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We are dedicated to making Medicare's program work well for all beneficiaries. Your feedback from your own or your client's concerns and experiences with Medicare, will guide our Medicare advocacy efforts with key policy and decision-makers in both California and nationally with the Centers for Medicare and Medicaid Services (CMS) and Congress.

  • 16Apr

    Medication management and good communication between caregivers and providers are two crucial factors to promoting successful patient recoveries, especially during transitions to and from hospital, long-term care, and home care settings. Caregivers often provide clinicians with valuable information that may not be available from the patient; they also provide continuity for the patient and help that would not be available anywhere else. Because of this importance in drug management and communication, the Centers for Medicare & Medicaid Services (CMS) and the United Hospital Fund of New York’s Next Step In Care Campaign produced a series of educational podcasts: Helping Patients and Caregivers Take the Next Step in Care: Medication Management. These podcasts are featured on the CMS YouTube channel.

    These free podcasts can be used for provider staff and caregiver trainings, or just played in providers’ waiting rooms. For more information for caregivers and providers, see the Caregiver section of

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  • 24May

    The Senate Special Committee on Aging will hold a hearing on Older Americans Act (OAA) reauthorization this Thursday, May 26, at 2 p.m. Eastern Time. The hearing will explore recommendations for strengthening and improving OAA programs, including testimony from Assistant Secretary for Aging Kathy Greenlee, former First Lady Rosalynn Carter, and Max Richtman, chair of the Leadership Council of Aging Organizations (LCAO). The hearing will be webcast live on May 26. See the Senate Special Committee on Aging webpage for the webcast.

    Since passed by Congress in 1965, the OAA has funded numerous essential social and nutritional services that keep seniors independent, in their homes and in their communities. Some of these services include: meals, job training, senior centers, caregiver support, benefits enrollment, transportation and more.

    See the Administration on Aging website for more details on the OAA. The National Council on Aging website also has many resources on the OAA, including a webinar on the history and promise of the OAA.

  • 26Apr

    The Centers for Medicare and Medicaid Services (CMS) has “Welcome to Medicare” videos in Mandarin Chinese and Vietnamese available on Youtube. These 22 minute videos provide easy-to-understand information about the basics of Medicare, including Medicare Advantage plans, Part D prescription drug plans, Medidare preventive services and the Medicare Savings Programs (MSPs). See the video clips below.

    These videos are also available on DVD — for free! You can go to the CMS Product Ordering site to register and order on-line.

    If you need more than 25 copies, please email Anne Avery at CMS’ Baltimore office at and she will mail them to you. Please be sure to include the following information when you send your order in:

    • Chinese or Vietnamese (or both)
    • Name of organization and point of contact
    • Address
    • Email and phone number
    • Quantity

    See for publications in other languages as well.

    Below are the youtube video links:

  • 05Apr

    Saturday, April 30 is the 2nd National Prescription Drug Take Back Day from 10 a.m. – 2 p.m.  Sponsored by the Drug Enforcement Administration (DEA), this event gives people the opportunity to turn in unused or expired medications for safe disposal. People can find a disposal site near them on the National Take Back Initiative website.

    The first event on September 25, 2010 was a huge success, with people across the nation turning in more than 121 tons of pills, and over 3,000 state and local law enforcement agencies nationwide participating in the event.

    Safe disposal of unused or expired drugs addresses both an important environmental and public health concern. According to the 2009 Substance Abuse and Mental Health Administration’s National Survey on Drug Use and Health, more than 7 million Americans (adults, teens and kids) abuse prescription drugs, and a majority of these are obtained through family and friends, including the family medicine cabinet.

    See the event website for more details, and please pass on the information.

  • 17Aug

    Health care reform changes are vast and include many changes that will affect Americans now and in the future. While we’ve focused several articles on the changes affecting Medicare and Medicare beneficiaries, this article below, focuses on those affecting Californians old and young. Excerpted from the Passages HICAP Recap July-August 2010 newsletter (PDF), this article lists some of these changes and explains some of the immediate benefits impacting Californians.

