Nebraska Department of Insurance
THE NEBRASKA HEALTH INSURANCE INFORMATION, COUNSELING, AND ASSISTANCE (NICA) PROGRAM
DECEMBER 2002 NICA NEWS
THIS & THAT
New brochures available! NICA has added some additional brochures to our library of knowledge. The brochures are "Medicare and You-2003", "Healthy Aging, Medicare Stop Smoking Program/Smoking, It's Never Too late to Stop!" and "Medicare Coverage of Diabetes Supplies & Services". If you are interested in viewing these brochures, or if you need additional NICA materials, brochures, or public activity and client contact forms call Chris Peterson at (402) 471-2841 or your Regional Representative to place your order. You can also submit your order online by contacting nica@doi.state.ne.us. As always, you can send your request by mail to: NICA Program, Nebraska Dept. of Insurance, 941 "O" Street, Suite 400, Lincoln, NE 68508.Scam Alert - It has been reported that a so-called "Medicare Planning Center" is making calls to Medicare beneficiaries. They appear to be official by being able to supply the beneficiary his/her social security number for identification. The caller states that there have been changes in available benefits, and that they are "required" to update the client's records to be sure that the beneficiary receives everything to which he is entitled. The beneficiary is also told that the company normally charges $95 for the service, but they are waiving the fee at this time. Finally, they ask the beneficiary for his/her bank information, such as the checking account number and routing number. This is a scam. Please contact the NICA program office or the Attorney General's Office at 1-800-727-6432 to report any concerns.
The NICA Program Office is handling the toll free phone line for 58 Nebraska counties. We again want to thank the Omaha Volunteers Intervening for Equity (VIE) office for covering these phone lines during our office transition.
Calling all Websites!!! No doubt during the course of your counseling, you have come across a website or two that has proved to be helpful to you and to Medicare beneficiaries. We are compiling a list of those "favorite sites" to share with all the volunteers. If you know of helpful sites, will you please let us know? You can email us (our email addresses are on the front page), phone, or just drop a note when you mail your client contact forms. We would all love to benefit by knowing where all the great information sources are. Look for the compilation in the next issue of the newsletter.
Have you noticed the Medicare Education Campaign? CMS has launched its national education campaign to introduce Medicare.gov and 1-800-MEDICARE as important sources of healthcare information. The advertising features Medicare's healthcare information resources that can help narrow the search for a Medicare health plan, a doctor in the area that accepts Medicare, or a nursing home. The multimedia education campaign runs from October 2002 through spring 2003.
New volunteers? Know someone who would like to become a NICA volunteer just like you? Call your Regional Representative or NICA Program office and let them know! Training courses will be offered for new volunteers next spring.
Correction -- The September 2002 issue of the NICA NEWS gave an incorrect Part A deductible amount for an inpatient hospital stay. Page 7, column 2, listed the 2001 Medicare deductible of $792 for days 1-60 in a hospital. The correct deductible amount for 2002 is $812.
Medigap Options for Persons under Age 65 with a Disability
The NICA hotline gets several calls each week from persons who are under the age of 65 and eligible for Medicare due to disability. While Medigap options are limited for these beneficiaries, they do have some options:- Employer/Group Insurance: Many disabled beneficiaries continue to be eligible for coverage under an employer's group plan or the plan of a spouse. If the employer has more than 20 employees eligible for insurance, it cannot drop a plan member due to Medicare eligibility. When disabled individuals are entitled to both Medicare and coverage under an employer or a spouse's group plan, the group insurance may be the best option. Many group insurance plans include benefits that most Medicare supplement plans do not offer, including prescription drug coverage. It is important that disabled individuals weigh all options before dropping coverage through the employer group plan. Once group coverage is terminated under these conditions, the option to re-enroll is not available.
- Medicare Supplement Policies: There are currently two companies in Nebraska that will sell a Medicare supplement policy to a person disabled under the age of 65, Banker's Fidelity (1-800-241-1439) and United American Insurance Company (1-800-331-2512). Both of these companies sell Plan A and Plan B. There is no open enrollment period for Medicare beneficiaries under the age of 65, and these companies are not required to sell a policy to disabled beneficiaries. Medical questions will be asked and if a person meets the requirements a policy may be offered. When a disabled person on Medicare becomes eligible for Medicare due to turning 65, they will then have a 6-month open enrollment period for Medicare supplement policies. During open enrollment, any company selling Medicare supplement policies in the state of Nebraska are required to accept that person, regardless of health.
- Medicare + Choice: The Medicare Complete HMO (1-402-445-5599) is an option for disabled beneficiaries who live in Douglas County. Sterling Private-Fee-For-Service (1-888-858-8572) is available to residents of all counties in Nebraska. Both M+C options are required to accept all beneficiaries who apply, regardless of health. (The only exception is those applicants with End Stage Renal Disease.) Both the HMO and Sterling PFFS are required to provide the same benefits that are provided through "regular" fee-for-service Medicare, but they are allowed to provide additional benefits as well.
- CHIP: The Comprehensive Health Insurance Pool is a nonprofit program created by the Nebraska Legislature for the purpose of providing health care coverage at an affordable price or without health restrictions. CHIP coverage was created to help persons who have been denied reasonable health insurance due to health conditions or other factors. Persons who are eligible for Medicare due to age are ineligible for CHIP coverage, but those on Medicare due to a disability may be eligible. Blue Cross Blue Shield of Nebraska administers the CHIP program, 1-800-356-3485.
Prescription Drug Assistance Programs
One of the most frequently asked questions by beneficiaries is "Where can I get assistance to pay for my prescriptions?" A good place to start is the Prescription Drug Assistance Program section found on Medicare.gov. This section provides information on public and private programs that offer discounted or free medication, as well as Medicare health plans that include prescription coverage. You simply enter your Zip Code or State to search for local program and plan information. Additional information is available by listing up to five companies and/or health conditions. Please note: These are private prescription assistance programs sponsored by pharmaceutical companies and organizations for specific health conditions and are typically available nationally with specific eligibility requirements.President's Prescription Drug Card Initiative
On August 30, 2002 Medicare issued a regulation that creates a prescription drug card assistance initiative. This initiative will help people with Medicare get information on how to get lower prices for prescription drugs, and help them access additional pharmacy services.This Medicare approved prescription drug discount card is not yet available, but will hopefully be made available soon. This drug discount program is not intended as a drug benefit, but it is helpful in providing people on Medicare the help they need to make the cost of prescription drugs more affordable.
Currently, several pharmaceutical companies have already started prescription drug card programs to help seniors and people with lower incomes with the cost of prescription drugs. Many of these programs are beneficial and provide help to those in need, but they are not endorsed or funded by the Medicare program. The NICA office has a list of drug manufacturers who offer indigent drug programs and other discount pharmaceutical resources.
A New Pharmacy Discount Program
The United States Pharmaceutical Group, Inc. (USPGI) is marketing its own discount program for brand name and generic drugs for Medicare beneficiaries. This free discount card can be used at any one of 38,000 retail pharmacies throughout the country, or members can purchase medications through its mail order service. The card requires no deductible payments and is available for medical supplies, diabetes and respiratory supplies and offers discounts on vision, dental and hearing examinations. See: www.uspgi.com or call 1-800-977-9655 for more information.