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In January's Issue:
HAP HAPpenings
- 2010 OEP Toolkit: Updated Tools
- HAP Revises SHIP Resource Guides…and Seeks Feedback!
- January Conference Call: SHIP to SHIP — Sharing Your AEP Experiences
- New Changes to Medicare in 2010
- HAP Provides Comments for Medicare & You Handbook
- Health Action 2010: HAP Selected to Host Workshops at National Conference
- HAPSaver: Setting the Stage for Online Certification
- Get Involved: January Is National Mentoring Month
- Give a Day, Get a Disney Day!
CMS News
- SHIPs Receive $45 Million in Federal Funds for 2010
Interesting Items
- SHIPs in the Media: AEP Round-up of Recognition
- An Update on Health Care Reform: What's the Status?
- SHIPs Needed More than Ever as States Struggle in Economic Downturn
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State of the SHIPs Coming Soon!
Want to learn what the top Medicare issues facing SHIPs and beneficiaries were for 2009? Results on training priorities, volunteer program development needs, and much more from our annual SHIPs Needs Survey will be released later this month in HAP's 2009 State of the SHIPs report!
To view the results of our 2008 Survey, please see our 2009 State of the SHIPs report. Stay tuned! |
HAP HAPpenings
2010 OEP Toolkit: Updated Tools
With the end of the Annual Enrollment Period (AEP) comes the New Year — and one more opportunity to make specific changes to Medicare Advantage (MA) coverage. The Open Enrollment Period (OEP), which runs from January 1 to March 31 each year, provides additional time for SHIPs to help clients make informed decisions about their MA coverage. Consider HAP's recently updated OEP Toolkit as your one-stop shop for resources, tools, and charts to help your clients sort through their options. Some of the new resources in the 2010 OEP Toolkit include:
- Changes to Medicare Effective January 1
- LI NET Program
An old favorite, our Guide to the OEP: Stop and Go Chart, helps you explain to clients which enrollments and disenrollments are allowed during the OEP.
If you have suggestions for additional tools or feedback on any of HAP's current materials, please e-mail us, and let us know how we can better support your work.
HAP Revises SHIP Resource Guides…and Seeks Feedback!
On behalf of our Medicare Education Team, HAP would like to express appreciation for all of your positive feedback about our 2009 SHIP Resource Guides. We're pleased to hear so many of you — both new and seasoned counselors alike — found the guides helpful to your program.
We're excited to announce that our three SHIP Resource Guides are updated for 2010 and ready for your use! The 2010 guides contain new and updated information, including the Medicare Savings Program (MSP) eligibility changes, changes to Special Needs Plans (SNPs), and the new rules taking effect June 1 surrounding the Medigap insurance modernization. These training manuals also contain updated numbers, such as cost-sharing amounts and the amount-in-controversy figures related to the appeals processes. Visit our SHIP Resource Guide homepage to view the updated versions, or check them out here:
We're interested in hearing more feedback from you on the guides. How do you plan to use them? What do you like about them? What would you like to see improved? If you have time, please e-mail us and let us know. We look forward to hearing from you!
January Conference Call: SHIP to SHIP — Sharing Your AEP Experiences
Join your friends from the SHIP network on HAP's upcoming Conference Call, to be held on January 20 at 3 p.m. EST. On this call we will discuss your experiences during the 2009 Annual Enrollment Period (AEP). Be prepared to share the good and the bad and to let the community know how your state or region fared during the AEP. As always, the stories and experiences you share on these calls help inform HAP’s future education and advocacy activities.
HAP will send an eAlert with more specific call information, including the toll-free number, on January 14. Stay tuned!
New Changes to Medicare in 2010
As many of us are finding ways to incorporate our 2010 resolutions into our daily routines, the Medicare program too, has made changes in the New Year — many that will benefit the people it serves. Here are just a few of the changes, most of which were brought about by the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008:
New MSPs Resource Amounts: As of January 1, 2010, all resource (asset) limits for the Medicare Savings Programs (MSPs) — QMB, SLMB, and QI-1 — increase to match the full low-income subsidy (LIS) asset limits. The MSP resource limits for 2010 are $6,600 for an individual and $9,910 for a couple*. The asset tests for LIS and MSPs will be indexed each year. Note that the resource amounts for MSPs do not include the burial fund allowance ($1,500 and $3,000 respectively). The burial fund allowance is typically added automatically to the LIS asset amounts in many published tools, creating a total asset limit in 2010 for LIS of $8,100 for an individual and $12,910 for a couple.
