In September's Issue:
HAP HAPpenings
- Calling All SHIP Directors
- Pre-AEP Tools to Rev Up Your SHIP
- Thank You SMP Conference Sponsors and Participants!
- New Best Practice: Arizona's Rural Outreach Strategies
CMS News
- HAP Submitted Comments on Draft Part D Manual Chapters
- New Improvement to Calculation for LIS Benchmarks
Interesting Items
- 2010 Updates for SHIPs
- HCR and Medicare Beneficiaries
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HAP's Extra Hand |
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September Conference Call: More Strategies and Tools to Help QMB Clients | | |
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HAP HAPpenings
Calling All SHIP Directors
Later this month, HAP will be sending our 3rd Annual SHIPs Needs Survey to all SHIP Directors. The purpose of this short survey is to learn more about the SHIP network's needs and priorities for the coming year so HAP can continue to be a helpful and effective partner in serving the nation's 45 million Medicare beneficiaries. The information you share with HAP also informs our efforts to position and promote the value of the SHIP network as a whole to key decisionmaker audiences.
You can learn more about last year's survey by reading a summary of the results in the 2008 State of the SHIPs.
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Pre-AEP Tools to Rev Up Your SHIP
As the Annual Enrollment Period (AEP) approaches, consider HAP's pre-AEP checklist of resources to help you and your SHIP prepare for this busy time of the year:
2010 Medicare Drug Coverage: Beneficiary Cost Sharing
Our recently updated drug benefit chart provides an easy-to-follow breakdown of the Part D cost-sharing amounts for 2010, including the initial coverage period limit and reaching the coverage gap. SHIP counselors can use this cheat sheet when explaining to clients how the drug benefit is calculated.
Marketing Fact Sheet
HAP offers SHIPs a two-page fact sheet that outlines the marketing rules that Medicare Advantage (MA) plans and Prescription Drug Plans (PDPs) must follow during the marketing year. These rules are according to CMS's Chapter 3, Marketing Guidelines, of its Medicare Managed Care Manual. MA and PDP plans will begin marketing for the 2010 plan year on October 1.
Refresh with Our SHIP Resource Guides:
- Medicare Basics offers an overview of the Original Medicare program, and covers eligibility, Medicare coverage issues, and related health insurance programs, such as supplemental coverage (Medigap).
- Medicare Advantage reviews eligibility, enrollment, coverage, and cost issues in MA plans.
- Part D provides an overview of the Medicare Prescription Drug (Part D) program, including eligibility; enrollment; coverage issues; costs; the low-income subsidy (LIS) program; and related programs, such as VA drug coverage.
HAPSavers
Counselor Exercises
Have an idea for an AEP tool, or feedback on any of our current tools? Let us know by contacting us. Check our October eNewsletter for HAP's updated 2009 AEP Toolkit full of practical resources to help you assist Medicare beneficiaries as they review their options during the enrollment period. |
Start Logging
Issues Now!
HAP has introduced an Issue Log as part of its Troubleshooting Medicare project to help SHIPs capture persistent issues affecting their clients. SHIPs can use the Issue Log to record and share information about a particular issue affecting a client, track client issues over time, and learn about the issues that other counselors are seeing in the field.
Please contact SHIPhelp with your name, organization, role, and county and state to receive a username and password, and to start logging your experiences now!
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Helpful SSA Webinar:
Changes to LIS app
for 2010
Social Security Administration
September 15, 2009
2 p.m. EDT
Click here to RSVP |
Thank You SMP Conference Sponsors and Participants!
We would like to thank the Administration on Aging (AoA) and the SMP Resource Center for inviting HAP to participate as an exhibitor at the national SMP Conference, in Washington, DC, August 18-20. We appreciated the opportunity to learn more about the SMP network, as well as the chance to meet and talk with many of the SHIPs that attended the conference.
The conference covered many important topics, including quality assurance measures in local SMP volunteer programs. In working with several state and local SHIPs, HAP has developed resources based on work with our Collaborative State Projects (CSPs) to support program coordinators as they recruit, screen, train, and certify SHIP volunteers. We think that some of these resources can be helpful for SHIP and SMP coordinators alike:
New Best Practice: Arizona's Rural Outreach Strategies
In HAP's newest Best Practice, we talked to Frank Brown, the SHIP regional coordinator for the Northern Arizona Council of Government (NACOG) in Flagstaff, Arizona. Like many of you, Frank has a large rural area to cover and limited resources. In his experience, a sure way to reach as many beneficiaries as possible is to maintain valuable relationships with local media and use them as resources. Read HAP's Q&A with Frank to learn more about his strategies for building successful relationships with the media and other advice you can use in your own work.
When visiting our Best Practices Resource Center you might notice we have updated this section. For those of you new to HAP's Best Practices, this center highlights the outstanding efforts of SHIPs who have generously shared their advice, experiences, tools, and resources with the entire SHIP network. If you would like to share a Best Practice idea, please e-mail SHIPhelp@hapnetwork.org.
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CMS News
HAP Submitted Comments on Draft Part D Manual Chapters
The Centers for Medicare and Medicaid Services (CMS) recently released its draft versions of Chapters 4 and 18 of the Medicare Prescription Drug Plan Manual for comments. Chapter 4 covers creditable coverage period determinations and the late enrollment penalty; and Chapter 18 addresses Part D enrollee grievances, coverage determinations, and appeals.