    Small business tax credits

    503,000 small businesses in California could be helped by a new small business tax credit that makes it easier for businesses to provide coverage to their workers and makes premiums more affordable. Small businesses pay, on average, 18% more than large businesses for the same coverage, and health insurance premiums have gone up three 3 faster than wages in the past 10 years. This tax credit is just the first step towards bringing those costs down and making coverage affordable for small businesses.

    Closing the Medicare Part D donut hole

    Last year, roughly 382,000 Medicare beneficiaries in California hit the donut hole, or gap in Medicare Part D drug coverage, and received no extra help to defray the cost of their prescription drugs. Medicare beneficiaries in California who hit the gap this year will automatically be mailed a one-time $250 rebate check. These checks began being sent to beneficiaries in mid-June and will be mailed monthly throughout the year as new beneficiaries hit the donut hole. The new law continues to provide additional discounts for seniors on Medicare in the years ahead and completely closes the donut hole by 2020. (See our past blog article, Are You Eligible for the Part D Rebate: Q & A for more info.)

    Support for health coverage for early retirees

    An estimated 430,000 people from California retired before they were eligible for Medicare and have health coverage through their former employers. Unfortunately, the number of firms that provide health coverage to their retirees has decreased over time. On June 1, 2010, a $5 billion temporary early retiree reinsurance program started to help stabilize early retiree coverage and help ensure that firms continue to provide health coverage to their early retirees. Companies, unions, and state and local governments are eligible for these benefits.

    New consumer protections in the insurance market beginning on or after September 23, 2010

    • Insurance companies will no longer be able to place lifetime limits on the coverage they provide, ensuring that the 19 million California residents with private insurance coverage never have to worry about their coverage running out and facing catastrophic out-of-pocket costs.
    • Insurance companies will be banned from dropping people from coverage when they get sick, protecting the 2.7 million individuals who purchase insurance in the individual market from dishonest insurance practices.
    • Insurance companies will not be able to exclude children from coverage because of a preexisting condition, giving parents across California peace of mind.
    • Insurance plans’ use of annual limits will be tightly regulated to ensure access to needed care. This will protect the 16.2 million residents of California with health insurance from their employer, along with anyone who signs up with a new insurance plan in California.

    Health insurers offering new plans will have to develop an appeals process to make it easy for enrollees to dispute the denial of a medical claim. Patients’ choice of doctors will be protected by allowing plan members in new plans to pick any participating primary care provider, prohibiting insurers from requiring prior authorization before a woman sees an ob-gyn, and ensuring access to emergency care.

    Extended coverage to young adults

    Beginning on or after September 23, 2010, plans and issuers that offer coverage to children on their parents’ policy must allow children to remain on their parents’ policy until they turn 26, unless the adult child has another offer of job-based coverage in some cases. This provision will bring relief to roughly 196,000 individuals in California who could now have quality affordable coverage through their parents. Some employers and the vast majority of insurers have agreed to cover adult children immediately.

    Affordable insurance for uninsured with preexisting conditions

    $761 million federal dollars are available to California starting July 1 to provide coverage for uninsured residents with pre-existing medical conditions through a new transitional high-risk pool program, funded entirely by the Federal government. The program is a bridge to 2014, when Americans will have access to affordable coverage options in the new health insurance exchanges and insurance companies will be prohibited from denying coverage to Americans with pre-existing conditions. If states choose not to run the program, the Federal government will administer the program for those residents.

    Strengthening community health centers

    Beginning on October 1, 2010, increased funding for Community Health Centers will help nearly double the number of patients seen over the next 5 years. The funding could not only help the 1,049 Community Health Centers in California but also support the construction of the new centers.

    More doctors where people need them

    Beginning October 1, 2010, the Act will provide funding for the National Health Service Corps ($1.5 billion over 5 years) for scholarships to help the 1,049 Community Health Centers in California but also support the construction of new centers and loan repayments for doctors, nurses and other health care providers who work in areas with a shortage of health professionals. This will help the 9% of California’s population who live in an underserved area.

