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Illinois Governor Urges Seniors to Lower Drug Costs
with Creative Illinois Cares Rx
HHS Secretary
could use this program as example, as he urges states to be innovative in
helping seniors with healthcare
April 3, 2006 - Illinois Governor Rod R.
Blagojevich today urged Illinois seniors to join the Illinois Cares Rx
program, which is designed to fill in the gaps in coverage of the
Medicare Part D prescription drug benefit. It is one of the unique state
programs in the U.S. that is helping senior citizens, particularly those
of limited means, to afford the medicines they need for survival. HHS
Secretary Mike Leavitt, who on Friday urged states to use innovative
approaches to provide health insurance and long-term care, may want to
point to this program as one good example.
(Read
news release from Health and Human Services below.)
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“We don’t believe that seniors should face gaps in
their prescription drug coverage, and that’s why we created Illinois
Cares Rx," said Gov. Blagojevich.
"So far, over 240,000 senior citizens have signed
up for our new program. But for those who have not, now is a good time
to enroll, so you don’t end up facing the gaps in the federal program’s
coverage."
He also thanked Emanuel and Schakowsky for "their
steadfast support of making less expensive prescription drugs available
to Illinois senior citizens.”
Blagojevich was joined by fellow Democrats,
Congressman Rahm Emanuel and Congresswoman Jan Schakowsky, at North Park
Village Senior Center in Chicago. Emanuel also expressed support for
Rep. Schakowsky’s legislation to extend the May 15th deadline for
enrollment in the Part D program.
“Across the nation, Medicare beneficiaries have
faced enormous obstacles in getting their prescription drugs,” said
Emanuel.
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HHS Urges States to
Help Seniors |
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States To Have New Options For Medicaid Programs
March 31, 2006 - HHS Secretary Mike Leavitt today
outlined new flexibilities available to states that will help
people served by Medicaid programs maintain access to affordable
health care, and allow states to use innovative approaches to
providing health insurance and long-term care services.
“Passage of the Deficit Reduction Act (DRA) will
provide great opportunities for states to cover more people at a
lower cost, and with greater continuity of coverage,” Secretary
Leavitt said. “It will allow states to connect their healthy
populations to the larger health insurance system and transform
their long-term care programs to a person-centered,
consumer-controlled model, that will allow beneficiaries to have
more choices about how and where they receive care.”
The DRA gives states greater control over both
the design and the administration of their Medicaid programs.
Prior to DRA, states wishing to implement new
delivery systems or experiment with benefits, such as home and
community based care, had to seek federal approval for a
“waiver” of Medicaid rules. DRA removes that requirement for
many such changes and allows states to add new designs as part
of their basic “state plan” or blueprint for their programs.
Over the next few weeks and months, the Centers
for Medicare & Medicaid (CMS) will work closely with states to
implement the new law. DRA grants states such options as
creating new benefit packages tailored to different populations,
improving access to mainstream health insurance coverage and
expanding ways to provide long-term care.
“We intend to work closely with states to enhance
access to mainstream coverage, including employer-provided
coverage for working families and care management programs to
provide better support for people with chronic diseases,” said
CMS Administrator Mark B. McClellan, M.D., Ph.D.
“We intend to work closely with states and people
with a disability to use the unprecedented opportunities created
by the new law to give people control over how they get their
long-term care services. Now is the time to update long-term
care services in Medicaid.”
As part of the initial guidance, CMS will issue
two “Roadmaps to Medicaid Reform.” The papers will outline
options for states to tailor their benefit packages to select
populations and explains ways states can support individuals
with disabilities and long-term care needs.
The paper on coverage options will outline how
states can:
● Expand access to affordable mainstream
coverage;
● Promote personal responsibility for health and accessing
health care; and
Improve quality and coordination of care.
The long-term care roadmap will guide states as
they:
● Expand coverage for individuals with
disabilities, by moving to beneficiary control of decisions
about long-term care services;
● Increase access to community supports; and
● Promote community-based care, independence, and choice.
The Roadmaps are the first steps in helping
states implement changes to bring the Medicaid program up to
date. More than 55 million Americans -- mostly low-income
children, the elderly and the disabled -- receive their health
care benefits from Medicaid. |
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“Here in Illinois, the Governor is working to solve
these problems with his 'Illinois Cares Rx' program. He has created the
nation's most comprehensive state response to filling the gaps created
by Medicare Part D. He is working to ensure that seniors in Illinois
will have access to the prescription drugs they deserve,” said the
Congressman.
“Illinois Cares Rx covers many of the gaps created
by President Bush's Part D disaster," said Schakowsky.
"Governor Blagojevich and Illinois have done more
than any other state to help beneficiaries. Our Governor is working to
ensure that seniors and people with disabilities have access to the
drugs their doctors prescribe,” said Schakowsky.
“I will continue to fight for a better Part D
benefit that meets the needs of seniors and people with disabilities,
not the drug and insurance companies."
The federal Medicare Modernization Act pays 75
percent of prescription drug costs up to $2,250 after a $250 deductible
with an average $32 per month premium. Beneficiaries are responsible for
all of their costs between $2,250 and $5,100, with the plan paying 95
percent of costs beyond that top threshold. The gap where a beneficiary
has to pay all the drug costs between $2,250 and $5,100 is commonly
referred to as the “donut hole.”
Gov. Blagojevich’s Illinois Cares Rx program allows
Illinois’ low-income seniors and persons with disabilities who have been
getting prescription drug assistance through state programs to avoid
high out-of-pocket expenses and gaps in coverage created by the new
Medicare Part D program.
The “wrap around coverage” provided to Illinois
seniors and persons with disabilities through Illinois Cares Rx will
help cover the increased costs of the Medicare program, including
premium costs, coinsurance, coverage during the “donut,” and the
deductible.
To help Illinois seniors know how to avoid facing
gaps in their coverage, nearly 35 Medicare Part D and Illinois Cares Rx
enrollment events scheduled by the Illinois Department on Aging (IDoA),
the Department of Healthcare and Family Services (HFS) and SHIP will
continue through May 15th and the nearly 200 SHIP locations statewide
are open with volunteers available to help guide enrollees through the
application.
"Aging staff and the 13 Area Agencies on Aging
across the state are still out in the communities answering last minute
questions and concerns that people may have. We have extra people
answering calls on our Senior HelpLine and there's a lot of important
information on our department's website and on illinoisbenefits.org,"
IDoA Director Charles D. Johnson said.
"Through interagency cooperation with HFS and SHIP,
we've been able to enroll more than a million Illinoisans in some sort
of prescription drug program."
Illinois seniors and persons with disabilities who
want to find out if they are eligible for or enroll in the Illinois
Cares Rx program, need assistance with Medicare Part D enrollment or
would like to know the nearest location of one of the over 200 SHIP
offices, they should call the Department on Aging Help Line at
1-800-252-8966, the Senior Health Insurance Program at 1-800-548-9034 or
click here or to find
help in your area
click here.
More information about help by the State of
Illinois on Medicare Part D –
click here
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