*Some state Medicaid programs may allow higher resource limits or eliminate resource tests entirely. Check your state’s rules for official guidelines.
Increased Outpatient Psychiatric Service Coverage: Medicare beneficiaries seeking outpatient mental health care will pay less in coinsurance in 2010. Beginning January 1, Medicare will cover 55 percent of outpatient psychiatric services such as counseling and psychotherapy, and beneficiaries will be responsible for the remaining 45 percent (compared to 50 percent in 2009). Inpatient mental health services remain covered and under Part A, with Medicare paying 80 percent.
LI NET Program: Effective January 1, the Centers for Medicare and Medicaid Services (CMS) replaced the former Point-of-Sale (POS) process, which helped dual-eligibles without a drug plan get prescription drugs at the pharmacy, with a new, enhanced Limited Income Newly Eligible Transition (LI NET) Program. The new LI NET, administered by Humana, will provide all prospective low-income subsidy (LIS) eligible individuals who present at the pharmacy with temporary drug coverage as well as auto-enrollment into a Part D plan. The program also provides new dual-eligibles reimbursement when they are eligible for retroactive LIS coverage.
HAP has pulled together the key changes to the Medicare program in 2010 into a one-page fact sheet for counselors to reference during counseling sessions. This fact sheet, along with our OEP Toolkit, can be helpful during counseling sessions, especially when meeting with beneficiaries during the current Open Enrollment Period (OEP).
HAP Provides Comments for Medicare & You Handbook
In late 2009, the Centers for Medicare and Medicaid Services (CMS) asked HAP and other advocacy organizations to provide responses to the following questions about the 2010 Medicare & You handbook:
- What did you like or find helpful when you used the Handbook this year?
- Is there anything you expected to see in the Handbook that wasn’t there? Do you think this should be added?
- Is there anything in the Handbook that is confusing or could be explained better?
- Is there anything that should be removed and/or covered in another product?
- How would you change the Handbook?
Our submitted comments reflected your consistent feedback about the need to make the handbook easier for beneficiaries to understand and use. HAP's position is that Medicare & You must provide clear and consistent information about the Medicare program to allow SHIPs to better assist beneficiaries.
As with all of these opportunities, remember that HAP is here to help. We welcome the opportunity to collaborate with you on submitted comments. Please write us at SHIPhelp@hapnetwork.org and share your feedback on the handbook. Also, please let us know if you have any questions about the comments process or if you’d like to see HAP’s comments.
Health Action 2010: HAP Selected to Host Workshops at National Conference
HAP has been invited to lead two workshops at Families USA's Health Action 2010 conference. Families USA, HAP's parent organization, hosts the annual conference, which gathers health care advocates from across the country to share field strategies and learn more about what the latest legislative developments mean for health care. This year's conference will focus on the health reform effort and what comes next for millions of Americans.
Held from January 28 through January 30 in Washington, D.C., this conference is a great opportunity to highlight the partnership between HAP and SHIPs. We are excited to host the following workshops:
SHIPs & Policy: Helping Medicare Beneficiaries
This workshop showcases the progress SHIPs have made in public education and policy activities in different states and highlights the role SHIPs play in improving Medicare beneficiaries' access to care.
Senior Advocacy Networks: Building Successful Models
This workshop takes a broader look at various organizations in select states that advocate on behalf of seniors. Participants will share examples of successful models, including the SHIP advocate model, and talk about how they work together with other consumer assistance programs, partners, and advocates.
For more information about Health Action 2010 and registration, please visit the conference homepage. If you plan on attending this year, we look forward to seeing you!
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HAPSaver: Setting the Stage for Online Certification
It takes some planning to set the stage for an effective, online SHIP certification program. And to do that, there are a handful of things you'll need to consider before you start. HAP's most recent HAPSaver: Setting the Stage for Online Certification guides you through the online SHIP certification planning process and offers tips to help you succeed!
To learn more about SHIP certification, check out HAP's SHIP Certification Resource Center.
