August 19th, 2015
Medicare and Medicaid: Keeping Us Healthy for 50 Years
It’s easy to forget that before 1966, roughly half of all seniors were uninsured, living in fear that the high cost of health care could propel not only them, but their families, into poverty. . Few of us remember that not that long ago, far too many disabled people, families with children, pregnant women and low-income working Americans were unable to afford the medical care they needed to stay healthy and productive.
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50 years ago, on July 30, 1965, the landscape of health care in America changed forever when President Lyndon B. Johnson signed the landmark amendment to the Social Security Act, giving life to the Medicare and Medicaid programs.
Medicare and Medicaid save lives, help people live longer, and provide the peace of mind that comes with affordable health care that’s there when you need it. Chances are, you or someone in your family either has Medicare or Medicaid or you know someone who does. In fact, Medicare and Medicaid cover nearly 1 out of every 3 Americans—that’s well over 100 million people.
Marking the 50th anniversary of these lifesaving programs this summer gives us an important opportunity to recognize and remember the ways these programs transformed the delivery of health care in the United States. Medicare and Medicaid have greatly reduced the number of uninsured Americans and have become the standard bearers for quality and innovation in American health care.
Fifty years later, no other program has changed the lives of Americans more than Medicare and Medicaid.
CHANGING LIVES: Medicare and Medicaid provide Americans with access to the quality and affordable health care they need to live happy, healthy and productive lives. Today, about 55 million Americans depend on Medicare to cover 23 types of preventive services, including flu shots and diabetes screenings (some of these services are free, and for others you have a small copayment or pay the deductible.) Medicare also covers hospital stays, lab tests and critical supplies like wheelchairs, as well as prescription drugs. Medicaid provides comprehensive coverage to more than 70 million eligible children, pregnant women, low-income adults and people living with disabilities. It covers essential services like annual check-ups, care for new and expecting mothers, and dental care for kids from low-income families.2
INCREASING ACCESS: Medicare and Medicaid provide more and more Americans with access to the quality and affordable health care they need and deserve. Though they started as basic health programs for people who had no other access to health coverage, Medicare and Medicaid have helped millions get access to care they wouldn’t get otherwise.
DRIVING INNOVATION TO SHAPE THE NEXT 50 YEARS: Over the course of 5 decades, Medicare and Medicaid have become the standard bearers for coverage, quality and innovation in American health care. Innovative and dedicated teams are combatting fraud and working to continually improve the quality of life and care delivered under these programs. Medicare and Medicaid are among the most efficient and well-managed health insurance programs in the world. They will continue to transform to create a health care system that delivers better care, spends health care dollars more wisely and results in healthier people.
President Johnson would be heartened to know that the hard-fought efforts to improve our health care system have not only succeeded, but that America is on track to give even better access, higher quality care and improved health for the next 50 years and beyond.
How has Medicare or Medicaid (or both programs) helped your life or the life of someone you care about? Whether you’ve just enrolled or have been covered for decades, we’d love to hear from you. You can share your Medicare or Medicaid story through our Medicare.gov website, or connect with us on Twitter or our just-launched Facebook page.
March 19th, 2015
Since 2010, 9.4 million people with Medicare have saved over $15 billion on prescription drugs and 39 million Medicare beneficiaries received preventive services with no cost sharing in 2014.
The Department of Health and Human Services released today new information that shows that millions of seniors and people with disabilities with Medicare continued to enjoy prescription drug savings and improved benefits in 2014 as a result of the Affordable Care Act.
Since the enactment of the Affordable Care Act, 9.4 million seniors and people with disabilities have saved over $15 billion on prescription drugs, an average of $1,598 per beneficiary. In 2014 alone, nearly 5.1 million seniors and people with disabilities saved $4.8 billion or an average of $941 per beneficiary. These figures are higher than in 2013, when 4.3 million saved $3.9 billion, for an average of $911 per beneficiary.
Use of preventive services has also expanded among people with Medicare. An estimated 39 million people with Medicare (including those enrolled in Medicare Advantage) took advantage of at least one preventive service with no cost sharing in 2014. In contrast, in 2013, an estimated 37.2 million people with Medicare received one or more preventive benefits with no cost sharing. In 2014, nearly 4.8 million people with traditional Medicare took advantage of the Annual Wellness Exam, which exceeds the comparable figure from 2013, in which over 4 million took advantage of the exam.
“Thanks to the Affordable Care Act, seniors and people with disabilities have saved over $15 billion on prescription drugs, and these savings will only increase over time as we close the Medicare coverage gap known as the donut hole,” said HHS Secretary Sylvia M. Burwell. “By providing access to affordable prescription drugs and preventive services with no cost sharing, the Affordable Care Act is working for seniors to help keep them healthier.”