    New Medicaid options for states

    For the first time, California has the option of Federal Medicaid funding for coverage for all low-income populations, irrespective of age, disability, or family status. For more information on health care reform issues visit:

    Also see our article, What Does Health Care Reform Mean for Beneficiaries? Summary of Key Provisions.

  • 11Aug

    The CLASS Act, part of the recent health care reform legislation, establishes a national voluntary cash benefit long-term care (LTC) insurance program.  Many of the program details, however, such as when and how people will be able to enroll, what premium amounts will be charged, which federal government agency will administer the program, etc. have yet to be figured out. Because these gaps leave a lot of ambiguity, we created a Frequently Asked Questions about the CLASS Act section on our website to answer some common questions and clarify what we know for certain now and what questions will be answered and by whom in the near future.

    Some of the FAQs include:

    • Who is eligible for the CLASS Act LTC insurance program?
    • If I need long-term care insurance now, should I buy it or just wait for the CLASS Act program to begin?
    • What benefit amount will the CLASS Act program pay if I require long-term care?
    • How much will the premiums be and how will they be collected?
    • Do I have to enroll in the CLASS Act program? What if I don’t want to?

    See our FAQs on the CLASS Act.

    See our CLASS Act Summary for more detailed information, and our long-term care section for general information on LTC.

  • 12Jul

    On July 1st, the US Department of Health and Human Services launched a new website (  to empower people with information and resources about their health care. The website is organized for 6 groups of users: 1) families with children; 2) individuals; 3) people with disabilities; 4) seniors; 5) young adults; and 6) employers. The site helps people find information on their insurance options, learn tips tailored to their particular condition/age on prevention and how to stay healthy, and understand the various components of the new health care reform laws.

    It also helps people compare hospitals using 44 quality of care measures. This section links to, a web tool created by the Centers for Medicare & Medicaid Services (CMS), HHS, and members of the Hospital Quality Alliance. In the past, this site only had data about the quality of care provided to hospital inpatients. As of July 7, 2010, however, it now has “data on the rates of outpatient MRIs for low back pain, outpatient re-tests after a screening mammogram, as well as two ratios that explain how frequently outpatient departments gave patients ‘double’ computed tomography (CT) scans when a single scan may be all that is needed….[It] also includes new measures that show whether outpatients who are treated for suspected heart attacks receive proven therapies that reduce mortality such as an aspirin at arrival, and how well outpatient surgical patients are protected from infection,” (see CMS press release). In the future, comparison information for nursing homes and dialysis centers will also be added, based on language in the Patient Protection and Affordable Care Act (PPACA) that requires broader quality of care information to be publicly available.

    The section on health reform is extensive and provides a summary of the legislation, links to the law’s text and major provisions, and detailed information on 7 major topic areas. These areas include: the pre-existing condition plan, how health reform strengthens Medicare, young adult coverage, early retiree coverage, small employer tax credits, the Patients’ Bill of Rights, and the $250 Part D donut hole rebate. This section also provides a timeline for what’s changing and when according to the health care reform law.

    As this is a new website, HHS invites comments and feedback to help make it even better. Some additional website improvements on the way include a full Spanish translation, which will be available at the end of July, and price information for private insurance plans, which will be available in October 2010.

    The website is a first of its kind, providing over 500 pages of information in a user friendly, easily search-able way. In fact, according to White House New Media Director, Macon Phillips, this site’s design was inspired and guided by the question, “How would [a travel website like] approach health insurance?” The result is a design with simple, focused searching that allows users to answer a few short questions and quickly find the info they require.

    Questions and suggestions regarding can be sent to

    For more information on health reform and Medicare, see our article, “What Does Health Reform Mean for Medicare Beneficiaries? Summary of Key Provisions.”

  • 19Jan

    The Administration on Aging (AoA) recently published a report giving a detailed profile of older Americans in 2009. The data is compiled from the U.S. Bureau of the Census, the National Center on Health Statistics, and the Bureau of Labor Statistics. Below are some highlights.