For more innovative and practical advice to assist your program, such as Hosting a Good Webinar or Making a Video, check out our HAPSavers Web page.
Get Involved: January Is National Mentoring Month
National Mentoring Month is a time to highlight the importance of mentors in our communities. This January, we encourage you to celebrate the mentoring program that exists within your SHIP team. Take time to recognize SHIP mentors for their devoted service during the AEP! Look through this list of simple and low-cost ideas to help you get started.
Visit HAP's SHIP Certification Resource Center to learn more about the mentoring programs at the Arizona, Connecticut, Indiana, Iowa, Massachusetts, Oregon, and Washington SHIPs.
Give a Day, Get a Disney Day!
Are you looking for a new way to celebrate your volunteers? HandsOn Network has just the solution!
HandsOn Network is partnering with Disney Parks to give one million volunteers free admission to a Disney attraction. SHIP coordinators can use this opportunity to thank existing volunteers or to recruit more helpers. To participate, simply sign up with HandsOn Network. The following requirements apply:
- Volunteer events must be entered into the system to qualify for free park tickets
- Organizations must verify volunteer service within 72 hours
- Organizations must fall into one of the following categories:
- 501(c)3 organizations
- Schools
- Faith-based organizations
- Healthcare organizations
- Government parks and recreation facilities
- Government sponsored volunteer programs
Celebrate the spirit of volunteering — and giving back — today! |
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CMS News
SHIPs Receive $45 Million in Federal Funds for 2010
The Labor, Health and Human Services, and Education appropriations bill (H.R. 3293) was signed into law by President Barack Obama on December 19, 2009. It provides $45 million in funding for SHIPs in federal fiscal year 2010. The same amount was provided for SHIP funding in FY 2009. This money will be distributed in the form of grants to the 54 State SHIP Programs by the Centers for Medicare and Medicaid Services (CMS) beginning in April 2010. SHIPs must submit their grant application to CMS by February 16, 2010.
To learn more about the 2010 SHIP Grant Application, please see the CMS Press Release from December 16, 2009. To learn more about HAP's efforts to increase federal funding for SHIPs, please visit our Funding SHIPs section.
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New SHIP Contact Numbers from AHIP
Each year, America's Health Insurance Plans (AHIP) provides HAP with updated SHIP-dedicated plan contact numbers for use by SHIPs. These SHIP-specific numbers allow SHIPs to call plans directly, bypassing the usual plan customer service assistance lines. If you would like to receive your state's list of plan numbers to share within your SHIP program, please send us an e-mail and be sure to mention your state!
Also, please send us your feedback on how these SHIP-dedicated numbers are working, so we can share your feedback and help improve the process in order to better serve your clients.
Share Your WellPoint Experiences
On September 9, CMS lifted a previously imposed sanction on WellPoint, allowing them to market and enroll for the 2010 plan year. CMS will be paying close attention to their on-going performance. CMS is requesting that SHIPs notify CMS of any significant issues related to WellPoint's operations at letusknow@cms.hhs.gov. Please note that this mailbox is not a substitute for the Complaints Tracking Module. |
Interesting Items
SHIPs in the Media: AEP Round-up of Recognition
In the months leading up to, and even during, this past Annual Enrollment Period (AEP), you may have come across a newspaper article that discussed SHIP services. Whether the media outlet was national, state, or local, the services SHIPs provide were recognized and promoted to readers nationwide. HAP worked with reporters to provide background information and quotes, and we would like to take the opportunity to highlight the articles, two of which appeared in The New York Times and The Wall Street Journal. Others are available online, including on CBS MoneyWatch.com and DailyFinance.com. All of the articles emphasize the value of the SHIP program in helping beneficiaries make informed decisions, especially as the Medicare landscape grows increasingly complex.
- Nearly 65? Time for the Medicare Maze (Walecia Konrad, Patient Money, The New York Times, October 14, 2009)
- Now Is the Time to Weigh Medicare Options (Walecia Konrad, Patient Money, The New York Times, October 30, 2009)
- Tools and Tips for Navigating Medicare Open Enrollment (David Schepp, DailyFinance.com, November 14, 2009)
- How to Navigate the Medicare Maze (Mark Miller, MoneyWatch.com, December 4, 2009)
Congratulations to the SHIPs for this much deserved recognition! If you have an article about your program that you would like to share with the SHIP network, please e-mail it to us at SHIPhelp@hapnetwork.org, and we will feature it in our February eNewsletter.
