The big news from Washington is the vote to approve the payroll tax extension through the end of 2012.  Also included in the bill is a provision to avoid  a 27% cut in pay for doctors serving Medicare patients.

And within the bill, HR 3630 is sec. 2211:  Extension of the Qualifying Individual (QI) program.

In late-December, the state of Arizona sent letters to about 12,500 people telling them they would lose the help they get paying for their Medicare Part B premium.  This would mean having $99.90 taken out of their monthly Social Security check – and thus about $100 less to live on each month.  In January these folks got a letter saying they would get help, but only through the end of February.  I wonder if the state will send another letter telling these folks about the extension of the QI program through the end of 2012?

The QI program is a fixed-amount block grant to states to administer through their Medicaid programs. In Arizona we know Medicaid as AHCCCS (pronounced “access”) which stands for the Arizona Health Care Cost Containment System.

The Center for Medicare Advocacy says the QI program has been extended year-to-year ever since its initial authorization expired in 2002. With this  funding record, I wonder why AHCCCS felt it necessary to scare so many low-income seniors and disabled Arizonans with letters saying the federal government would not continue the QI program?

Through the QI program, states have a limited amount of money from which they must pay, on a first come, first serve basis, the Medicare Part B premium for Medicare beneficiaries with incomes between 120% and 135% of the federal poverty level.  In 2012, the limit for this group is $1,256.63/month ($15,079.50/year) for an individual; $1,702.13/month ($20,425.50/year) for a couple.

Add $20 to these figures due to a rule that sets aside $20 of a person’s income. And the state of Arizona does not consider a person’s assets, like money in the bank or IRAs, when a person applies for this help. Arizona (AHCCCS) just wants to know a person’s income.

Contact me for more information about getting help through AHCCCS and the QI program, SLMB, and QMB.

There are other levels for getting this help and more, and I wrote about them last week: Extra Help for Medicare and Part D costs.

The following information was provided by Medicare’s Regional Administrator, David Sayen.

Heart disease and stroke have reached epidemic levels in our country. Heart disease is the leading killer of Americans; stroke is the fourth leading killer. One of every three deaths in this county is caused by cardiovascular disease.

 

That’s why Medicare is helping to lead the Million Hearts campaign, a national initiative that aims to prevent 1 million heart attacks and strokes over the next five years. Because February is also American Heart Month, I wanted to tell you what Medicare is doing to help fight this serious public health problem. And what you can do to fight it, too.

 

Heart disease refers to several types of heart conditions. The most common one in the United States is coronary artery disease, which can trigger heart attack, severe chest pain, heart failure, and irregular heartbeat. Genetics, high blood pressure, high cholesterol, and lifestyle factors such as smoking, unhealthy diet, and lack of exercise can contribute to heart disease.

 

Stroke is a brain attack that occurs when blood flow to the brain becomes blocked. This can be caused either by a blood clot or by a burst blood vessel in or around the brain. Lack of blood flow during stroke can cause portions of the brain to become damaged, often beyond repair.

 

Thanks to the Affordable Care Act, Medicare recently began covering new preventive health services to help people with Medicare reduce their risk of heart disease and stroke.

 

Starting this year, Medicare will pay for one face-to-face visit each year so that Medicare beneficiaries can discuss with their care providers the best ways to help prevent cardiovascular disease.

The visit must be with your primary care provider, such as your family practice doctor, internal medicine doctor, or a nurse practitioner. And it has to take place in settings such as your primary care provider’s office.

 

During the visit, your doctor can screen you for high blood pressure and give you advice on how to eat a healthy diet. The idea is to empower people with Medicare to make heart-healthy lifestyle changes.

 

Medicare also now covers counseling to help people with Medicare lose weight if they’re obese. An estimated 30 percent of the men and women with Medicare are obese.

 

If you’re obese based on your body mass index, you’re eligible for face-to-face counseling sessions with your primary-care provider for up to a year.

 

In addition to the above services, Medicare pays for counseling to help people with Medicare stop smoking and to manage diabetes, which is a significant risk factor for cardiovascular disease.

 

The good news is that most major risk factors for heart disease and stroke are preventable and controllable. These factors include inactivity, obesity, high blood pressure, cigarette smoking, and high cholesterol.

 

What can you do to reduce your risk? A good first step is talking to your doctor about your heart health and getting your blood pressure and cholesterol checked. Many other lifestyle choices—including eating healthy, exercising regularly, and following your doctor’s instructions about your medications—can help protect your heart and brain health.

 

Ask your doctor, too, if taking an aspirin each day is right for you.

For more information about the Million Hearts campaign, and about Medicare’s healthy-heart and other preventive health benefits, go to www.Medicare.gov.

If you’d like to check your 10-year risk of heart attack or dying from coronary heart disease — and what you can do about it – go to the American Heart Association’s website, at www.heart.org. In the search box, type “heart attack risk calculator.”

David Sayen is Medicare’s regional administrator for California, Arizona, Nevada, Hawaii, and the Pacific Trust Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).

Seniors who have higher income will have to pay more for their Medicare.  This seems to be one part of the plan for putting Medicare on a stronger financial footing.  Here is what the National Committee to Preserve Social Security & Medicare has to say about that.

Congressional deliberations about how to address the nation’s long-term deficit, as well as how to pay for preventing a reduction in payments to physicians, include proposals for means testing Medicare – that is, requiring higher-income beneficiaries to pay more of Medicare’s costs.

Higher-Income Medicare Beneficiaries Already Pay More

Medicare Part B, which covers physician and outpatient services, has been means tested since 2007 for beneficiaries at the $85,000 and above income level for an individual, and $170,000 and above for a couple. In 2012, higher-income beneficiaries are paying premiums ranging from $139.90 to $319.70 per month, depending on their level of income, compared with the standard premium of $99.90.

The number of beneficiaries subject to this means-tested premium is expected to increase from 2.4 million in 2011 to 7.8 million in 2019, an increase from 5 percent to 14 percent of Part B enrollees. Medicare Part D, the prescription drug benefit, is also means tested with the same income thresholds.

The Medicare Hospital Insurance (Part A) is financed with payroll taxes of 1.45 percent on employees, matched by employers, with self-employed individuals paying the full 2.9 percent. Since 1994, this payroll tax has been levied on all covered wages and self-employment without a limit. Therefore, the higher an individual’s earnings, the more he or she will contribute to Medicare Part A during their working years.

In addition, the Part A payroll tax will increase in 2013 by an additional 0.9 percent on taxpayers earning above $200,000 for an individual and $250,000 for a couple. These same income thresholds will also trigger a 3.8 percent surtax on unearned income, such as interest, dividends and capital gains, which will be applied to Medicare.

NATIONAL COMMITTEE POSITION

Additional means testing would undermine the social insurance nature of Medicare and ultimately raise costs for middle and lower-income seniors who depend on it. If mean-testing results in Medicare becoming increasingly unfair to higher-income beneficiaries, they may opt out and purchase their own policy on the private market. The departure of higher-income beneficiaries, who tend to be younger and healthier, would increase overall costs and reduce public support for the program.

It is also important to keep in mind that over the past decade Medicare spending per enrollee has grown more slowly than private health insurance spending. Proposals which shift costs to beneficiaries, such as means testing and increasing the age of eligibility, fail to address the underlying reason for growth in Medicare spending – the increase in general health care inflation nationwide.