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Jan 24, 2014

Social Security Benefits Eaten Up By Medical Costs


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  • Sep 25, 2013

    Health Care Exchange Widget Added To Blog

         I have added a Health Exchange widget on the right side of the page. This allows readers to get information from the Department of Health and Human Services on the Health Care Exchanges set to begin operation on October 1, 2013. There is massive confusion across the country about the Health Care Exchanges. Most of this is due to the fact that it's all new. Some of it is due to deliberate lies told by those who oppose the Health Care Exchanges. On the whole, apart from the deliberate lies, I'd compare this to the implementation of the Medicare Prescription Drug benefit. The Prescription Drug benefit, although less important, was at least as complex to implement as the Health Care Exchanges. Things settled down fairly quickly on the Medicare Prescription Drug benefit. I've seen new government programs implemented over the decades. There will be the inevitable glitches but I expect things will settle down fairly quickly with the Health Care Exchanges. Despite what you've heard, it's not all that complicated and the Obama Administration has been working hard to achieve a smooth implementation.
         By the way, if you get your health care insurance through your employer or a family member's employer, just ignore the Health Care Exchanges. You don't need to sign up. In fact, you can't sign up if you have employer based health care insurance. I expect that nearly 100% of the people who are scared about "Obamacare" won't notice anything different once "Obamacare" is fully implemented.

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  • Feb 11, 2013

    Social Security Cuts On The Table But Not Medicare Cuts

         The White House said today that increasing the age at which Medicare is first available from 65 to 67 is off the table but reducing Social Security by switching to the Chained CPI method of computing Cost of Living Adjustments is on the table.

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  • Jul 30, 2012

    Hearing On Removing SSNs From Medicare Cards -- What Do You Use Instead?

         From a press release:
    House Ways and Means Social Security Subcommittee Chairman Sam Johnson (R-TX) and Health Subcommittee Chairman Wally Herger (R-CA) today announced that the Subcommittees will hold a joint hearing on removing Social Security numbers from beneficiaries’ Medicare cards.  The hearing will take place on Wednesday, August 1, 2012, in 1100 Longworth House Office Building, beginning at 9:30 A.M. ...
    In 2008, the Social Security Administration (SSA) Inspector General found that displaying SSNs on beneficiary Medicare cards unnecessarily places millions of Americans at risk for identity theft and recommended that the SSN be removed from Medicare cards.  Also in 2008, the House of Representatives passed H.R. 6600, the “Medicare Identity Theft Prevention Act of 2008,” introduced by Representatives Lloyd Doggett (D-TX) and Sam Johnson (R-TX), directing the Secretary of Health and Human Services (HHS) to establish cost-effective procedures to ensure that SSNs are not included on Medicare cards moving forward.  This legislation passed the House by voice vote on September 28, 2008.  Unfortunately, the Senate did not act on this legislation. ...
    To date, CMS [Center for Medicare and Medicaid Services] has not developed a plan for removing the SSN from the Medicare card to protect beneficiaries from identity theft and protect taxpayers from fraudulent billing.

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  • Apr 2, 2012

    Why?

         It is not unusual for a Social Security disability claimant to be approved by an Administrative Law Judge (ALJ) and to be immediately eligible for Medicare, despite what amounts to a two and a half year waiting period for Medicare. After some problems in the latter part of last year, Social Security is paying cash benefits relatively promptly after a favorable ALJ decision. However, it has always taken significantly longer for the Medicare card to come in. Why? It's not unusual for a claimant to have an urgent need for that Medicare card. I know that the award certificates in these cases say that the award certificate itself can be used in lieu of a Medicare card but I've heard of providers refusing to accept the award certificate as proof of entitlement to Medicare. For that matter, the award certificates come out slower than the payment of benefits. I know that I can send a claimant to their local field office and someone there may be kind enough to give them something in writing saying they are eligible for Medicare but sometimes they refuse to do this and providers won't always accept it. Why does it take so long to print and mail a Medicare card? Are retirees subjected to the same delays? I've never understood why the Medicare card isn't mailed at the same time as the award certificate.

