March 11, 2010

March 11, 2010


Medicare News


Welcome to another day in my life. Today is Thursday and a cloudy, rainy and windy day here in South Florida. I hope you are having a safe and great week so far. It has been a rough week for me.

The picture today is of my rescue dog, Chipper, and myself. Chipper is 16 years old now, blind and mostly deaf. He also unfortunately has cancer but luckily does not seem in pain yet. I am not looking forward to the day when I have to put him down. He is literally my shadow and constant companion.

So due to health problems, I have not been getting out much this week. Chipper has also been having problems and keeping me up at night so I have been sleeping a lot during the day while he is resting which have almost reversed my days and nights.

But today I would like to talk about some news I heard about changes with Medicare which I am not happy about hearing. I am hoping it will not further endanger people with HIV and AIDS in our country. This news actually happened a couple of days ago but I am now just catching up on my emails and reading.

Today, the Centers for Medicare & Medicaid Services (CMS) terminated its contract with Fox Insurance Company. After an onsite review of the plan and its services, CMS determined that the plan's significant deficiencies not meeting Medicare's requirements to provide enrollees with prescription drugs or recognized standards of care poses a serious risk to the health of Fox enrollees. The termination is effective immediately.

CMS is immediately transitioning the more than 123,000 Medicare beneficiaries enrolled in Fox plans to other coverage to ensure these beneficiaries will not experience any delays or disruption in access to their needed medicines. All members will temporarily obtain their drugs through LI-NET, a program run by Medicare and administered by Humana to ensure that beneficiaries receive their Part D drugs without restriction until they are enrolled in a new plan. Beneficiaries need to take no action to be transitioned to LI-NET, and should not experience any disruption at the pharmacy counter. CMS is notifying relevant partners such as pharmacies, pharmacy organizations, states Medicaid agencies, and other stakeholders of this action so that they are prepared to help affected beneficiaries with this transition. Affected beneficiaries will have an opportunity to enroll in a new Part D plan by May 1--those who do not choose a plan will be enrolled into a new plan by Medicare.

If member offices receive calls from Fox enrollees who have concerns regarding their Part D coverage they should be directed to contact 1-800-MEDICARE (1-800-633-4227) or their state health insurance assistance program (SHIP) for additional assistance.

If this affects you, I would urge you to contact your case manager as soon as possible to see what you need to do.

Until we meet again; here's wishing you health, hope and happiness.



big bear hug,





Daddy Dab