Category

Health Care

FAQ: Adding a Dental Benefit to Medicare Part B

By | FACT SHEET, Health Care, Medicare, Oral Health, REPORTS

As Justice in Aging has been engaged in advocacy to add an oral health benefit to Medicare Part B, we’ve received a number of questions from advocates and others about how older adults currently access oral health benefits, what coverage the various parts of Medicare offer, and what adding an oral health benefit to Medicare Part B would look like.

We created a new resource, Adding a Dental Benefit to Medicare Part B: Frequently Asked Questions, to answer these common questions.

Fact Sheet: Open Enrollment for 2020 Coverage through Medicare & Covered California—Basics for Advocates

By | Affordable Care Act, CA Health Network Alert, FACT SHEET, Health Care, Medicare, REPORTS

Justice in Aging has updated our California fact sheet that provide the essential information advocates for older adults need to know about this year’s open enrollment periods for both Medicare and the Affordable Care Act Marketplaces. Changes consumers make to either their Medicare or Marketplace coverage during open enrollment will take effect January 1, 2020.

Fact Sheet: Open Enrollment for 2020 Coverage through Medicare & the Marketplace—Basics for Advocates

By | Affordable Care Act, FACT SHEET, Health Care, Medicare, REPORTS

Justice in Aging has updated our national fact sheet that provide the essential information advocates for older adults need to know about this year’s open enrollment periods for both Medicare and the Affordable Care Act Marketplaces. Changes consumers make to either their Medicare or Marketplace coverage during open enrollment will take effect January 1, 2020.

Issue Brief: Adding a Dental Benefit to Medicare – Addressing Racial Disparities

By | Health Care, ISSUE BRIEF, Medicare, Oral Health, REPORTS

The Medicare statute currently excludes nearly all dental coverage for the 60 million older adults and people with disabilities who rely on the program. This dental exclusion disproportionately impacts populations of color, who suffer adverse oral health outcomes at significantly higher rates than white older adults.

Justice in Aging’s new issue brief, Adding a Dental Benefit to Medicare: Addressing Racial Disparities, examines how adding an oral health benefit to Medicare would address disparities in access to care and oral health outcomes based on race, and puts forth additional policy options that can be implemented to further advance oral health equity.

This issue brief is the first in a series of papers that will examine how to address disparities in access to care and oral health outcomes among certain groups of Medicare beneficiaries, including people of color, people with disabilities, older adults with dementia and cognitive impairments, and nursing facility residents. 

Free Webinar: Medicaid Retroactive Coverage: What’s at Stake for Older Adults When States Eliminate this Protection?

By | Health Care, WEBINAR, Webinar Trainings

When:  Tuesday, October 1, 2019 11 am-12 pm PT/2-3 pm ET​

Medicaid retroactive coverage is an important financial protection that helps ensure prompt access to care for low-income, uninsured, and under-insured older adults and families. By authorizing states to provide payment for care and services that an individual received up to three months prior to applying for Medicaid, the policy helps protect people who cannot otherwise afford coverage—especially older adults—from crushing medical debt. Retroactive Medicaid coverage is an especially critical protection for people experiencing health emergencies, needing long-term services and supports (LTSS) following an acute illness, or facing other unexpected high-cost health care needs. The policy also relieves uncompensated care burdens on providers. Despite the immense value retroactive Medicaid coverage provides, several states have received federal permission to eliminate this protection.

This webinar—sponsored by Justice and Aging and the AARP Public Policy Institute—will highlight key findings from a new Justice in Aging issue brief on Medicaid retroactive coverage. Experts will discuss a survey of states that have eliminated retroactive coverage and the implications for older adults, families, and providers.

Who Should Participate:
Aging and legal advocates, policymakers, and others wanting to learn more about how waiving Medicaid retroactive coverage impacts older adults, their families, and providers.

