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Weekly Newsletter 


Issue # 016 May  24th 2005

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In This Weekly Issue

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1  Our Weekly Sponsor
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3. Some words from Ley and Bill
4. Ask The AdMistress
5. News about Seniors and Boomers
6. Subscribers Ads
7. Subscription & Advertising Details

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3. Some words from Ley and Bill

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Welcome new subscribers, and thank you. 

Dear friends

This week, for some reason we needed to think about health.
When a friend is sick we can only pray for this person isn’t?

Well, but this situation made us think that we need to take
Advantage from our medicare, and go to the doctor and 
Make all the examinations they order, in this way you can
Prevent any big health problems. You pay for these services
Use them to better health and life in your aging process.

Remember is better be preventive that corrective with your
Health a lot of big injuries can be fixed if they were discovered
In the beginning. Go to the doctor, take the medicines and
Have a good wealth and life.

For your good health

Best regards,

Ley Gal and Bill Vannot
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4 ASK THE ADMISTRESS - CLUES 4 SUCCESS
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5. News about Seniors and Boomers

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Today you'll get an Article about the new benefits
to be in the medicare plans.

Ley Gal and Bill Vannot

_____________________________


Read online

Medicare Will Revise Guide to New Benefits for 2006

By ROBERT PEAR

WASHINGTON, May 21



- For two years, health policy experts have been warning that
Medicare beneficiaries may be confused by complexities of the
new prescription drug benefit. Now it turns out that Medicare
officials were also confused, not just about the drug benefit
but also about other options.

The Bush administration is revising a preliminary draft of the
2006 Medicare handbook - the main tool for educating
beneficiaries - after discovering that many statements in the
document were inaccurate, misleading or unclear, even to people
who have worked on the program for decades.

Members of Congress, insurance companies, advocates for
beneficiaries and state insurance regulators all told the Bush
administration that the new handbook was flawed.

For example, in describing the drug benefit, the handbook says,
"After you meet the deductible, you pay part of the cost of
covered prescription drugs, and the plan pays part."

The handbook does not mention that beneficiaries face a gap in
coverage. After the beneficiary pays a $250 deductible, Medicare
pays three-fourths of the next $2,000 in drug costs. But then
the beneficiary is normally responsible for all of the next
$2,850, and Medicare pays nothing. Beyond that, Medicare pays
about 95 percent of drug costs.

Moreover, the handbook lumped together the traditional
government-run Medicare program, which covers 36 million people,
and tiny private fee-for-service health plans, in which fewer
than 100,000 beneficiaries have enrolled. Both, it says, are
"fee-for-service plans, available nationwide."

In fact, the two are fundamentally different. Private
fee-for-service plans are available in selected counties from
private insurance companies under contract to Medicare, with
premiums and co-payments set by the insurers. By contrast,
traditional Medicare is offered by the government throughout the
country, with uniform premiums and co-payments set by law.
Beneficiaries may have to pay more in some private
fee-for-service plans than in traditional Medicare.

Vicki Gottlich, a lawyer at the Center for Medicare Advocacy, a
nonprofit group that counsels beneficiaries, said it was
"inaccurate and misleading" to emphasize the similarities
between traditional Medicare and the private fee-for-service
plans.

Insurers agree. In written comments, the Blue Cross and Blue
Shield Association told the government: "There is no need to
have pages and pages on the private fee-for-service option. Most
people will think you are talking about traditional Medicare
when you use that term."

Gary R. Karr, a spokesman at the Centers for Medicare and
Medicaid Services, said the agency was revising the 106-page
handbook to address such concerns. The handbook, he said, will
include "a more detailed description" of the new drug benefit,
including the gap in coverage, and will clarify the differences
between traditional Medicare and private plans. The final
version will be mailed to beneficiaries this fall.

"It's a real challenge to describe things accurately and
completely while not giving so much detail that you overload and
confuse the beneficiaries," Mr. Karr said. "It's a balancing
act. The handbook is taken very seriously by beneficiaries.
We've got to make sure we get it right."

