| June 2006 | Volume 5, Number 4
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I N T H I S I S S U E
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June Luncheon: 6/16 at Andrea's Restaurant
· NAHU Annual Convention
· Health Care Expo a Success!
· NAHU Health Coverage Options Database
· 38 Million Enrolled in Medicare Prescription Plans
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2006-2007 Board Nominations
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Annual Meeting
Elections & Awards Luncheon
Friday, June 16th
Andrea’s Restaurant
Metairie, LA
11:30 am Networking
Lunch begins promptly at 12:00pm
Members:
RSVP- $20
At the Door- $25
Non-Members:
$25
Don't Forget to Bring Your Change for a Change!
To RSVP, send an email to rsvp@noahu.org
with your name and guest's name (if applicable).
The proposed by-law changes will be voted on at this meeting.
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Health Expo a Great Success!
Thank you to all of of the attendees, exhibitors & sponsors who made the 2006 Health
Care Expo a great success. We had so manu wonderful comments on the program and
speakers! We are looking forward to making next year better than ever! Thanks again
to our sponsors Blue Cross Blue Shield of LA, Humana, United, Coventry, CBSA &
Gilsbar.
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NOAHU Members to Attend NAHU Annual Convention in San
Francisco
President Kenny Collins, Vice-President Jennifer Toups and Awards Chair Dottie Smith will represent the New Orleans chapter at the NAHU Annual Convention in San Francisco. Other members who will be in attendance are Denny Ebersole, Cindy Osborne, George Emrick & James Henderson.
Denny Ebersole has been nominated for the position of Region 6 Vice President and is running unopposed. The position is being vacated by Mike Stephens from Oklahoma as he ends his second term. Cindy Osborne will attend as the outgoing Louisiana state president. George Emrick & Jim Henderson are both past national presidents and Harold R. Gordon Memorial Award winners. The Gordon Memorial Award is the
highest honor that NAHU awards and the conference culminates in the presentation of this award.
The featured speakers at the convention this year are James Carville & Mary Matalin. Be on the lookout next month for the a recap of the event!
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Health Coverage Database Options- A Great Resource
There were as many as 45 million Americans that went without health insurance coverage at some point during the last year. Many of these people may not have obtained needed medical care as a result, and all took a significant financial gamble. The National Association of Health Underwriters, a professional association of more than 20,000 health insurance agents, brokers
and benefit specialists, is extremely concerned about the problem of the uninsured. One of our primary goals is to help ensure that Americans have access to appropriate health coverage. To help address this problem, we have developed the Health Care Coverage Options Database (Database), an on-line tool to help make American health care consumers aware of all of the
coverage options available to them. The Database contains information about private health insurance coverage, as well as the many public and private programs available to Americans to help them obtain the medical care they need. Policymakers, the media and other interested parties can also use the Database as a means of comparing health care coverage options for
Americans on a state-by-state basis.
The Database is broken up in to four components:
Employer-Based Health Insurance Coverage
The majority of Americans have group health insurance coverage through either their employer, or the employer of a family member. This section is designed for consumers who need more information about what requirements apply to group health insurance coverage, or need to know what their options are if they are about to lose access to their group coverage. It also
provides contact information for the state and federal regulators who oversee private group health insurance in America, in case consumers have questions or need to report a problem. Consumers who are looking to purchase a group health insurance product can go to NAHU's Find An Agent feature to find an NAHU member in their area to assist them in obtaining
coverage.
Individual Health Insurance Coverage
Many Americans who do not have access to group health insurance coverage, like selfemployed people, early retirees, students and people whose employers do not offer health benefits, choose to purchase their own coverage privately. The laws concerning individual health insurance products are different than the laws regulating group coverage, and the requirements vary significantly on a state-by-state basis. This section helps consumers understand how individual insurance is regulated in their area, and it also helps explain the state-specific options available to individual consumers who have serious medical conditions that may preclude them from obtaining traditional coverage. Furthermore, this section contains information about the entities that regulate the individual market, so that consumers can contact them if they have questions or concerns. People who are looking to purchase health insurance on an individual basis can go to NAHU's Find An Agent feature to find an NAHU member in their area to help them buy coverage.