Presenters:
Natalie Kean, Senior Staff Attorney, Justice in Aging
Edem Hado, Policy Research Senior Analyst, AARP Public Policy Institute

Moderator:
Amber Christ, Directing Attorney, Justice in Aging

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Issue Brief & Fact Sheet: What’s at Stake for Older Adults When States Eliminate Retroactive Medicaid Coverage?

By | Affordable Care Act, FACT SHEET, Health Care, ISSUE BRIEF, Long Term Care, Medicaid

Retroactive Medicaid coverage is a key financial protection that helps older adults and others who develop sudden illnesses or long term care needs access the care they need right away. It is a smart policy intended to protect low-income people from crushing medical debt in instances where they need emergency medical or long-term care and cannot apply for Medicaid immediately. But several states are eliminating this protection through Medicaid demonstration waivers approved by the federal government.

A new Justice in Aging issue brief—Medicaid Retroactive Coverage: What’s at Stake for Older Adults When States Eliminate This Protection?—discusses typical situations that cause older adults to need Medicaid retroactive coverage, and how the policy helps them access care, while protecting them from financial hardship. The issue brief also delves into how states are using waivers to eliminate this coverage, which states are doing so, and how older adults, their families, and health care providers are harmed when the coverage is eliminated. A companion fact sheet provides a higher level view of the issue.

 

FAQ: Low-Income Subsidy (“Extra Help”) for Dual Eligibles Receiving Home and Community-Based Services

By | FACT SHEET, Health Care, Health Care Defense, Home & Community Based Services, Medicaid, Medicare, REPORTS

The Affordable Care Act (ACA) enables full-benefit dual eligibles who receive certain Medicaid home and community-based services (HCBS) to receive Medicare Part D covered drugs at no cost. This requirement is called institutional cost-sharing, and was designed to put people who receive HCBS at home on an equal footing with those who are in institutions (who are also not charged any co-pays). Unfortunately, despite the institutional cost-sharing requirement, pharmacies still ask dual eligibles to pay co-pays for covered drugs.

Justice in Aging created an FAQ, Low-Income Subsidy (“Extra Help”) for Dual Eligibles Receiving Home and Community-Based Services, to give advocates working with dual eligibles the tools they need to prevent these co-pays. The FAQ discusses whom the cost-sharing rule applies to, the length of the cost-sharing protection, and what to do if a dual eligible HCBS-enrolled individual is prompted for a co-pay at the pharmacy or is entitled to a refund. Advocates should review the FAQ and make sure to their HCBS-enrolled dual eligibles are not paying any co-pays for their Part D drugs.

Free Webinar: The Qualified Medicare Beneficiary (QMB) Program—An Update for Advocates: Part 2 of 2

By | Health Care, Medicaid, Medicare, WEBINAR, Webinar Trainings

When: Wednesday, July 24, 2019 11 am-12 pm PT/2-3 pm ET​

The Qualified Medicare Beneficiary (QMB) program provides significant Medicare cost savings to low income individuals, including payment of Medicare premiums and protection from liability for any Medicare co-insurance or deductibles for health services. Those enrolled in the program also are automatically enrolled in the Part D Low Income Subsidy program (LIS). Despite its value, the QMB program is chronically under-enrolled. Many eligible individuals don’t know about the program or face barriers when they try to enroll. Those who are enrolled often face difficulties in accessing QMB protections.

This two-part webinar series gives advocates updated information on the QMB benefit and tools to use to ensure that their clients are enrolled and can use the benefit effectively.

Part One provides an overview of the QMB program, including eligibility criteria and program basics and focus on the specifics of QMB billing protections. We focus on recent improvements that make it easier for QMBs and their advocates to understand their payment responsibilities and the tools available to address problems with providers who improperly bill QMBs. We also distinguish between the QMB program and a Medicaid agency’s Part B buy-in agreement, and discuss QMB issues in Medicare Advantage.

Part Two focuses on enrollment. It looks at barriers to QMB enrollment, including problems that have arisen in various states and advocacy approaches, especially for individuals with Medicaid linked to Supplemental Security Income. We explore both ways to untangle individual problems and ways to work with your state to improve QMB enrollment systemically.