An Update on Health Care Reform: What's the Status?
On Christmas Eve, the Senate passed the Patient Protection and Affordable Care Act. HAP discussed many of the provisions in the Senate bill during our December Conference Call — Health Care Reform: Improvements to Medicare. You can now listen to this call on our December Conference Call Web page. As a reminder, the Senate bill includes language to move and extend the Annual Enrollment Period (AEP) to run from October 15 to December 7. Other improvements to the Medicare program in the Senate bill include shrinking the Part D coverage gap, or doughnut hole, and eliminating cost-sharing amounts for preventive care services.
In the coming weeks, members of Congress will work together to reconcile the differences between the Senate and House bills. For additional information on the Medicare provisions in each bill, the Kaiser Family Foundation (KFF) offers an updated side-by-side comparison of the final House and Senate bills. In the meantime, HAP will continue its advocacy work as part of the Troubleshooting Medicare project to help make sure that the language to move and extend the AEP is in the final bill, ensuring Medicare beneficiaries the time they need to make informed decisions about their health care.
SHIPs Needed More than Ever as States Struggle in Economic Downturn
Most states are finding themselves between a rock and a hard place — increases in requests for programs and services and less revenue and fewer resources to respond to the demand. A recent report released by the Center on Budget and Policy Priorities (CBPP) provides an interesting perspective on the impact that the economic crisis continues to have on states.
A growing number of states are struggling with 2010 budgets that are falling short of anticipated revenue projections, while bracing for additional fiscal gaps in the coming 2011 budget year. And at the same time, as an all-state survey on states and the economy conducted by the National Association of State Units on Aging (NASUA) shows, the majority of states surveyed by NASUA are experiencing an increase in the demand for programs and services, most of which are delivered at the community level. The NASUA survey found that between June and December of last year, the individualized information and counseling services offered by SHIP programs represented the single largest increase in request for services in most states. What does this increase in request for services mean for SHIPs? They are needed now more than ever.
Look for HAP's soon-to-be-released 2010 State of the SHIPs report, which offers additional information on how the economic downturn is affecting program operations, including volunteer programs, and the demand for services.
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A New Year, a Familiar Problem: QMB and Medicare Cost-Sharing
As we wrapped up 2009, HAP took a look back at a persistent issue affecting access to care for people enrolled in the Qualified Medicare Beneficiary (QMB) program. In our December eNewsletter, we compiled resources to assist your program with affected clients. Beneficiaries enrolled in the QMB program found they were not receiving all of the benefits they were entitled to under the program, and often, were being billed for Medicare cost-sharing amounts. To begin 2010, we are providing you with a case study of the kind of access-to-care problem that QMBs run into — it should help you recognize this problem when meeting with your own QMB clients:
Case Study: QMB and Medicare Cost-Sharing
Ms. Brown visits her primary care physician, a non-Medicaid, Medicare-participating provider. She presents her QMB card to the receptionist at check-in. By law, Ms. Brown is exempt under the QMB program from paying Medicare copay amounts. Currently in Ms. Brown's state, there is no billing system in place (between the provider’s billing office and the state Medicaid office) for the provider to submit a claim to Medicaid for reimbursement.
Ms. Brown's physician's office, unaware of the law and with no billing system in place to bill Medicaid, inadvertently bills her for the remaining balance after Medicare has paid its 80 percent share for the visit. Ms. Brown, unknowingly, pays the 20 percent balance to her provider.
HAP encourages SHIP counselors to be aware of situations like these — this is just one example of how the issue can play out in your state. We are currently working on the next information tool in the QMB and Medicare cost-sharing series — the QMB Counseling Guide, scheduled for a spring release. This counseling guide is intended as a practical tool to help SHIPs counsel and assist their QMB clients.
In the meantime, continue to share your QMB experiences with us so we can make informed recommendations to policymakers about improving policies concerning the coordination of care for the QMB program. You can either e-mail us, or log your experiences in our Troubleshooting Medicare Issue Log. |
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