Carmelo Gonzalez News Page 17

Extra Help for Medicare Drug Benefit

Extra Help. If your monthly income in 2005 is below $1,197 for singles ($1,604 for couples) and your assets are below specified limits (see chart below for details), you may be eligible for Extra Help, a federal program that helps you pay for some or most of the costs of Medicare prescription drug coverage.

Even if your income or assets are above the limit you may still qualify for Extra Help because certain types of income and assets may not be counted.

If you are enrolled in Medicaid, Supplemental Security Income (SSI) or a Medicare Savings Program (MSP) (see above), you automatically qualify for Extra Help. You do not have to apply for this extra assistance.

If you are not enrolled in one of the programs that automatically qualify you for Extra Help, you will have to fill out an application. You can do that through the Social Security Administration (SSA), using either the agency's print or online application (call 800-772-1213), or at your local Medicaid office.

Note: Even if you qualify for the extra assistance paying for your Medicare drug costs, you must choose a private plan offering Medicare drug coverage in your area in order to get the Medicare prescription drug benefit.

If You Have...		Your Assets		You Pay

Medicaid¹ and income below 100% FPL (below $798² a month for singles and $1,070 a month for couples in 2005³)		State Medicaid asset test applies. Note: If you have Medicaid you automatically qualify for Extra Help—you do not have to apply for it.		· No monthly premium² · No deductible · $1/generic and $3/brand-name³ (no copay after $5,100 in total annual drug costs)
Medicaid and income above 100% FPL⁵ (above $798 a month for singles and $1,070 a month for couples in 2005³)		State Medicaid asset test applies. Note: If you have Medicaid through spend-down, once you have met your spend-down amount you are automatically eligible for Extra Help for the rest of the calendar year—you do not have to apply for it.		· No monthly premium² · No deductible · $2/generic and $5/brand-name⁴ (no copay after $5,100 in total annual drug costs)

Income below 135% FPL and do not have Medicaid (below $1,077 a month for singles and $1,444 a month for couples in 2005³)	Below $7,500 for individuals and $12,000 for couples⁶		· No monthly premium² · No deductible · $2/generic and $5/brand-name⁴ (no copay after $5,100 in total annual drug costs)

Income between 135% and 150% FPL and do not have Medicaid (between $1,077 and $1,197 a month for singles, or $1,444 and $1,604 a month for couples in 2005³)	Below $11,500 for individuals and $23,000 for couples⁶		· Sliding scale monthly premium · $50 deductible · 15% coinsurance ($2/generic and $5/brand-name⁴ copay after $5,100 in total annual drug costs)

¹ Institutionalized individuals with Medicaid, at all income levels, pay no copay, deductible or premium. ² Premium is $0 if you enroll in a plan with a premium at or below the Extra Help premium amount that offers only basic coverage. If you choose a plan with a higher premium or one that offers enhanced coverage, you will have to pay the difference. ³ Federal poverty levels change every year. They will be higher in 2006. Limits are higher if there are more than two people in your household. Limits are also higher in Hawaii and Alaska and may vary in U.S. Territories. ⁴ Indexed to the overall increase in drug costs. ⁵ This includes "spend-down" or medically needy individuals, who spend a portion of their income to become eligible for Medicaid. ⁶ If you answer "no" to the question on the application that asks if you intend to use any of your assets for funeral or burial expenses, then your asset limits will be reduced by $1,500 for singles or $3,000 for couples.

Starbucks is Reaching Out to People with Disabilities

The Wall Street Journal has published an article on the efforts of Starbucks to employ individuals with disabilities and make the approximately 10,000 stores more accessible for customers with disabilities.

Just as more and more companies are starting to realize that individuals with disabilities make up a tremendous customer base, so too has Starbucks come to this conclusion.

In addition to providing more accommodations for employees with disabilities such as registers with Braille keys, Starbucks is making sure that counters are at an appropriate height for customers who use wheelchairs, and replacing signs such as “Disabled Customers” with “For a Customer with a Disability.”

“For Starbucks, the equation is simple. ‘Customers tend to patronize a business that is like them,’ says Jim Donald, president and chief executive officer.”

To read the article in its entirety, use the following link: Michael Corkery, Starbucks is Reaching Out to People with Disabilities, Blind World Magazine, Nov. 14, 2005. http://www.home.earthlink.net/~blindworld/NEWS/5-11-14-04.htm

CASE FLASH: COVERING EXCLUDED DRUGS

Ms. Q is a New York State resident who has Medicare and Medicaid. Because she has both, Ms. Q is automatically eligible for the new drug benefit’s low income Extra Help program and was automatically enrolled by CMS in a randomly selected Medicare prescription drug plan. She received a yellow letter in the mail giving her the name and phone number of the plan she will automatically be enrolled into if she does not choose a different drug plan before January 1, 2006. Ms. Q made a list of all of her prescription drugs and called the drug plan in the letter to see if it covered her medications. She found out that one of them, Klonopin (clonazepam), is not covered by that drug plan. She called her local State Health Insurance Assistance Program (SHIP) for help figuring out what she could do to get all her drugs covered.

The counselor informed Ms. Q that Klonopin is in a class of drugs called benzodiazepines. Benzodiazepines will not be covered by Ms. Q’s drug plan but will continue to be covered by Medicaid in New York State. After January 1, 2006, Ms. Q can use her Medicaid card at the pharmacy to refill her prescription for Klonopin. To find out if your state is covering benzodiazepines, go to the Mental Health Part D web site created by a partnership of professional and consumer mental health groups with funding from pharmaceutical companies.

This message was generated by the Medicare Rights Center list-serve.

If you want more information about the Medicare Rights Center, send an e-mail to info@medicarerights.org.

Medicare Rights Center
1460 Broadway, 17th Floor
New York, NY 10036
Telephone: 212-869-3850
Fax: 212-869-3532

Ruling Leads to City Settling Suit

The Federal Transit Administration (FTA) recently ruled that a bus service that carries passengers between Denver and Colorado Springs, Colorado, is a fixed route service that is subject to Americans with Disabilities Act requirements. As part of a settlement agreement subsequent to this ruling, the nine buses in the fleet which are not wheelchair-lift equipped will be retrofit to comply with the ADA.

To read more:
http://www.gazette.com/display.php?id=1310133&secid=1

Inexpensive Ways to Retrofit Existing Home for Accessibility

This is a brief article examining some easy ways people can make their homes more accessible for their use and enjoyment.

Some suggestions include using levers instead of doorknobs, and front loading washers and dryers, which are more easily accessible by seated individuals.

To read the article in its entirety, use the following link:
http://www.courier-journal.com/apps/pbcs.dll/article?AID=/20050828/FEATURES08/508280321

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