This month staff members from Marathon Health Center decided to have our monthly meeting at the Marathon Coffee Shop so we could have a continuous meeting without the phone ringing. Besides enjoying the good food and relaxing atmosphere, we arrived at an unusual schedule for holidays this year in our meeting.
Thanksgiving is the normal holiday. The clinic was closed on the traditional day. But the Christmas days off are going to be different this year since Christmas and New Year’s come on Sunday. My son, Mark, is getting married in Kentucky on New Year’s Eve so my family and I will be flying there for a few days. As a result the clinic will be closed on Thursday December 29 and January 2 for our holidays. Ruth Spitzer, LVN also has a son getting married this month; Martin will be married on December 10 in El Paso. She will work 1/2 day on December 8, but Isabel Shackelford and I will be there the rest of the day, so please don’t hesitate to come in if needed.
We will be having our annual Christmas Open House on Thursday Dec. 22, from 9-4. There will be our usual home-baked goodies, cider, coffee, giveaways, drawings of 2 children’s Christmas bags stuffed with goodies, and a diabetic glucose testing machine with supplies (Donated by Nurses Unlimited) will also be drawn for. This is not a raffle; come in and add your name to the drawing. The glucose testing meter is a new type that you can use to test your blood sugar anywhere on the hand or arm.
Medicare Launches the Prescription Drug Plan January 1, 2006
This month I know everyone is trying to figure out the new Medicare drug benefit. Those on limited incomes are worried that they cannot pay the co-pay and deductibles. Those on Medicaid don’t even know how they can come up with a co-pay. Those on private insurance wonder if they should switch or stay with their current insurance; will their own insurance company drop them? They wonder if they will have to pay a penalty if they sign up later than the current deadline as announced. These are some of the many questions being addressed as the program evolves. It seems to be changing as the questions come up.
The actual program starts January 2006. Sign up is between November 15, 2005 and May 15, 2006. While not joining by May 15 can lead to higher premiums, your current drug coverage may be at least as good as the standard Medicare prescription drug coverage (such as a former employer health insurance or a union plan). These employer agencies will notify participants whether they should stay with their own plans or not.
If a person’s Medigap policy is at least as good as Medicare coverage, and the client decides to keep his or her current drug coverage, they may be able to buy a Medicare prescription drug plan at a later date without paying a penalty. On the other hand, if their current plan pays less than the Medicare prescription drug plan and they delay signing up after May 15, 2006 they will have to pay at least 1% more for every month they waited to join after the sign up date.
Those on Medicaid automatically qualify for extra help and do not need to apply for the Medicare Drug Prescription program. Medicare will begin paying for their prescriptions starting January 1, 2006. This also applies to those on SSI.
If you are on a limited income and have limited resources, and not on one of the above programs, you must apply for extra help. Speak to your Social Security Administration officer or call 1-800-MEDICARE for information about who to contact in your area. In Texas, the State Health Insurance Assistance Program will help you. Call 1-800-252-9240. This is for individuals making or receiving incomes under $14,355 a year or couples making under $19,245 per year. Another way to find out where you can get help is to check on the internet at www.medicare.gov. If you do receive a letter and 4-page application from Social Security, fill it out and mail it back. This is an application for extra help with premiums, deductibles and co-pays.
Another item you will need help with is choosing the right plan for coverage. Medicare has subcontracted the insurance coverage to prescription drug plans like Merck Medco or Caremark. How to know which plan to join can be challenging. Get a list of your current medications and call one of the numbers listed above. They will tell you what plans are available in your area and which ones cover your medications. Sometimes your healthcare professional will have to change the drug to one in the same family that matches the approved drugs for your plan. The drug plans must contract with pharmacies in your area. Be sure the plan you choose serves the pharmacy where you trade. While some plans will offer prescriptions through the mail, this is not as timely as picking it up the same day after it is prescribed. The wait will be 1 to 2 weeks for mail order pharmacies.
Everyone should at least consider joining the Medicare Prescription Drug plan, even if they are not on many prescriptions now, just to avoid higher premiums if joining later on. Of course, if you plan to stay healthy and are blessed to never need such a plan, that is something else to think carefully about until next May.
This information is taken from Medicare brochures and letters. The
Big Bend Regional Medical Center Senior Circle has more detailed
information and brochures. Call Mary Clare Spear for a copy if you are
interested, at 837-3447.
JoAnn Lister is a Family Nurse Practitioner Certified, at both the Marathon Health Center and Alpine Family Health Care Services.
The Marathon Health Center, at South First at Post Road in Marathon, is open Mondays & Thursdays, 8:30 a.m. - noon, 1:00 - 5:30 p.m. Phone: 432/386.4316. Appointments and walk-ins.
Alpine Family Healthcare Services is located at 910 East Lockhart Street in Alpine. Phone: 432/837.1541.
