Helping Ohioans get the prescription help they need
Ohio's MIPPA grant
Ohio Medicare beneficiaries who have limited income and resources may qualify for the Low-Income Subsidy (LIS), also called "Extra Help," and the Medicare Savings Program (MSP). LIS helps beneficiaries pay for their Medicare Part D monthly premiums, annual deductible and coinsurance for prescription drugs, saving each person an average of $3,900 annually. Some beneficiaries also are eligible for the Medicare Savings Program which can help pay their Medicare Part A and B premiums, deductibles and coinsurance.
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), funded by the Centers for Medicare and Medicaid Services and the Administration on Aging, provided grants to states to help enroll individuals who are eligible but who have not applied. More than 67,000 Ohioans are estimated to be eligible for Extra Help, but have not enrolled. The Ohio Department of Aging is working with the area agencies on aging, the aging and disability networks and Ohio's Senior Health Insurance Information Program and its local volunteers, to locate, counsel and help potentially eligible individuals apply for programs.
There are many reasons that individuals who are eligible for the program do not apply. Some do not know about the program or how to apply, or may assume they are not financially eligible. Others were formerly ineligible and are unaware of program changes that make them eligible now. Some individuals who had automatically qualified for Extra Help but whose eligibility is no longer automatic must apply, but do not. Others are unwilling to share information about their income and assets, or they do not want to assemble the information they need to for an application.
The MIPPA challenge is to locate these individuals, persuade them to apply and submit applications on their behalf. From June 2009 to Sept. 2010, MIPPA partners submitted 2,891 LIS and MSP applications, with an estimated value of more than $10.7 million in benefits.
Ohio's area agencies on aging used innovative strategies to increase applications. In some areas, consumers were encouraged to complete LIS applications at physicians' offices or medical clinics. Newspaper articles about the new eligibility requirements for LIS increased the number of inquiries. Because LIS eligibility is similar to eligibility for the Senior Farmers' Market Program (SFMNP), one agency contacted its SFMNP participants. The department will request approval from the USDA to include an option on the SFMNP application for individuals to request that a MIPPA partner contact them about LIS and MSP and provide assistance in applying. A similar agreement was reached with the Ohio Department of Development to add an option on applications for the Low Income Home Energy Assistance Program (LIHEAP).
The National Center for Benefits Outreach and Enrollment, part of the National Council on Aging, has compiled information and promising practices in LIS, which the department shares with partners. The department also partners with the Ohio Benefits Bank, which determines eligibility for many benefits, including LIS and MSP. Individuals who are applying for child care subsidies or filing their income tax returns also may learn they are eligible for LIS and apply.
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Medicare publications available
The Centers for Medicare & Medicaid Services released the 2011 version of the "Medicare & You" handbook, handbook, which provides beneficiaries with information about their Medicare benefits, plan choices and rights. The Kaiser Family Foundation released the latest version of its Medicare Chartbook, which provides recent and reliable data about the Medicare program and the 47 million seniors and younger people with disabilities who get health insurance coverage through it. Topics covered include the program's utilization, the Medicare Advantage program, the role of Medicaid for Medicare beneficiaries, out-of-pocket spending and Medicare spending and financing.
Crosswalking Medicare Advantage plan members
Crosswalking, or mapping, is when a Medicare Advantage plan moves a group of consumers into a similar plan within the same organization for the upcoming year. It is different from non-renewal from the plan perspective, but may feel the same. Mapped clients are treated differently from those in non-renewing plans and do not have the same rights to notice and special enrollment period as members of plans that are leaving traditional Medicare. They do, however, have the same options and choices as everyone with Medicare to decide what plan best meets their needs in 2011. There is confusion about the rules of crosswalking, how consumers learn they will be crosswalked, what notices plans are required to send to members and how many people with Medicare are subject to crosswalking for 2011. Consumers need to check their Annual Notice of Change during the Annual Enrollment Period to review their plan options for 2011 and choose the plan that best meets their needs.