIECE OF THAT, AND KATHY JUST MENTIONED
THE HOSPITAL, IS WORKING -- PART OF THE PLAN WILL BE TO WORK MORE
CLOSELY WITH HOSPITALS IF SOMEONE HAD TO ACCESS HOSPITAL
CARE, IF THEY GO IN THE HOSPITAL.
WHAT WE WANT TO DO IS WHEN THEY GET RELEASED FROM THE HOSPITAL IS
KEEP THEM HEALTHIER. ONE OUT OF EVERY FIVE MEDICARE
BENEFICIARIES GO BACK INTO THE HOSPITAL WITHIN 30 DAYS.
SOME OF THAT IS UNAVOIDABLE. SOME PEOPLE HAVE A HEALTH CRISIS
OR EMERGENCY. A LOT OF PEOPLE HAVEN'T BEEN
SEEN BY A DOCTOR, HAVEN'T HAD ANYBODY FOLLOW UP ON ARE THEY
TAKING THEIR MEDS, HELPING TO MANAGE.
AGAIN, PART OF THE AFFORDABLE CARE ACT IS TO MAKE SURE WE
FOLLOW UP ON FOLKS THAT THEY GET SOME HELP AND TREATMENT.
ONCE THEY LEAVE THE HOSPITAL, TO STAY OUT OF THE HOSPITAL, TO BE
HEALTHIER. -- SOME OF THESE OPPORTUNITIES
WE'VE KNOWN WERE GOOD IDEAS. WHAT WE HAVE THE ABILITY TO DO
NOW IS PROVIDE THEM TO EVERYONE, TO GET TO EVERYBODY WHO NEEDS
THE HELP SO WE CAN BRING OUT THINGS THAT WE KNOW ALREADY WORK
AND MAKE THEM BETTER FOR EVERYONE.
WE'RE GOING TO TAKE ONE MORE TWEET.
MARYILYN SAID THAT BENEFICIARIES -- WILL AUTOMATICALLY RECEIVE 250-DOLLAR
CHECK ON A ROLLING BASIS WHEN THEY REACH THE GAP.
WHAT IF THEY ALREADY REACHED IT? -- IF THEY'VE ALREADY REACHED IT,
WE HOPE TO ISSUE THOUGH FIRST CHECKS OR PAYMENTS IN JUNE.
SO THEY SHOULD LOOK TO RECEIVE THEIR CHECK IN THE JUNE TIMEFRAME.
-- THANK YOU FOR JOINING US. THAT'S ALL THE TIME WE'VE GOT
TODAY, SO LET ME THANK OUR GUESTS.
KATHLEEN SEBELIUS, SECRETARY OF THE U.S. DEPARTMENT OF HEALTH
AND HUMAN SERVICES. KATHY GREENLEE, THE ASSISTANT
SECRETARY FOR THE ADMINISTRATION ON AGING.
AND MARILYN TAVENNER, THE PRINCIPAL DEPUTY ADMINISTRATOR
OF CMS. WE HOPE YOU'VE HAD SOME OF YOUR
QUESTIONS ANSWERED TODAY DURING THIS WEBCAST.
WE'RE MAKING IT AVAILABLE ON-DEMAND SHORTLY, AND SOON
AFTERWARDS IT WILL BE AVAILABLE AS AN ARCHIVED WEBCAST.
YOU CAN WATCH IT ANY TIME WHEN YOU'RE UP LATE AT NIGHT WATCH
GOING T.V., KNITTING. WHATEVER.
ANY TIME OF DAY. YOU CAN ALSO FIND IT ON
WWW.HEALTHREFORM.GOV, AND PLEASE KEEP LOOKING AT THE
SITE. IT'S TRULY A RESOURCE TO YOU.
THANKS A LOT. I'M JENNY BACKUS AND WE'LL SEE
YOU NEXT WEEK.