Important Things to Know about Medicare Part D

Medicare Part D Patient Facts

  1. It is voluntary, except for people who have both Medicaid and Medicare.
  2. Private insurance companies, not Medicare, offer the prescription plans.  However, Medicare has approved of every company that has a plan.
  3. There are two ways of getting prescription drug coverage:  through a stand alone plan or from a Medicare Advantage Plan with prescription benefits (MA-PD). The MA-PD combines coverage for Medicare Parts A and B with drug coverage.
  4. Plans will have a monthly premium and costs for the drugs you get through that plan. These costs vary depending on what state you live in and what plan you choose.
  5. Your yearly income and the amount of assets you have (not including the home you live in or your car) determine how much of the Part D costs Medicare will pay.
  6. If your income is under 150% of the Federal Poverty Level and you have limited assets, Medicare will give you “extra help” in paying for Part D. This can mean paying for part or all of your premium costs and paying a larger share of the medication costs than it does for people who have higher incomes.
  7. If your income is over 150%, once your drug costs (the part you pay and the part Medicare pays) go over $2,400 you are in the doughnut hole or coverage gap.  Now, you will need to pay all of your drug costs until you spend $3,051 more on
  8. medication. Then Medicare will pay almost all of your drug costs for the rest of the year.
  9. Most states have many, many plans to choose from, making it difficult to make a decision. All plans have to offer what Medicare calls a basic package, but some companies will offer more than one plan.  The average premium in 2007 will be about $24, but premiums can be higher or lower, depending on the plan and where you live.  See in the Compare Prescription Drug Plans link.
  10. In order to reduce your medication costs should:
    • Decide whether you can take generic medications for any of the brand name medications you are currently taking;
    • Decide whether you can use a mail order pharmacy or another pharmacy if the pharmacy you usually use is not one that the plan uses
  11. In order to decide which plan is best for you should:
    • Make a list of all the prescription medications you are taking as well as the dosage and how much medication you use in a month;
    • Make sure the medications you take are covered by the plan;
    • Look at your what the plans tell you your annual costs will be, based on your medication list and their monthly premiums;
    • Decide whether it makes sense for you to find a plan that has coverage in the doughnut hole.
  12. Enrollment for 2007 begins on November 15, 2006 and ends onDecember 31, 2006.  After that date you will not be able to enroll in a plan until November 15, 2007. If you do wait to enroll and you haven’t been part of another prescription plan that the government considers to be as good as Part D you will have a late fee added to your premiums. This fee is one percent of the premium.

What counts as an asset?

Under the Medicare Part D regulations, assets to be considered in determining eligibility for “extra help” are:

  • Real estate other than the beneficiary’s primary residence, such as rental property, vacation or undeveloped property
  • Business equity
  • Assets at financial institutions, such as savings, checking accounts, CDs
  • Retirement accounts such as IRAs, Keogh, 401(k) accounts
  • Stocks and mutual funds
  • Bonds, securities and U.S. savings accounts
  • Other financial assets

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
The official Medicare web site; the drug plan comparison tool is very useful for looking at the costs of different plans in your community.
The website of the Social Security Administration where Medicare beneficiaries may apply for Medicare’s “extra help” for assistance with Part D costs.
Medicare Rights Center (MRC) is the largest independent source of health care information and assistance in the United States for people with Medicare. Founded in 1989, MRC helps older adults and people with disabilities get good, affordable health care. MRC provides telephone hotline services to individuals who need answers to Medicare questions or help securing coverage and getting the health care they need. MRC also works to teach people with Medicare and those who counsel them–health care providers, social service workers, family members, and others–about Medicare benefits and rights.
The Access to Benefits Coalition and the National Council on Aging are working together to help enroll individuals in Medicare Part D and to make information available to consumers. This website gives information in easy-to-understand language so that people with Medicare can work on their own to assess their options, find and compare plans, and enroll online if they choose to enroll.
The Eldercare Locator is a public service of the U.S. Administration on Aging. The Eldercare Locator connects older Americans and their caregivers with sources of information on senior services. You can also call 1-800-677-1116.
The State Health Insurance Assistance Program, or SHIP, is a national program that offers one-on-one counseling and assistance to people with Medicare and their families. Through federal grants directed to states, SHIPs provide free counseling and assistance via telephone and face-to-face interactive sessions, public education presentations and programs, and media activities.
This website uses information prepared by the Disability Policy Collaboration, a partnership between The Arc and United Cerebral Palsy, and is tailored for individuals with disabilites.

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

Type-2 or Adult Onset Diabetes
Type-2 or Adult Onset Diabetes photo

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.

Click here to read the rest of this article.

Making Buckets of Adult Stem Cells

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.

Malaria Acquired in Haiti – 2010

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.

Click on this link for the whole article from the Center for Disease Control – CDC