Nebraska Department of Insurance
THE NEBRASKA HEALTH INSURANCE INFORMATION, COUNSELING, AND ASSISTANCE (NICA) PROGRAM
DECEMBER 2003 NICA NEWS
Trainer Notes
All I want for Christmas is Medicare Part D?
December is here and, just in time for holiday party conversation, Congress has passed new Medicare reform legislation. This new law will bring big changes to how the Medicare program works, especially with the institution of the new prescription drug benefit, sometimes referred to as "Medicare Part D." NICA Volunteers are going to be more important in the next few years than ever before, as this new bill brings about the biggest changes in Medicare since the program began and every Medicare beneficiary in the state of Nebraska will be affected in some way. It is our program's duty to help educate beneficiaries on what the new legislation means, how it will impact them, and eventually help counsel on what choices and options will be best for each individual person. This is an intimidating task, but the seniors and disabled persons in Nebraska are going to need our help.As you have probably guessed, our spring update training will be focused on educating our volunteers about these changes. It is very important that volunteers attend the update training, as the new prescription drug assistance card goes into effect in April. We will also have a segment on long-term care financing options for seniors, based on a new initiative the Centers for Medicare & Medicaid Services will be beginning this spring. I am working with the Regional Representatives right now to set up dates for the spring update. We are anticipating having the trainings in Omaha, Lincoln, Kearney, North Platte, Hastings, and Norfolk in March and early April. The NICA program will also be having Initial Trainings for new volunteers this spring. If you know anyone in your community that would be interested in learning more about their Medicare benefits, and willing to share that information with others, please encourage them to contact NICA to learn more about becoming a volunteer.
Take care, and be watching your mailbox for more information about the upcoming training on the new Medicare reform legislation.
Happy Holidays!
Good Luck Jennifer!
The NICA Program would like to wish Jennifer Cunningham best of luck in her new endeavor. Jennifer has left her position as the Director of the Volunteers Intervening for Equity office in Omaha, where she as served as Regional Representative for the NICA Volunteers in Omaha. Jennifer did a wonderful job and will be missed. Aimee McKim, who was Jennifer's assistant, has been named Interim Director. Aimee has always done a fabulous job working with the VIE volunteers, and we are excited for her new opportunity.2004 Premiums, Copays, and Deductibles
The Department of Health and Human Services announced changes to Medicare premium, deductible and coinsurance amounts for 2004. Every year these premiums and deductibles are updated in accordance with the formulas set by law. The Part B premium is required to be the amount needed to cover 25 percent of estimated program costs for enrollees age 65 and older. General revenue tax dollars cover the other 75 percent of the costs. The same statute prescribes the method for computing the Part A inpatient hospital deductible. Below is a table comparing Part A and B premiums and deductibles for 2003 vs. 2004.| PART A | |||
| HOSPITAL CHARGES | In 2003, You Paid | In 2004, You Pay | |
| For the first 60 days | $840 | $876 | |
| Each Day for the 61st-90th day | $210 | $219 | |
| Lifetime reserve days 91-150 | $420 | $438 | |
| Beyond 150 days | All | All | |
| SKILLED NURSING FACILITY | In 2003, You Paid | In 2004, You Pay |
| Each Day 1-20 days | Nothing | Nothing |
| Each Day 21-100 days | $105.00 | $109.50 |
| Beyond 100 days | All | All |
Most Medicare beneficiaries do not pay a premium for Part A since they have 40 quarters of Medicare-covered employment. However, seniors and certain persons under age 65 with disabilities who have worked fewer than 30 quarters may obtain Part A by paying a monthly premium.
2004 Premiums for Part A
Worked 1-29 quarters: $343 per month
Worked 30-39 quarters: $189 per month
Worked 40 or more quarters: Premium Free Part A
| PART B | ||
| SERVICES | In 2004, MEDICARE Pays | In 2004, YOU Pay |
|
Medical Expenses Physician's services, physical speech therapy, etc. |
80% of the Medicare approved amount (after $100 deductible). | $100 deductible. 20% of approved amount, plus excess charges above the approved amount |
All beneficiaries pay a monthly premium for Part B. In 2004 the monthly premium is $66.60.