    • The older population (65+) numbered 38.9 million in 2008, an increase of 4.5 million or 13.0% since 1998.
    • The number of Americans aged 45-64 – who will reach 65 over the next 2 decades – increased by 31% during this decade.
    • Over 1 in every 8, or 12.8%, of the population is an older American.
    • Persons reaching age 65 have an average life expectancy of an additional 18.6 years (19.8 years for females and 17.1 years for males).
    • Older women outnumber older men at 22.4 million older women to 16.5 million older men.
    • In 2008, 19.6% of persons 65+ were minorities–8.3% were African-Americans.** Persons of Hispanic origin (who may be of any race) represented 6.8% of the older population. About 3.4% were Asian or Pacific Islander,** and less than 1% were American Indian or Native Alaskan.** In addition, 0.6% of persons 65+ identified themselves as being of two or more races.
    • Older men were much more likely to be married than older women–72% of men vs. 42% of women (Figure 2). 42% older women in 2002 were widows.
    • About 31% (11.2 million) of noninstitutionalized older persons live alone (8.3 million women, 2.9 million men).
    • Half of older women (50%) age 75+ live alone.
    • About 471,000 grandparents aged 65 or more had the primary responsibility for their grandchildren who lived with them.
    • The population 65 and over will increase from 35 million in 2000 to 40 million in 2010 (a 15% increase) and then to 55 million in 2020 (a 36% increase for that decade).
    • The 85+ population is projected to increase from 4.2 million in 2000 to 5.7 million in 2010 (a 36% increase) and then to 6.6 million in 2020 (a 15% increase for that decade).
    • Minority populations are projected to increase from 5.7 million in 2000 (16.3% of the elderly population) to 8.0 million in 2010 (20.1% of the elderly) and then to 12.9 million in 2020 (23.6% of the elderly).
    • The median income of older persons in 2008 was $25,503 for males and $14,559 for females. Median money income (after adjusting for inflation) of all households headed by older people did not change in a statistically different amount from 2007 to 2008. Households containing families headed by persons 65+ reported a median income in 2008 of $44,188.
    • Major sources of income for older people in 2007 were: Social Security (reported by 87% of older persons), income from assets (reported by 52%), private pensions (reported by 28%), government employee pensions (reported by 13%), and earnings (reported by 25%).
    • Social Security constituted 90% or more of the income received by 35% of all Social Security beneficiaries (21% of married couples and 44% of non-married beneficiaries).
    • About 3.7 million elderly persons (9.7%) were below the poverty level in 2008 which is not statistically different from the poverty rate in 2007 (9.7%).
    • About 11% (3.7 million) of older Medicare enrollees received personal care from a paid or unpaid source in 1999.

    The full report will be posted on the AoA’s website soon.

  • 14Dec

    COBRA subsidies from the American Recovery and Reinvestment Act (ARRA) passed in February 2009 are about to run out for people who started receiving it 9 months ago. Over a million Californians rely on the subsidy to continue their health care coverage, which pays 65% of their monthly COBRA premium.

    COBRA, the Consolidated Omnibus Budget Reconciliation Act passed in 1985, allows involuntarily laid-off workers to continue their health coverage for 18-36 months by assuming the premium payments formerly paid by their employers. These monthly insurance premiums, however, after almost 25 years of health care inflation, are often bigger than unemployment checks.

    When the economy went downhill last year, and the unemployment rates skyrocketed, Congress approved this subsidy to help the millions of people who lost their jobs between Sept. 2008 and Dec. 2009 continue their health coverage for the short-term. The first recipients from 9 months ago are now starting to lose their subsidies, and unless Congress extends the program, more subsidies will expire each month through fall of next year.

    Also, unless Congress acts, people who loose their jobs in 2010 won’t receive a similar subsidy. Because of the high premium costs, many of these people will most likely become uninsured.