Assistance for Obtaining Health Coverage
Many Americans need to obtain health care services but may have trouble paying for them. This section provides comprehensive information about all of the major federal and state programs to provide coverage assistance to individuals age 65 and under. It includes specifics and contact information for large-scale programs like Medicaid, the State Children's Health
Insurance Program and the federal Health Care Tax Credit Program. In addition, this section contains overviews and contacts for the hundreds of smaller state and federal-level and private programs that provide coverage assistance and services to specific populations. This section may be a particularly helpful resource to people with lower incomes who are either uninsured or under-insured, and to people who are looking for either primary care or preventive assistance or help with a serious medical condition, as many of these programs target those groups.
Health Care Coverage Contacts
This section provides consumers with a quick reference list of important health coverage assistance contacts
Click here to view the Louisiana Health Coverage Options Database.
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Over 38 Million People With Medicare Now Receiving Prescription
Drug Coverage
HHS Secretary Mike Leavitt today announced that 38.2 million people with Medicare are now receiving comprehensive prescription drug coverage, in many cases even better coverage than they ever had before. A surge in enrollment took place in the closing weeks of the enrollment period, with more than 2 million beneficiaries signing up between May 1 and the May 15th
deadline.
“Introduction of the Medicare prescription drug benefit created an unprecedented opportunity and a breathtaking challenge,” Secretary Leavitt said. “The challenge has been met, and today, for over 38 million Americans -- 90 percent of people with Medicare -- the promise is being fulfilled, day in and day out, prescription by prescription. In fact, more than 3.5 million Part D
prescriptions are being filled each day and the cost of monthly plan premiums is nearly 40 percent lower than original estimates.”
The average premium in 2006 for beneficiaries, not counting retiree coverage, is less than $24. In addition, 87 percent of beneficiaries chose plans other than the standard benefit, according to the Centers for Medicare & Medicaid Services (CMS).
“With help from thousands of partners across the country, and personalized assistance from 1- 800-MEDICARE and www.medicare.gov, people with Medicare and their family members were able to get the drug coverage they prefer at a far lower cost than expected,” said CMS Administrator Mark B. McClellan, M.D., Ph.D. “Thanks to Medicare beneficiaries making
informed choices to meet their needs, the costs of Medicare drug coverage are way down -- and we will continue to support effective competition to provide high-quality, low-cost coverage.”
Total enrollment in Medicare Advantage plans increased by over 26 percent (1,249,041 self enrollees) during the six month enrollment period, bringing the total number of beneficiaries enrolled in Medicare Advantage plans to 7.4 million. Included in that total are about 4.8 million who chose to enroll in these plans before January, 2006.
About 87 percent of all beneficiaries who enrolled in a prescription drug plan chose a plan that offers coverage other than the standard benefit, such as no deductibles or coverage in the “donut hole.” Most beneficiaries enrolled in Medicare Advantage plans are also getting more comprehensive drug coverage than in the standard plan. In addition, almost 10 million lowincome
beneficiaries are getting comprehensive drug coverage for little or no cost.
Among the 38.2 million beneficiaries who are now receiving prescription drug coverage, approximately 32.8 million have coverage from Medicare and 5.4 million have coverage from other sources, including the Department of Veterans Affairs (VA), primary coverage from an employer (from beneficiaries who are working after age 65), and state prescription drug programs that are not yet combined with Medicare Part D. Based on the latest information on the choices of veterans with VA benefits and Medicare coverage, almost 40 percent are enrolled in Medicare Part D, a much larger number of VA beneficiaries than previously expected.
Enrollment for the new Medicare prescription drug coverage began on November 15, 2005 and ended on May 15, 2006.
Overall prescription drug coverage enrollment figures as of June 11 are:
· Stand-Alone Prescription Drug Plans (PDPs): 10.4 million people with Medicare have enrolled in stand-alone prescription drug plans, including 2.2 million enrollees receiving the low income subsidy (LIS).