Dr. Mark B. McClellan, administrator of the Centers for Medicare
and Medicaid Services, said the first draft of the handbook was
prepared by career employees of the Medicare agency and would be
revised to reflect the comments from outside experts. "There
will be changes," Dr. McClellan said. "We can communicate some
things more effectively, more simply and more clearly."

When asked whether he had read the handbook, Dr. McClellan said:
"I am not sure that I've read a complete draft of the handbook
from cover to cover, but I am familiar with the different
pieces. I will pay more attention in coming weeks and will
thoroughly review the handbook before it becomes final." A major
goal of the 2003 Medicare law was to create a competitive
insurance market so beneficiaries would have more options. But
as the options proliferate, it becomes more difficult to explain
them, especially because the terminology has changed three times
in eight years.

In 1997, Congress established the Medicare+Choice program to
foster the growth of health maintenance organizations and other
private plans. In 2003, Congress overhauled the program and
renamed it Medicare Advantage. That name, widely used in this
year's handbook and in marketing materials, disappears from the
draft of the 2006 handbook. H.M.O.'s and preferred provider
organizations are called simply "Medicare health plans."

Traditional Medicare is also called a plan, the "original
Medicare plan."

AARP, the lobby for older Americans, strongly supported the 2003
law, but now points to research suggesting that "too many
options can produce paralysis." For example, it says, as the
number of mutual funds in a 401(k) plan increases, the
likelihood of employees' choosing any fund goes down.

In a poll on health issues by the Kaiser Family Foundation in
April, two-thirds of those 65 and older said they did not
understand the new drug benefit. Nine percent said they would
sign up for drug coverage, 37 percent did not intend to enroll
and 54 percent said they did not know or had not heard enough to
decide.

John C. Rother, policy director of AARP, said his group had met
several times with Medicare officials to express concerns about
"the accuracy, understandability and balance" of information in
the handbook. The handbook repeatedly suggests that private
plans offer a better value than the traditional Medicare
program. Those plans - H.M.O.'s and P.P.O.'s - "give you more
health care coverage choices and better health care benefits,"
it says.

In a separate notice to beneficiaries, the administration says
the new Medicare drug benefit "will cover all the types of
prescription drugs you may need," without noting that
beneficiaries may have to appeal to get coverage for specific
drugs they are using.

The new drug benefit becomes available Jan. 1. Medicare
beneficiaries can sign up for it from Nov. 15 of this year to
May 15, 2006. People who delay enrolling face higher premiums,
with a 1 percent surcharge for each month of delay, but the
handbook understates the penalty. It gives the example of a
beneficiary named Hannah who has to pay 19 percent more - $35.70
a month, rather than $30 - because she signed up 19 months late.
Hannah "will have to pay this higher amount as long as she has
this plan," the handbook says. In fact, she is likely to pay
more than that amount. Her late enrollment penalty is 19 percent
of her basic premium. If, as expected, the premium increases in
later years, the penalty will grow with it, unless Congress
changes the law.

· Copyright 2005 The New York Times Company



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Frank Kaiser, sent to us this news, he didn't write or even like
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them and he and us we are only the messangers.

Ley And Bill
---------------------------- 
Frank Kaiser

frank@suddenlysenior.com http://www.suddenlysenior.com The
nationally syndicated column for the 79 million Americans over
50 who've become senior before their time. Read by over one
million monthly.

SEE SUDDENLY SENIOR


=====================

Disclaimer:
In accordance with Title 17 U.S.C. Section 107, this 
material is distributed without profit for research 
and educational purposes. Senior Life Changes has no 
affiliation whatsoever with the originator of this 
article nor is Senior Life Changes endorsed or 
sponsored by the originator


Ley Gal & Bill Vannot

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Regards,

Ley Gal & Bill Vannot
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