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  • Jan 18, 2012

    Final Rules On Medicare Prescription Drug Subsidy

         Social Security has adopted final rules on eligibility for the Medicare prescription drug subsidy. These are the same as the interim final rules already in place.

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  • Oct 18, 2011

    3.5% COLA

    CBS Money Watch is reporting that the Social Security Cost of Living Adjustment (COLA) to be announced tomorrow will be 3.5%. However, many Social Security recipients will not see this. Their Medicare premiums should have increased but they saw no decrease in their net benefits because of the "hold harmless" provision of the law. Now that there is a COLA, their Medicare Part B premiums will go up, maybe even eliminating any COLA for them.

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  • Apr 4, 2011

    Republicans Plan To Privatize Medicare

    Republicans are not currently proposing to privatize Social Security but it appears that they are set to propose what amounts to privatizing Medicare, converting it to a program where those eligible for Medicare would receive a voucher which they could use to buy private medical insurance -- if such insurance is available and if they can afford it

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  • Dec 7, 2010

    Medicare Prescription Drug Regulations

    From today's Federal Register:
    We are adding a new subpart to our regulations, which contains the rules we will apply to determine the income-related monthly adjustment amount for Medicare prescription drug coverage premiums. This new subpart implements changes made to the Social Security Act (Act) by the Affordable Care Act. ... These rules describe the new subpart; what information we will use to determine whether you will pay an income-related monthly adjustment amount and the amount of the adjustment when applicable; when we will consider a major life-changing event that results in a significant reduction in your modified adjusted gross income; and how you can appeal our determination about your income-related monthly adjustment amount. These rules will allow us to implement the provisions of the Affordable Care Act on time that relate to the income-related monthly adjustment amount for Medicare prescription drug coverage premiums, when they go into effect on January 1, 2011.

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  • Nov 12, 2010

    Study On Accelerated Medicare Benefits For The Disabled

    Social Security has released a new issue of the Social Security Bulletin, the agency's scholarly publication. One article is of particular interest for the long term. Social Security has been doing a demonstration project which has allowed a few people approved for Disability Insurance Benefits by Social Security to go on Medicare immediately without the brutal two year and five month waiting period. This is the first report on that project. Not surprisingly, those few who received early Medicare reported better health care.

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  • Aug 30, 2010

    That Two Year Waiting Period

    From Kaiser Health News:

    After Russ Hillard developed Huntington's disease, a devastating neurological disorder, he lost his $35,000-a-year job as a welder and, with it, his health insurance.

    His wife, who was working part time, had insurance, but it didn't come close to covering the medical bills for the incurable disease, which causes uncontrolled movements, emotional problems and the loss of cognitive abilities. Eventually, Hillard qualified for Medicare, which covers disabled people under 65 after a two-year waiting period. But the coverage didn't kick in until after the family went deeply into debt and had to take out a $20,000 loan on their home in Methuen, N.H. ...

    Under federal rules, most people with disabilities who are younger than 65 aren't eligible for Medicare until more than two years after they qualify for Social Security disability income. A coalition of more than 65 organizations led by the Medicare Rights Center has been pushing Congress to do away with the waiting period. But the effort has stalled because of the high cost to the federal government – an estimated $113 billion over 10 years ...

    Some groups, including the Huntington's Disease Society of America, are going their own way, asking Congress for specific waivers from the Medicare waiting period for their diseases.

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  • Jul 30, 2010

    Medicare's 45th Anniversary

    Today is Medicare's 45th anniversary. When Medicare first started, the Social Security Administration was in charge of the program. The picture is of Social Security Commissioner Robert Ball holding a press conference to announce Social Security's plans for implementing Medicare.

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  • Jul 15, 2010

    New IRMAA Regs

    From today's Federal Register:
    We are modifying our regulations to clarify and revise what we consider major life-changing events for the Medicare Part B income-related monthly adjustment amount (IRMAA) and what evidence we require to support a claim of a major life-changing event. Recent changes in the economy and other unforeseen events have had a significant effect on many Medicare Part B beneficiaries. The changes we are making in this interim final rule will allow us to respond appropriately to circumstances brought about by the current economic climate and other unforeseen events, as described below.
    Does this seem hopelessly confusing and boring? Yes, but it affects real people and somebody has to administer it. Computers cannot do much of this. A lot of this cannot be done from a remote call center. It takes warm bodies spread out in offices around the country.