· Medicare Advantage with Prescription Drugs (MA-PDs): 6 million beneficiaries receive coverage through Medicare Advantage plans with drug coverage (MA-PDs), including 1.2 million new enrollees. Medicare Advantage includes 925,000 enrollees receiving the LIS. About 478,000 of these are full Medicare/Medicaid beneficiaries. About 1.1 million beneficiaries are currently enrolled in MA-only plans; many of these beneficiaries in private fee-for-service plans are receiving Part D through a separate PDP and therefore included in the enrollment totals for PDPs.
· Medicare/Medicaid: 6.1 million Medicare/Medicaid beneficiaries were automatically enrolled in prescription drug plans. An additional 478,000 Medicare/Medicaid beneficiaries enrolled in Medicare Advantage plans with prescription drug coverage and
are counted in the MA-PD total above.
· Retiree Coverage: 6.9 million retirees are enrolled in the Medicare retiree subsidy. In addition, about 1.5 million retirees are in employer and union-sponsored coverage that incorporates Medicare group drug coverage and about 400,000 retirees are in employer and union-sponsored coverage that wraps around Medicare drug coverage -- these beneficiaries are counted in the PDP and MA-PD totals above.
· Federal retiree coverage: 3.5 million
o TRICARE: Estimated 1.9 million beneficiaries with TRICARE retiree coverage, based on data that was provided by the Department of Defense (DoD). This number excludes nearly 7 percent who were found to be enrolled in Part D plans based on a person-level data match.
o FEHB: Estimated 1.6 million beneficiaries with FEHB retiree coverage, includes both retirees and spouses, and excludes 2 percent who might be enrolled in Part D plans (based on information from OPM).
· Additional Sources of Prescription Drug Coverage for Medicare Beneficiaries: HHS estimates that approximately 5.4 million Medicare beneficiaries have alternative sources of “creditable” prescription drug coverage:
o VA: There are an estimated 2 million beneficiaries with creditable drug coverage through the VA who have not signed up for Part D. About 1 million VA beneficiaries enrolled in a Part D plan, and about 400,000 are receiving drug coverage from an employer receiving the Part D subsidy. These numbers are based on a sample person-level match provided by the VA.
o Indian Health Service (IHS): There remains 0.1 million beneficiaries with creditable drug coverage through the IHS being served by I/T/U pharmacies in 28 states.
o Active Workers with Medicare Secondary Payer: Nearly 2.6 million beneficiaries receive creditable drug coverage through an employer group health plan based on a person level match of our coordination of benefits files and Part D enrollment files.
o Other Retiree Coverage: An estimated 0.1 million retirees are continuing in retiree coverage who are not already included in the other retiree coverage categories. Some of these retiree plans may apply for the Medicare retiree subsidy in their next full plan year, while others may have only a limited number of eligible retirees so that the financial impact of the RDS is small.
o State Pharmaceutical Assistance Programs (SPAP): An estimated 0.59 million beneficiaries are continuing to receive creditable coverage through SPAPs. The estimate is based on information from four SPAP programs that have creditable
coverage and are currently not requiring enrollment in Part D plans in order to retain SPAP coverage (NJ, NY, PA, and WI), and a person level match of SPAP files with Part D enrollment files.
Of the approximately 4.4 million Medicare beneficiaries who do not have secure, quality drug coverage, approximately 3.2 million are estimated to be eligible for the extra help. As President Bush announced, enrollment for these beneficiaries with limited incomes will continue throughout the year, with no late enrollment penalty.
HHS and CMS are continuing to work closely with the thousands of local organizations, whose efforts helped to inform and enroll the millions of Medicare beneficiaries across the country who enrolled in a prescription drug plan before the deadline, to reach these remaining beneficiaries.
New outreach efforts include:
· Collaboration with several intergovernmental partners including SSA; HUD; USDA; AoA; HRSA; and ACF to raise awareness and coordinate outreach events.
· Enhanced outreach with many external partner organizations. For example, CMS is collaborating with minority groups including the NAACP to target federal outreach grants to the areas with greatest number of LIS eligibles.
· New targeted outreach activities, including collaborations with NCOA to inform partners of best practices regarding data driven outreach methods.
“People with Medicare are already seeing significant savings through the new drug coverage, and beneficiaries with limited incomes have even more to save,” said Dr. McClellan. “It’s imperative that we reach as many of them to make sure that they are able to get the drugs they need.”
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