As part of the Department’s “better care, smarter spending, healthier people” approach to improving health delivery, providing affordable prescription drugs and certain preventive services with no-cost sharing are some of the many initiatives advanced by the Affordable Care Act. To achieve better care, smarter spending and healthier people, HHS is focused on three key areas: (1) linking payment to quality of care, (2) improving and innovating in care delivery, and (3) sharing information more broadly to providers, consumers, and others to support better decisions while maintaining privacy. Today’s news comes on the heels of Secretary Burwell’s recent announcement that HHS is setting measurable goals and a timeline to move Medicare toward paying providers based on the quality, rather than the quantity of care they give patients.
Closing the prescription drug “donut hole”
The Affordable Care Act makes Medicare prescription drug coverage more affordable by gradually closing the gap in coverage where beneficiaries had to pay the full cost of their prescriptions out of pocket, before catastrophic coverage for prescriptions took effect. The gap is known as the donut hole. The donut hole will be closed by 2020, marking 2015 as the halfway point.
Because of the health care law, in 2010, anyone with a Medicare prescription drug plan who reached the prescription drug donut hole received a $250 rebate. In 2011, beneficiaries in the donut hole began receiving discounts on covered brand-name drugs and savings on generic drugs.
People with Medicare Part D who fall into the donut hole in 2015 will receive discounts and savings of 55 percent on the cost of brand name drugs and 35 percent on the cost of generic drugs.
For state-by-state information on discounts in the donut hole, go to:http://downloads.cms.gov/files/Part-D-donut-hole-by-state-2014-YTD.pdf (Download Adobe Reader).
For more information about Medicare prescription drug benefits, go to:http://www.medicare.gov/part-d/.
Medicare preventive services
The Affordable Care Act eliminated coinsurance and the Part B deductible for recommended preventive services covered by Medicare, including many cancer screenings and other important benefits. By making certain preventive services available with no cost sharing, the Affordable Care Act is helping Americans take charge of their own health. By removing barriers to prevention, Americans and health care professionals can better prevent illness, detect problems early when treatment works best, and monitor health conditions.
For state-by-state information on utilization of preventive services at no cost to Medicare beneficiaries, please visit: http://downloads.cms.gov/files/Beneificiaries-Utilizing-Free-Preventive-Services-by-State-YTD-2014.pdf (Download Adobe Reader).
February 22, 2015
National Coverage Determination (NCD) for Screening for Lung Cancer with Low Dose Computed Tomography (LDCT)
Today the Centers for Medicare & Medicaid Services (CMS) issued a final national coverage determination that provides for Medicare coverage of Screening for Lung Cancer with Low Dose Computed Tomography (LDCT). The coverage is effective immediately.
“This is the first time that Medicare has covered lung cancer screening. This is an important new Medicare preventive benefit since lung cancer is the third most common cancer and the leading cause of cancer deaths in the United States,” said Dr. Patrick Conway, chief medical officer and deputy administrator for innovation and quality for CMS.
Medicare will now cover lung cancer screening with LDCT once per year for Medicare beneficiaries who meet all of the following criteria:
they are age 55-77, and are either current smokers or have quit smoking within the last 15 years;
they have a tobacco smoking history of at least 30 “pack years” (an average of one pack a day for 30 years); and
they receive a written order from a physician or qualified non-physician practitioner that meets certain requirements.
Medicare coverage includes a visit for counseling and shared decision-making on the benefits and risks of lung cancer screening. The NCD also includes required data collection and specific coverage eligibility criteria for radiologists and radiology imaging centers, consistent with the National Lung Screening Trial protocol, U.S. Preventive Services Task Force recommendation, and multi-society multi-disciplinary stakeholder evidence-based guidelines.
“We believe this final decision strikes an appropriate balance between providing access to this important preventive service and ensuring, to the best extent possible, that Medicare beneficiaries receive maximum benefit from a lung cancer screening program,” Conway said.
December 23, 2014
This week n4a and the Aging Network Volunteer Resource Center announced the six teams that will receive monetary awards as part of a national competition to recognize and support the work that trained volunteer teams are plying in communities across the country in making sure that older adults get to critical medical appointments, are counseled in Medicare options, and more.
The six volunteer teams will each receive $4,000 to help further their missions:
Area Agency on Aging 1-B, Medicare Medicaid Assistance Program (MMAP), Southfield, MI.
Healthcare notice- Dec 2013 (Download Adobe Reader)
Part D Without Paying a Dime- March 2013 (Download Adobe Reader)
Senior Drug Savings Due to ACA – March 2013 (Download Adobe Reader)
Medicare Fraud Alert in Michigan – March 2013 (Download Adobe Reader)
New Provisions Ban Discrimination Against (Download Adobe Reader)
Fraud Alert: Medicare Telemarketing Fraud scheme (Download Adobe Reader)
Preventive Services to 524,279 People in Michigan NCOA Week (Download Adobe Reader)
New Support for Nonprofit Health Plan (Download Adobe Reader)