THE CARE PACKAGE: Homecare Workers & Medicare and Medicaid Eligibility

February 13, 2012

Nicole's Notes 

At our most recent Campaign for Better Care luncheon in Goldsboro, a woman asked, “How do you get in the doughnut hole?” Our special guest speaker, Regional Director of the US Department of Health and Human Services Anton J. Gunn explained that this hole is a gap in prescription drug coverage for Medicare Part D beneficiaries. Essentially, once the total spent on the individual’s drug costs reaches $2,700, the individual is responsible for the full cost of the drugs until the total reaches $6,154. Then Medicare Part D coverage begins again.

This doesn’t sound very sweet to me or to the millions of seniors who have fallen into this horrible hole since 2006. However due to the new health care law, in 2010, more than 4 million seniors who had fallen into the doughnut hole received a $250 rebate check, and in 2011 those who fell into the hole received a 50% discount on brand-name drugs. This coverage gap will get smaller each year and by 2020 will permanently close. Dually eligible beneficiaries (those on both Medicare and Medicaid) have fully subsidized prescription drug costs and do not have this coverage gap. Mr. Gunn spoke about many initiatives of the Affordable Care Act that will change the way we pay for and coordinate care to older adults. He also pointed out that efforts to combat fraud have already saved the country $4 billion.

Calendar 

  • NC CAMPAIGN FOR BETTER CARE

Stay tuned for details on our next Campaign for Better Care community luncheon.

  • Medical Care Advisory Committee Meeting

Federal law and regulation require that state Medicaid agencies have a Medical Care Advisory Committee (MCAC). The purpose of the MCAC is to advise the Medicaid agency on health and medical care services that may be covered by Medicaid. The next Advisory Committee meeting is scheduled for March 16th, 9:00 a.m. - 12:00.p.m. at the McKimmon Center, NC State University Campus, Raleigh. For more information, click here.     

Keeping You Posted 

Summary of Health Access Coalition Director Adam Searing’s February 6 blog post on NC Policy Watch’s The Progressive Pulse:

Back in November at our Campaign for Better Care Luncheon in Wilmington, I spoke with Sylvia Colbert about how the NC General Assembly’s cuts to the Medicaid program meant she could no longer get new eyeglasses. Well, others are also feeling the pinch, and the Lions Club of Wilmington is trying to fill the gap for at least a few low-income people who need eyeglasses, according to the Wilmington Star-News. That’s great, but – and it’s a big but:

Dick Gerrish, secretary of the Wilmington Lions Club, said that currently his branch of the Lions Club provides eye exams and glasses to five or six people a month, serving “the employable” first. “And we probably have about 10 people on the waiting list,” he said.

So, out of the thousands of people on Medicaid in the Wilmington area, some five to six will be able to get eyeglasses they need, but the rest are out of luck.

Although some lawmakers’ predictions that “private charity” would step in to fill the neglected needs of the poor aren’t coming true, at least they saved us all the 1 cent sales tax they let expire.

If you or your loved one is on Medicare and Medicaid (dually eligible), we would like to talk with you. Also, please pass on my contact information to anyone you know who is dually eligible. You can contact me at Nicole@ncjustice.org or 919-856-2146.

News for You 

Homecare Workers Could Benefit from Minimum Wage, Overtime Rules

The U.S. Department of Labor is proposing new regulations that would mean most homecare workers would be covered by minimum wage and overtime laws. More than 2.5 million workers who provide companionship and other services to people who are elderly or have disabilities in their homes would benefit. For more information about the proposal, see dol.gov for a side-by-side comparison of current and proposed rules and notice of proposed rulemaking. It’s very important that the Department of Labor hear from homecare workers about how the new rules would help them.

If you are interested in supporting these new rules, please contact my colleague Carol Brooke of the NC Justice Center’s Workers’ Rights Project at carol@ncjustice.org. The deadline for comments is February 27, 2012.

Resource Spotlight 

NC Care Link
www.nccarelink.gov
Interactive website that provides current information about programs and services across North Carolina for everyone

National Respite Network and Resource Center
archrespite.org
Online, interactive resource for families who need access to planned or emergency care of a loved one

We have created extensive lists for the resources available in various communities in North Carolina. So far, we have lists for the following:

Stay tuned for resources lists for more communities throughout the year.

First Person 

If you would like to share your story on video or in writing, please contact me at 919-856-2146 or nicole@ncjustice.org

 

 

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