HAP partnered with Medicare advocates and based on the feedback you've shared with us, developed and submitted comments on the draft manual chapters that will help to make the documents clear, concise, and user-friendly as possible for Medicare beneficiaries.
In the past few weeks, CMS has released final versions of several documents and guidance that HAP reviewed earlier this year, including:
If you have any questions or comments, please contact us.
New Improvement to Calculation for LIS Benchmarks
On August 14, HAP sent an eAlert to the entire SHIP community to share the news that CMS calculated the low-income subsidy (LIS) premium benchmarks for 2010 under a new formula. Advocates for Medicare beneficiaries, including HAP, have long requested that CMS consider a different approach to this calculation because of its serious implications for so many lower-income Medicare beneficiaries. More Part D plans in 2010 will be available premium-free to beneficiaries with LIS under the new formula, which represents a significant improvement from last year's below benchmark plan availability.
As the SHIP and Medicare advocacy communities await the release of Part D plans for 2010, SHIPs may begin to hear from beneficiaries in early October about a color-coded notice they've received from CMS on their LIS status. One notice (grey) will be sent to beneficiaries losing their LIS status in 2010; the other notice (orange) informs beneficiaries that they will continue to have LIS in 2010, but that their copayment amount will change beginning in 2010.
HAP will continue to keep you updated as CMS releases further information on the Part D plans for 2010.
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Interesting Items
2010 Updates for SHIPs
SHIPs are starting to ask about the changes that will take effect in 2010 that will affect their clients' decision making during the AEP. Here are some of the immediate changes effective January 1:
- 2010 Social Security COLA and Part B Premium Increase: In 2010 and 2011, there will likely be a zero cost of living adjustment (COLA). As a result, the amount of the Part B premium will increase, but only for approximately 25 percent of Medicare beneficiaries. These beneficiaries include those new to Medicare in 2010, dual-eligibles (though Medicaid will pay the higher premium on behalf on the dual), and those paying the higher Part B premium because of an income-related surcharge. SHIPs can inform these beneficiaries during the AEP of the anticipated increase come January 1.
For more detailed information on the Part B premium increase, read the Kaiser Family Foundation's five page FAQ-style issue brief.
- New LIS/MSP Application Process: With the passing of the Medicare Improvement for Patients and Providers Act (MIPPA) in 2008, the application process for applying for the low-incomes subsidy (LIS) and the Medicare Savings Programs (MSPs) will change in 2010. Beginning on January 1, 2010, the Social Security Administration (SSA) will be sharing (on an opt-out basis) the LIS application with state Medicaid offices. SSA will continue to process the LIS portion of the application; the states will process the MSP.
Since MIPPA also eliminates life insurance cash value and in-kind support from the LIS application beginning in 2010, states may need to collect additional information from MSP applicants to process the MSP portion. Note, SHIPs assisting beneficiaries during the AEP are advised to hold any LIS applications until January 5, 2010 if these income and resource questions would otherwise make the person ineligible for LIS in 2009.
Here are some additional tools from SSA's Web site to help SHIPs understand changes to 2010 LIS program as a result of MIPPA:
Please contact us if you have any questions about these changes, or if there are additional resources your SHIP would find helpful this coming AEP.
HCR and Medicare Beneficiaries
With this year's AEP right around the corner, SHIPs are gearing up to reach out to Medicare beneficiaries in their communities. Many of you will likely encounter questions about what the proposed health care reform legislation may mean for Medicare beneficiaries and the Medicare program as a whole. Two new resources offer additional information on the topic from the U.S. Department of Health and Human Services (HHS) and Families USA*:
- Families USA has developed a new fact sheet, Help for People with Medicare, to help describe some of the benefits proposed for Medicare beneficiaries under health reform legislation, including improvements to the doughnut hole and to copayments for preventive care, along with additional assistance for people with limited incomes.
- HHS Secretary, Kathleen Sebelius, has released Stable and Secure Health Care for America, a series of new state-by-state reports discussing projected improvements to health care through health care reform.
* HAP is an independent project of Families USA, a national nonprofit, nonpartisan organization.
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September Conference Call: More Strategies and Tools to Help QMB Clients
HAP received considerable feedback from the SHIP community after the August conference call, Strategies and Tools to Help Your QMB-Eligible Clients. SHIPs were interested in learning more about why Qualified Medicare Beneficiaries (QMB) are exempt from Medicare cost-sharing charges as well as sharing their own experiences in assisting their QMB clients. In response, HAP has put together a number of resources on the August Conference Call Web page, including a link to the conference call audio recording along with the updated SHIP Shout Out.
Due to the strong interest this topic has generated across the SHIP community over the last few months, HAP's September conference call will again focus on QMB clients, including actions SHIPs at the local and state level can pursue to assist their clients. If you're joining us for the first time, check out the following HAP resources on QMB and Medicare cost sharing:
Note the conference call this month is scheduled for September 23 at 3 p.m. EDT. As always, HAP will send an eAlert in advance of the call with additional details on how to join. Stay tuned! |
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