Who should participate:
Aging and legal advocates, community-based providers and others who counsel older adults on health benefits.

Presenters:
Denny Chan, Senior Staff Attorney, Justice in Aging
Georgia Burke, Directing Attorney, Justice in Aging

Part 1 occurs on Tuesday, July 23, 2019 11 am-12 pm PT/2-3 pm ET​

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Free Webinar: The Qualified Medicare Beneficiary (QMB) Program—An Update for Advocates: Part 1 of 2

By | Health Care, Medicaid, Medicare, WEBINAR, Webinar Trainings

When: Tuesday, July 23, 2019 11 am-12 pm PT/2-3 pm ET

The Qualified Medicare Beneficiary (QMB) program provides significant Medicare cost savings to low income individuals, including payment of Medicare premiums and protection from liability for any Medicare co-insurance or deductibles for health services. Those enrolled in the program also are automatically enrolled in the Part D Low Income Subsidy program (LIS). Despite its value, the QMB program is chronically under-enrolled. Many eligible individuals don’t know about the program or face barriers when they try to enroll. Those who are enrolled often face difficulties in accessing QMB protections.

This two-part webinar series gives advocates updated information on the QMB benefit and tools to use to ensure that their clients are enrolled and can use the benefit effectively.

Part One provides an overview of the QMB program, including eligibility criteria and program basics and focus on the specifics of QMB billing protections. We focus on recent improvements that make it easier for QMBs and their advocates to understand their payment responsibilities and the tools available to address problems with providers who improperly bill QMBs. We also distinguish between the QMB program and a Medicaid agency’s Part B buy-in agreement, and discuss QMB issues in Medicare Advantage.

Part Two will focus on enrollment. It will look at barriers to QMB enrollment, including problems that have arisen in various states and advocacy approaches, especially for individuals with Medicaid linked to Supplemental Security Income. We will explore both ways to untangle individual problems and ways to work with your state to improve QMB enrollment systemically.

Who should participate:
Aging and legal advocates, community-based providers and others who counsel older adults on health benefits.

Presenters:
Denny Chan, Senior Staff Attorney, Justice in Aging
Georgia Burke, Directing Attorney, Justice in Aging

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Free Webinar: Changes to the Rule Implementing the Health Care Rights Law and the Impact on Older Adults

By | Health Care, WEBINAR, Webinar Trainings

When: Wednesday, July 10, 2019 11 am-12 pm PT/2-3 pm ET​

The Trump Administration has published a proposed rule to eliminate key nondiscrimination protections under the Health Care Rights Law (Section 1557 of the Affordable Care Act) for LGBTQ seniors, people with limited English proficiency and others in health care settings. If finalized, this rule change would increase the likelihood that older adults would experience discrimination in accessing health care and make it harder for them to seek redress in the face of that discrimination.

This webinar, Changes to the Rule Implementing the Health Care Rights Law and the Impact on Older Adults, begins with an overview of the Health Care Rights Law. It then discuss the Trump Administration’s proposed changes to the regulations implementing the law and the ways in which those changes would be particularly harmful to older adults. As outlined in our new resource, “Five Frequently Asked Questions about the Health Care Rights Law and Proposed Changes,” those changes include attempting to eliminate the rights of LGBTQ seniors, rolling back protections for limited English proficient (LEP) older adults, and limiting the way that victims of any type of discrimination can seek redress under the law.

The proposed rule is open for a 60-day public comment period through August 13, 2019. In the coming weeks, Justice in Aging will add resources and tools to this page to help advocates respond. 

Who should participate:
Aging and legal advocates, advocates serving LGBTQ and LEP communities, community-based providers, health plan leaders, and others wanting to learn more about changes to the regulations implementing the Health Care Rights Law and the impact on older adults.

Presenter:
Denny Chan, Senior Staff Attorney, Justice in Aging
Natalie Kean, Senior Staff Attorney, Justice in Aging

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