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  • Jun 28, 2010

    Left Out Of Health Care Reform

    Sue Sherman of Southwest Portland lived a peaceful, healthy life until she was dealt an ugly card last year: a diagnosis of pancreatic cancer. ...

    She joined nearly 2 million disabled Americans -- at least 15,000 in Oregon -- who fall into a twilight with the first monthly Social Security disability payment, for they then must wait two years to become eligible for Medicare. ...

    This year, nearly 8 million Americans are receiving Social Security disability income. About a quarter, 1.8 million, are in the 24-month waiting period. ...

    [T]he Congressional Budget Office, which estimates the cost of legislation to the taxpayer, calculated that eliminating the wait would cost an average of $10 billion a year over 10 years. ...

    A private 2003 study found that nearly 25 percent of the disabled in the waiting period go the two years without any insurance.

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  • Mar 23, 2010

    I Wish It Were True, But It's NOT TRUE!

    From The Daily Tribune of Oakland County, Michigan:
    People with early-onset Alzheimer's disease or any of 37 other diseases now are eligible for Medicare benefits without having to wait two years after being diagnosed.

    Currently, the Social Security Administration has a "compassionate allowance" for people with any of 50 different diseases, most of which are fatal, that allows the patient to begin receiving medical coverage under Medicare without being 65 or having to comply with the mandatory two-year wait after becoming eligible for Social Security Disability Insurance.

    "These patients will no longer be stuck in 'no-man's land' in regards to medical coverage," said Carrie Collins, the client access director for the Alzheimer's Association.
    I have no idea where this came from but it is completely wrong. There are only two exceptions to the two year waiting period for Medicare, Amyotrophic Lateral Sclerosis and End Stage Renal Disease (ESRD). The ESRD exception is only for Part A of Medicare. I hope the Alzheimer's Association nationally is not spreading this nonsense. The Commissioner of Social Security has no authority to change that.

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  • Jan 17, 2010

    The 24 Month Medicare Gap

    From the Associated Press:

    Disabled by chronic back pain and unable to afford medical insurance, Lea Walker hoped President Barack Obama's health care overhaul would close a coverage gap that has trapped her and millions of other workers.

    It won't.

    Although disabled workers can expect improvements, the legislation moving toward final passage in Congress doesn't deliver the clean fix that advocates for people with serious medical conditions hoped for. Some of the neediest could find themselves still in limbo. ...

    She started receiving monthly disability checks from Social Security, but found she would face a 24-month wait for Medicare. Insurance available through her husband's job was out of reach at $800 a month.

    At any given time, an estimated 1.8 million disabled workers languish in the Medicare coverage gap, a cost saver instituted nearly 40 years ago. Many, like Walker, are uninsured. Lawmakers had hoped to eliminate the gap as part of health care overhaul, but concluded it would be too expensive. ...

    "I think everyone needs to realize this is going to be a first, very major step toward health care reform and then there will be a need to come back in the next several years and make midcourse adjustments," said Sen. Jeff Bingaman, D-N.M., who pushed unsuccessfully to phase out the waiting period.

    While I wish that Congress would deal fully with the problem now, this article makes the problem out to be worse than it is. Many, perhaps most, of the people in the 24 month waiting period will be eligible for Medicaid under the health care reform bills pending in Congress. Because Medicare lacks an adequate prescription drug benefit, Medicaid may be better for low income families anyway. These bills would also give Medicaid coverage to many of those who are stuck in the lengthy process of appealing Social Security disability denials.

    By the way, I will make a prediction now. If some combination of the plans pending in Congress come into effect, a higher percentage of Social Security disability claims will be approved because of better documentation of illness. I think we can also hope that eventually the rate of disability in this country will decrease because of better access to medical care.

