Medicare Part D Patient Facts
What counts as an asset?
Under the Medicare Part D regulations, assets to be considered in determining eligibility for “extra help” are:
Primary residence, first and second cars and burial plots and/or life insurance worth less than $1,500 do not count as assets.
An asset test is required ONLY for beneficiaries seeking “extra help.” If your total household income is over 150% of the Federal Poverty Level you are not eligible for “extra help” so it doesn’t matter how many assets you have.
If your total household income is between 135% and 149% of the Federal Poverty Level, in order to get “extra help” from the government your assets must be less than 10,000 for an individual and $20,000 for a couple. You may have life insurance worth less than $1,500.
If your total household income is under 135% of the Federal Poverty Level, in order to get extra help from the government your assets must be less than $6,000 for an individual and $9,000 for a couple.
Medicare Part D Resources
Blood Pressure and Combination Lipid Therapies do not Reduce Combined Cardiovascular Events in Adults with Diabetes
Landmark ACCORD Trial Finds Intensive Blood Pressure and Combination Lipid Therapies do not Reduce Combined Cardiovascular Events in Adults with Diabetes
Lowering blood pressure to normal levels — below currently recommended levels — did not significantly reduce the combined risk of fatal or nonfatal cardiovascular disease events in adults with type 2 diabetes who were at especially high risk for cardiovascular disease events, according to new results from the landmark Action to Control Cardiovascular Risk in Diabetes (ACCORD) clinical trial. Similarly, treating multiple blood lipids with combination drug therapy of a fibrate and a statin did not reduce the combined risk of cardiovascular disease events more than treatment with statin alone. The study of more than 10,000 participants is sponsored by the National Institutes of Health.
ACCORD is one of the largest studies ever conducted in adults with type 2 diabetes who were at especially high risk of cardiovascular events, such as heart attacks, stroke, or death from cardiovascular disease. The multicenter clinical trial tested three potential strategies to lower the risk of major cardiovascular events: intensive control of blood sugar, intensive control of blood pressure, and treatment of multiple blood lipids. The lipids targeted for intensive treatment were high density lipoprotein (HDL) cholesterol and triglycerides, in addition to standard therapy of lowering low density lipoprotein (LDL) cholesterol.
The results of the ACCORD blood pressure and lipid clinical trials appear online in the New England Journal of Medicine (NEJM) today and will be in the April 29, 2010, NEJM print edition. The results are also being presented today at the American College of Cardiology’s 59th annual scientific session in Atlanta. Results of the ACCORD blood sugar clinical trial were reported in 2008.
“ACCORD provides important evidence to help guide treatment recommendations for adults with type 2 diabetes who have had a heart attack or stroke or who are otherwise at especially high risk for cardiovascular disease,” said Susan B. Shurin, M.D., acting director of the NIH’s National Heart, Lung, and Blood Institute (NHLBI), the primary sponsor of ACCORD. “This information provides guidance to avoid unnecessarily increasing treatment that provides limited benefit and potentially increases the risk of adverse effects.”
ACCORD researchers from 77 medical centers in the United States and Canada studied 10,251 participants between the ages of 40 and 79 who had type 2 diabetes for an average of 10 years. When they joined the study, all participants were at especially high risk of cardiovascular events because they had pre-existing cardiovascular disease, evidence of subclinical cardiovascular disease, or at least two cardiovascular disease risk factors in addition to diabetes.
by David Prentice
Growing lots of adult stem cells in the lab, for study or for a patient treatment, has been difficult in the past.
While some groups have successfully grown large numbers of adult stem cells, many labs have difficulties keeping the cells growing for more than a few days. Now scientists at Weill Cornell have shown that culturing adult stem cells with endothelial cells, the cells that compose the innermost linings of blood vessels, is the key to growing unlimited amounts of adult stem cells.
The research group reasoned that because endothelial cells line blood vessels and are often in contact with adult stem cells, these cells might play a significant role in the growth and maintenance of stem cells. Using a mouse model, the scientists were able to grow adult stem cells for weeks at a time and increase the number of cells over 400-fold. They also showed that even after one year, there was no indication of tumor formation from the adult stem cells. Senior author, Dr. Shahin Rafii, noted:
“This study will have a major impact on the treatment of any blood-related disorder that requires a stem cell transplant.”
Previous work from Dr. Rafii’s lab had demonstrated that endothelial cells are not “passive conduits” for delivery of oxygen and nutrients but also produce novel stem-cell-active growth factors.
The breakthrough promises broad clinical benefits, from bone marrow transplantation to therapies for heart, brain, skin and lungs. If the system continues to be validated, physicians could use any source of hematopoietic (blood-forming) stem cells, grow large numbers, and bank the adult stem cells for transplantation into patients.
The paper is published in the journal Cell Stem Cell.
During January 12 –February 25, CDC received reports of 11 laboratory-confirmed cases of P. falciparum malaria acquired in Haiti.
Patients included seven U.S. residents who were emergency responders, three Haitian residents, and one U.S. traveler. This report summarizes the 11 cases and provides chemoprophylactic and additional preventive recommendations to minimize the risk for acquiring malaria for persons traveling to Haiti.
Of the seven emergency responders, six were U.S. military personnel. Among the six, four cases were uncomplicated and treated locally in Haiti. Two other patients were moderately to seriously ill and transferred to the United States for intensive care; one required intubation and mechanical ventilation for acute respiratory distress syndrome. All are expected to make a full recovery.
All six military personnel had been provided oral chemoprophylaxis with doxycycline before departure from the United States and personal protective equipment (e.g., insect repellent and insecticide-treated netting and uniforms) after arrival in Haiti. Of the 11 total patients, chemoprophylaxis was indicated for the seven emergency responders and the lone U.S. traveler. Six of these eight patients (including the two hospitalized military personnel) reported nonadherence to the recommended malaria medication regimen. Adherence status was unknown for the remaining two patients.
Three cases occurred in Haitian residents who traveled to the United States, including one Haitian adoptee. The number of U.S. malaria cases imported from Haiti likely is underestimated because typically not all cases are reported to CDC.