    Families USA recently released a report with a state-by-state estimate of the average COBRA premium, average amount covered by the federal subsidy, and the average monthly unemployment check. In California, the average monthly COBRA premium is $1,107, about $720 of which is covered by the federal subsidy. Unemployment compensation amounts to an average of $1,349 a month. This leaves little left over if an unemployed Californian choses COBRA coverage and does NOT receive the federal subsidy.

    The federal  subsidies (which people may qualify for through Dec. 31, 2009) also apply to people who qualify for Cal-COBRA, California’s “mini-COBRA” program for employees laid off from companies with fewer than 20 workers.

    For more information, see the Families USA report, Expiration of COBRA Subsidy (PDF).

    For general info, see our sections on COBRA and Cal-COBRA.

  • 25Nov

    This time of year stress levels can rise as beneficiaries face increased Medicare and health plan costs for 2010, make choices on which health plan to switch to, enroll in, or disenroll from in Medicare’s annual election period, and prepare for the holidays. One easy way to reduce stress and strengthen health during this season that doesn’t involve health plans or doctor referrals is a “medicine” we all have. It’s also fun and free –it’s  laughter.

    Research has shown that kids laugh about 400 times a day, and adults only about 15. Research also shows numerous benefits associated with laughter, including:

    • Helping to reduce stress
    • Enhancing the immune system
    • Strengthening cardiovascular functions
    • Oxygenating the body by boosting the respiratory system
    • Improving circulation
    • Toning muscles
    • Helping with digestion and constipation

    How does laughter help in these areas?

    In terms of enhancing our immune system, just the act of laughing itself, and the muscular contractions we experience when laughing, moves our lymph fluid, therefore boosting the immune system’s function. Moving lymph helps clear out old, dead waste products from our cells, tissues and organs. As our lymph system doesn’t have a separate pump, our body needs to move around in order to circulate our lymph fluid so our immune system can function properly. Laughter is one good way to do so.

    In addition, when we laugh, we oxygenate our body by taking in large amounts of oxygen at both the cellular and organ level. Being one of the primary catalysts for biological energy for the human body, oxygen is absolutely necessary for sustaining life. It also has the effect of destroying cancer cells in its presence. Many parasites and bacteria don’t survive well in oxygen’s presence as well. To the extent we can circulate extra oxygen throughout our body, we can help prevent, or in some cases treat, diseases.

    Oxygenating our body also increases our circulation. And the physical act of laughing exercises our abdominal muscles, giving a good internal massage to all our digestive organs and supporting healthy digestion.

    Laughing also has several healing biochemical effects on our body, emotions and general outlook on life. Below is an excerpt from Mike Adams, author of the Five Habits of Health Transformation.

    When you laugh, you generate a wealth of healing biochemicals. I’ve often stated that for every minute of laughter, you produce somewhere around $10,000 worth of healthy body chemistry, and what I mean is that if you had to go out and actually purchase these refined chemical compounds from labs or pharmaceutical companies, you would have to pay at least $10,000 for the very same chemistry that your brain is producing free of charge when you engage in laughter.

    Some of these are brain-altering chemicals such as serotonin; others are immune-boosting chemicals such as interleukins. If you were to make a long list of all the chemicals created by engaging in healthy laughter, you would have quite a list of healthy body chemicals that would carry a hefty price tag if you purchased them retail. And yet, once again, you can create these chemicals for yourself at no cost by simply engaging in laughter.

    You will find that these chemicals have extraordinary positive healing effects on your body and mind. They will boost immune system function; they will improve your outlook on life; they will tend to diminish any symptoms of depression; and because they help reduce stress, they will also prevent all of the various diseases and disorders that are caused by chronic stress.

    With all these benefits, how can one start laughing more? One way is to just laugh, be more silly, watch funny movies, get together with a friend and tell funny stories or make up goofy dances. When working with your beneficiary clients, see if you can get them and yourself laughing just for the fun of it!

    Laughter yoga also offers an easy venue for laughing with large groups of people. Keep learning from children and grandchildren. With children laughing at an average of 400 times a day, adults have a lot more laughing catch up to do!

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