Social Services
Senior Monongalians is fortunate to have three wonderful Social Services workers assisting seniors and their families. Amanda, Ellen, and Sue work with clients to understand & enroll for Medicare Part D, finding answers to Social Security questions, directing clients to utility assistance programs, senior housing options, and much more.
CAREGIVER SUPPORT GROUP
News reports recently have talked about Vice President Biden’s Middle Class Task Force’s proposal to strengthen supportive services for older Americans and their caregivers. This month’s caregiver support group will talk about these community programs, and in addition, discuss the news from Social Security regarding the Compassionate Allowance Initiative, social security disability and Alzheimer’s disease.
Anyone who informally cares for someone 60 years of age or older is welcome to attend. Meetings take place at Senior Monongalians, Inc. (located at the Mountaineer Mall in Morgantown, WV) at 10:00AM on the third Wednesday of every month. For additional information, please contact Sue (304-296-9812).
ATTENTION MEDICARE BENEFICIARIES
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Medicare's New Requirements for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers*
What's Changing
Starting October 2009, new rules will go into effect for suppliers of certain Durable Medical Equipment (reusable medical equipment such as walkers, wheelchairs, or hospital beds), Prosthetics, Orthotics, and Supplies (DMEPOS) in order to be paid by Medicare. The new requirements for suppliers include being accredited and having a surety bond which will help assure that Medicare beneficiaries continue to get high-quality products and services, and, help to prevent fraud in the Medicare program.
What You Need to Know
Although most suppliers will continue in the Medicare program, some have chosen not to stay enrolled. Medicare beneficiaries should ask if their current supplier plans to meet these new Medicare program requirements to avoid any interruption in services. If a supplier doesn't meet these new requirements, call 1-800-MEDICARE or visit www.medicare.gov and select “Find Suppliers of Medical Equipment in Your Area” to locate a new supplier.
Suppliers must post notice if they are not accredited by Medicare, or, have beneficiaries sign an Advanced Beneficiary Notice (ABN) before they are charged for the items or service. However, in order to ensure payment, beneficiaries should always ask any new supplier they contact if they are still approved by Medicare to provide covered medical equipment and supplies.
*From: www.medicare.gov
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Medicare Drug Program (Part D)
Standard Benefit 2009 & 2010
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2009
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2010
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Annual Deductible Maximum
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$295
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$310
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Member pays 25% of the next…
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$2,405
(25% = $601.25)
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$2,520
(25% = $630)
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Initial Benefit Period Maximum
(what the member AND the plan have spent)
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$2,700
($295 + ($2,405)
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$2,830
($310 + $2,520)
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DONUT HOLE
Member pays 100% of the next…
("TrOOP")
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$3,453.75
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$3,610
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Catastrophic Coverage
Begins when member (NOT plan) has spent a total of…
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$4,350
($295 + $601.25 +
$3,453.75)
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$4,550
($310 +
$630 + $3,610)
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Cost sharing during Catastrophic Coverage
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$2.40/$6
or 5% (whichever is higher)
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$2.50/$6.30
or 5% (whichever is higher)
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LOW INCOME SUBSIDY CO-PAYS 2009 & 2010
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2009
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2010
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Long-Term Care Facility Resident
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$0
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$0
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Up to or at 100% Federal Poverty Level (generic/brand)
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$1.10/3.20
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$1.10/3.3 0
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Other Low-Income Subsidy (generic/brand)
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$2.40/6.00
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$2.50/6.30
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Partial Low Income Subsidy (deductible/cost sharing)
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$60/15%
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$63/15%
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Taken from The Center For Medicare Advocacy @ www.medicareadvocacy.org
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Help for People with Early Onset Alzheimer's Disease
Good news - the Social Security Administration (SSA) adds early onset Alzheimer's disease and several other dementias (frontotemporal dementia (FTD) – Pick’s disease, Creutzfeldt - Jakob disease and mixed-dementia and primary progressive aphasia) to the Compassionate Allowance Initiative, making it easier for people with these diagnoses to qualify for Social Security disability benefits.
What is the Compassionate Allowance Initiative?
Under this initiative, the Social Security Administration (SSA) finds individuals with certain diseases/conditions eligible for Social Security disability (SSDI) and Supplemental Security Income (SSI) benefits by the nature of the disease. While applicants still have to meet other SSDI criteria and/or SSI criteria, when it comes to the disability criterion, they are considered eligible by virtue of the disease and fast-tracked for a favorable decision about their eligibility for SSDI and SSI benefits.
What is Social Security Disability Insurance (SSDI)?
Social Security disability benefits (SSDI) are paid to individuals who have worked for enough years and have a condition that is so severe that they are not able to work. (A person can earn a maximum of four work credits per year. To be eligible for SSDI, in general, a person will be required to have earned 20 work credits in the last 10 years ending with the year he or she became disabled. However, younger workers may qualify with fewer credits.) Administered by the SSA, SSDI makes monthly payments to eligible disabled individuals and is a significant benefit for individuals with early-onset (younger-onset) Alzheimer’s disease. In addition to a monthly payment, it serves as entry to Medicare benefits for those under the age of 65. Family members (e.g., spouses and minor children) may also be eligible for benefits based on the applicant’s work record.
What is Supplemental Security Income (SSI)?
Supplemental Security Income benefits (SSI) are paid each month to individuals who are
aged, blind or disabled and have limited income and resources (assets). The “disability”
criteria for SSI are the same as for SSDI benefits. Unlike SSDI, eligibility for SSI is not
based on prior work experience. In addition, in most states, individuals who receive SSI
are also automatically eligible for Medicaid (medical assistance) benefits.
Who does this change to the Compassionate Allowance Initiative affect?
It only affects individuals with early-onset (younger-onset) Alzheimer’s disease and related dementias; generally, those individuals who are diagnosed with Alzheimer’s and are under the age of 65. It does not affect individuals who are currently receiving full Social Security retirement benefits.
How do I apply for SSDI or SSI?
To apply for SSDI or SSI benefits, you must submit an application and other documents at your local SSA office.
Helpful Resources
1. SSA (304-291-4785) or www.socialsecurity.gov (Specific information about the Compassionate Allowances Initiative can be found at http://www.ssa.gov/compassionateallowances/)
2. Alzheimer’s Association (304-599-1159) or www.alz.org
Taken From: www.mymedicarecommunity.org, www.alz.org and www.socialsecurity.gov
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