This morning the AHCCCS (Arizona Medicaid) web site had no updated information on the QI-1 program funding.  (See posts from the last two days.)  This afternoon I checked the News and Updates section of the AHCCCS website, and there is good news.  People who received the cancellation letter from AHCCCS, dated 12/23, can ignore it.  Here is the statement from AHCCCS:

QI-1 Program Update

On Friday, December 23, 2011, the President signed into law the “Temporary Payroll Tax Cut Continuation Act of 2011″ (TCCA). Under section 310 of that legislation, the Congress continued authority and additional funding for the QI program through February 29, 2012. Arizona is currently working with federal authorities at the Centers for Medicare and Medicaid Services (CMS) to ensure that the State has sufficient funding for AHCCCS members enrolled in the QI-1 program through February 29, 2012. Therefore, AHCCCS sent the following revised notice to all QI-1 members explaining that AHCCCS will continue to cover their Part B premiums through the end of February. AHCCCS will NOT move ahead with any discontinuances for now. However, Congress must still act to extend the QI-1 program for the remainder of the year. AHCCCS will continue to monitor, but federal officials believe that the Congress will act to extend authorization and full funding for the upcoming year. Continue to check the website for updates.

So it looks like 12,500 seniors and disabled Medicare beneficiaries will get a two-month reprieve.  But actually, the QI-1 program will most likely be funded through 2012.  According to an email from the Center for Medicare Advocacy, this program has survived on short-term funding for many years.

The program, a fixed-amount block grant to states to administer through their Medicaid programs, has been extended for short periods ever since its initial authorization expired in 2002. The extension legislation authorizes $150 million dollars to continue the program through February 29, 2012.

I just got a bit more info from Jack Cheevers, a public information officer for CMS (Centers for Medicare and Medicaid). The information below is part of an announcement from CMS.

For informational purposes, in September 2011 we provided States with draft preliminary QI allotments for FY 2012; such amounts were based on a funding level of $280 million. As indicated above, we continue to expect that Congress will fund the QI program for the entire fiscal year.

A client called today to tell me about a letter she received from AHCCCS (Arizona Health Care Cost Containment System), which is Medicaid in Arizona.  Here’s what the letter, dated 12/22, says:

You receive help paying your Medicare Part B premium through the Qualified Individual-1 (QI-1) program. Although AHCCCS determines eligibility for this program, it is funded 100% by the Federal government.

Your QI-1 benefits will end December 31, 2011 because Congress has not authorized any additional funding for the program.

You will be responsible for paying your Medicare Part B premiums beginning January 1, 2012

What this means is that anyone with income over $1,089 for an individual (or $1,471 for a couple) must now pay their Medicare Part B premium, which is $99.90 per month in 2012. So people like my client, Shirley, will have $99.90 less in their Social Security checks starting in January.

Shirley falls into the income category called “QI-1″, which means she makes more than $1,089 but less than $1,246 each month. She has been getting help from the Medicare Savings Program which has paid her Part B premium.

I haven’t heard anything about these changes, so I am left to wonder:  Has our dysfunctional Congress decided to cut money for the QI-1 program from the budget? Was the continued funding of this program inadvertently left out of the budget?  Did someone determine that seniors living on $1,200 per month don’t need this help?

Because of her income, Shirley also gets help with her drug costs, and this will continue for 2012.  But things will change for 2013, as the AHCCCS letter goes on to say:

You will still be automatically eligible for Extra Help with your Medicare Part D Prescription Drug costs through December 31, 2012. However, to continue to receive this Extra Help in 2013, you will need to apply for Extra Help through the Social Security Administration at 1-800- 772-1213 or on line at: http://www.ssa.gov/

The AHCCCS letter also warned Shirley about one more problem that will come with the reduction of her benefits. The letter says:

IMPORTANT: While you will be responsible for your Medicare Part B premiums beginning January 2012, the premiums will not be deducted from your Social Security payments for a few months because it takes about two months for the Social Security Administration to update your records. However, the Social Security Administration will withhold the Medicare premiums for the
months beginning January 2012 from the Social Security payment you receive when the records are updated. You will need to plan for this reduction in your income for that month. If you have questions about your Medicare premium, please call the Social Security Administration at 1-800-772-1213.

According to a letter which AHCCCS sent to the Arizona congressional delegation in October, there are approximately 12,500 Arizonans who will be affected by these cuts.  I have a number of clients who will be losing this Medicare premium help, and this is going to be devastating for them. These folks need more help, not less.

Merry Christmas and happy new year from your millionaire congressmen and senators!

CLICK HERE FOR AN UPDATE ON THIS STORY.

There are two ways for seniors to get help with their Medicare premium and Part D drug costs. Medicare beneficiaries with monthly income below $1,246 (individual) or $1,675 (couple) can apply to the state of Arizona for help.  Seniors with slightly higher income can go to Social Security for help with their Part D premium and drug costs. The “Limited Income Subsidy” is for people whose monthly income is less than $1,381 (individual) or $1,859 (couple).

Apply through the state of Arizona:
A person on Medicare fills out an AHCCCS form (Arizona Health Care Cost Containment System, pronounced “access”) and provides proof of income or where it comes from. (AHCCCS is Medicaid in Arizona.) This proof can be the annual letter from Social Security that shows how much a person receives and how much is being taken out for the Part B premium and any other charges, such as a Part D premium to an insurance company. Sometimes bank statements may need to be provided.

For people in other states, you can find info on where to get this help by googling “medicare savings program (your state name)”.

Here’s the help: Once approved for the Medicare Cost Sharing program, the state will pay the person’s part B monthly premium, which is $96.40, $110.50, or $115.40 (for those who are new to Medicare this year). Social Security will waive the Part D premium, up to about $25.00 per month. Then Social Security provides a subsidy to help with prescription costs, so the person will pay only $6.30 for a one-month supply of even the most expensive brand name drugs. Generics would cost $2.50 for a one-month supply.

Another important benefit is that people getting this help do not have a “doughnut hole” in their drug plan. This is the gap in Part D plans during which the plan stops paying for drugs and the person must pay 100% of the cost – until $4,550 has been spent. In 2011, people in the doughnut hole get a 50% discount on their brand drug costs.

Asset limits: When processing an application for help, AHCCCS has no asset limit (bank accounts, stocks, bonds, life insurance), but only considers income (Social Security check, pension, annuity payments, alimony). With no asset limit, it is best to apply through the state of Arizona (AHCCCS) for this help.  Social Security does consider assets when it processes an application for help.

Apply through Social Security:
Some people qualify for help with their drug costs, but not the state’s help with their Medicare Part B premium. People who have monthly income of less than $1,381 (for a single person) or $1,859 (for a couple) can get help with their Part D premium and their prescription costs. This help is received through an application to Social Security. Go to ssa.gov and see the link in the left hand column “Get extra help with Medicare prescription drug costs”. The application is pretty simple and Social Security will process it in about two weeks.

No penalty: Some people who qualify for help with their drug costs have never enrolled in Part D. Once approved for help, a person can enroll in a Part D plan and will not be penalized for a late enrollment.

I’ve heard that over 25% of seniors who qualify for help are unaware of these assistance programs. Having $96 more to spend each month is a big help. But the drug cost help can be the difference between choosing to take needed prescriptions and having money to buy food. So spread the word.

Forms can be found on-line at: http://www.azahcccs.gov

Or email me at medicareblog@gmail.com