Quick Facts about Medicare’s New Coverage for Prescription Drugs for people with limited income and resources
Starting January 1, 2006, Medicare will offer prescription drug coverage for all people with Medicare. If you have Medicare and have limited income and resources, you may qualify for extra help paying for prescription drugs.

What do I need to know?

• If your annual income is below $14,355 for a single person (or $19,245 if you are married and living with your spouse), you may qualify for extra help. Slightly higher income levels may apply if you provide ½ support to other family members living with you, or if you work or reside in Alaska and Hawaii.
• And if your resources (including your savings and stocks, but not counting your home or car) are under $11,500 (for a single person) or under $23,000 (for a married couple) you may qualify for extra help paying for your Medicare prescription drug costs.
• You can apply for this extra help through the Social Security Administration or your State Medical Assistance Office. Social Security is mailing the application for extra help to those who may qualify. If you receive an application, fill it out and return it in the enclosed postage paid envelope.
• The amount of extra help you get depends on your income and resources.
• You still need to join a Medicare prescription drug plan for Medicare to pay for your drug costs.
• You can join a Medicare prescription drug plan from November 15, 2005 through May 15, 2006. If you join by December 31, 2005, your coverage begins
  January 1, 2006. If you join after January 1, 2006, your coverage starts the first day of the month after the month you join.
• If you qualify for extra help, you will have continuous drug coverage and will pay only a small amount for your prescriptions.

How do I get more information?

For more information on who can get extra help with prescription drug costs and how to apply, call the Social Security Administration at 1-800-772-1213, or visit
www.socialsecurity.gov on the web. TTY users should call 1-800-325-0778.

 

You will receive detailed information from Medicare about your choice of Medicare prescription drug plans in October 2005. You can look at the “Medicare
& You 2006” handbook, visit www.medicare.gov on the web or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

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Quick Facts about Medicare’s New Coverage for Prescription Drugs If You Applied for Extra Help
You’ve applied for extra help with Medicare prescription drug costs using Social Security’s application, so what happens next?

Social Security will begin processing applications for extra help on July 1, 2005. If your online or paper application is not complete, Social Security will call you or
write to you asking for the missing information. Your application will be processed as quickly as possible, and you will receive a letter in the mail telling you if you qualify.

 

What do I need to know?

• Applying for extra help is just one step. You still need to join a Medicare
  prescription drug plan to get Medicare prescription drug coverage.
• Even if you don’t qualify for extra help, you should still consider joining a
  Medicare prescription drug plan. If you join a Medicare prescription drug plan,
  Medicare pays about half of your prescription drug costs, even without any
  extra help.
• You can join a Medicare prescription drug plan November 15, 2005 through
  May 15, 2006, but the sooner you join the sooner you’ll start saving money on
  your prescription drug costs. If you join a plan by December 31, 2005, your
  coverage will begin January 1, 2006. If you join after January 1, 2006, your
  coverage starts the first of the month after the month you join.

How can I get more information?

If you need more information about your application for extra help,

• call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778.
• visit www.socialsecurity.gov on the web.

If you haven’t yet applied for extra help with your Medicare prescription drug costs, you should know that many people will receive an application for extra help
in the mail. If you think you qualify, fill it out and return it in the enclosed postage paid envelope. Also, Social Security has a tool available online where you
can see if you may qualify for help with your prescription drug costs. In addition to the tool, beginning July 1, 2005, you can apply for the extra help online.

For more information about Medicare prescription drug coverage,

• read the “Medicare & You 2006” handbook that you get in the mail in October 2005.
• visit www.medicare.gov on the web. Select “search tools” to get personalized information.
• call your State Health Insurance Assistance Program (see your copy of the“ Medicare & You 2006” handbook for their telephone number).
• call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
• look for local Medicare-related events.

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Compare Quality of Care in Ohio
Instant, objective, easy-to-use and free information about the quality of care in nursing homes, home health agencies, and hospitals in Ohio and nationwide is now available for all healthcare consumers by visiting www.medicare.gov and selecting Nursing Home Compare, Home Health Compare, and Hospital Compare. Consumers without Internet access can also call 1-800-MEDICARE for assistance with comparison.

 

Ohio KePRO has created a state map of Ohio for each comparison resource, divided by county, that will assist you in your search. Each map is accessible through the link included in each section described below:

 

View our compare resources

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Resources:

 

• Find a healthcare provider

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Medicare Prescription Drug Improvement and Modernization Act of 2003
Questions about Medicare reform? This link to www.medicare.gov provides you with access to the most current information regarding the Medicare Prescription Drug Improvement and Modernization Act of 2003 that you will need to help make the best decisions regarding your Medicare coverage.

 

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Mediation

 

Medicare beneficiaries will be able to resolve quality of care complaints against health care providers through an optional mediation program beginning this fall. The new program, which is free of charge, is sponsored by the Centers for Medicare & Medicaid Services (CMS). The mediation program will bring together a health care provider or physician and a patient (or his or her representative) for a face-to-face meeting facilitated by an impartial mediator. This is an alternative to the traditional medical review process, which can last from 85 to 165 days.

 

This national mediation program begins this fall. For further information please contact the Ohio KePRO Medicare Beneficiary Help Line at 1-800-589-7337, or call 1-800-MEDICARE (1-800-633-4227). More information about the mediation program is available by clicking on the link below:

 

Beneficiary Questions & Answers about Mediation

 

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The Ohio Medicare Partners are teaming up to serve you! We are dedicated to assisting you with your Medicare issues and other related health and health insurance concerns you may have. Together, we have lots of resources. If your group would like a presentation about Medicare or related topics, please call one of our offices listed on this Web page.

 

Medicare Part A provides information on:

 

• Inpatient hospital services

• Skilled nursing facility services

• Outpatient facility services/procedures

• Rehabilitation services

 

Call AdminaStar Federal: (513) 852-4314

 

 

Medicare Part B handles your claims for:

 

• Medical/professional services rendered in an office, inpatient or outpatient settings

• Lab tests, x-rays and diagnostic tests

• Ambulance transportation

 

Call Palmetto: 1-800-282-0530

 

 

DMERC processes claims for durable medical equipment & supplies including:

 

• Home dialysis equipment

• Immunosuppressive & oral anti-cancer drugs

• Therapeutic shoes for diabetics

• Wheelchairs, walkers, canes, etc.

• Power operated vehicles

 

Call AdminaStar Federal: 1-800-270-2313

 

 

Quality Improvement Organizations (QIOs) handle quality of health care issues including:

 

• Inpatient hospital, skilled nursing facility, and home health care

• Your rights as a patient, including premature discharge issues

• Care in a Medicare HMO

 

Call Ohio KePRO: 1-800-385-5080

 

 

Ohio Department of Aging is a State Agency which provides information about:

 

• Ohio Aging Network

• Benefits Eligibility Screening Services (BESS)

• PASSPORT program, Care Choice Ohio

• Golden Buckeye Card

• Long Term Care Ombudsmen

 

Call: 1-800-282-1206

 

 

OSHIIP is a State Counseling Office which provides information about:

 

• Medicare supplemental insurance

• Medicare HMOs

• Long term care insurance

• Medicaid, QMB, and SLMB programs

 

Call: 1-800-686-1578

 

 

Ohio Department of Health, Division of Quality Assurance, handles complaints against:

 

• Licensed & certified health care providers, including long term & non long term facilities

 

Call: 1-800-342-0553

 

 

Social Security Administration will help you with:

 

• Medicare eligibility and enrollment

• Changing your address for Medicare

• Replacing a Medicare card

• Questions on Medicare premiums

 

Call: 1-800-772-1213