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  • Jan 14, 2010

    Award To Medicare Rights Center

    The Medicare Rights Center has received an award from the Social Security Administration for its outreach efforts on Extra Help, a program which helps low income Americans pay deductibles and co-payments for the Medicare prescription drug benefit.

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  • Jan 12, 2010

    Health Care Reform And Medicare

    The Coalition to End the Two-Year Wait for Medicare has sent a letter to the Speaker of the House of Representatives and the Senate Majority Leader giving their views on the pending health care reform legislation. The two year wait that the Coalition's name refers to is the waiting period for Medicare after a person becomes eligible for disability benefits under Title II of the Social Security Act. The waiting period is actually two and a half years since it is on top of a five month waiting period before cash benefits begin that is usually six months because it is five full calendar months.

    The letter is a good summary of the possible effects of the bills going into conference between the House and the Senate. Eliminating the two year waiting period is out of the question at the moment. The main issue is how many of these people will qualify for Medicaid. Here is an excerpt from the letter:
    While both bills have a Medicaid expansion as an essential element in providing coverage to the uninsured, the House bill extends eligibility to people not eligible for Medicare with incomes up to 150 percent of the federal poverty level. The Senate bill’s ceiling on eligibility is set at 133 percent of the federal poverty level. Expanding eligibility for Medicaid will provide people with disabilities living near the poverty level access to comprehensive health coverage with limited cost sharing. Compared to providing coverage through an exchange, expanding Medicaid is both cost-effective and provides a level of benefits that helps eliminate cost as a barrier to care. We urge you to adopt the House bill’s directive to set eligibility for Medicaid at 150 percent of the federal poverty level.

    The House and Senate bills also differ considerably in the help they provide with premiums and cost-sharing for individuals with limited incomes but above the Medicaid eligibility threshold. For example, under the Senate bill, individuals at 200 percent of the federal poverty level pay a higher share of income in premiums for plans that pay a smaller percentage of health care costs (lower actuarial value) than under the House bill. As a result, people with disabilities and limited incomes could face a combination of high premiums and large deductibles that make cost, even under the new coverage options available through the exchange, a continuing barrier to care. The Senate bill does provide valuable protections worth maintaining in the final bill, including overall caps on out-of-pocket spending and more generous premium subsidies for individuals between 250 percent and 400 percent of the federal poverty level. However, it is essential that the final bill provide affordable coverage to people with disabilities on limited incomes. We urge you to adopt the actuarial values for exchange plans and the premium subsidies for people with limited incomes from the House bill.

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  • Dec 21, 2009

    Social Security And Senate Version Of Health Care Reform -- Some Asbestosis Victims Gets Special Benefits

    From the New York Times:
    Buried in the deal-clinching health care package that Senate Democrats unveiled over the weekend is an inconspicuous proposal expanding Medicare to cover certain victims of “environmental health hazards.”

    The intended beneficiaries are identified in a cryptic, mysterious way: individuals exposed to environmental health hazards recognized as a public health emergency in a declaration issued by the federal government on June 17, 2009.

    And who might those individuals be? It turns out they are people exposed to asbestos from a vermiculite mine in Libby, Mont.

    The bill (page 198) gives authority to the Commissioner of Social Security to determine exactly who is entitled to this benefit. I think that the bill extends Medicare to this group for screening purposes only (see page 207) but the language is opaque.

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  • Oct 24, 2009

    Class Action Settled

    From SeniorJournal.com:
    A suit filed in 2007 by Medicare beneficiaries against the Centers for Medicare & Medicaid Services and the Social Security Administration has been settled. One of the legal teams that represented the beneficiaries, The Center for Medicare Advocacy, says the Machado case was brought by beneficiaries who experienced lengthy delays in having their Part D premiums accurately withheld, or not withheld, from their Social Security benefits. ...

    [U]nder the terms of the settlement, customer service representatives at 1(800)MEDICARE are now directed to advise people to call back, or to call their plan, if 90 days elapse after the "triggering date" without resolution of their problem. ...

    Pursuant to the settlement agreement, CMS has also formally revised its operating procedures to prioritize and track the resolution of every Part D premium withholding complaint ...
    It is not clear whether Social Security agreed to do anything as part of the settlement.

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