APPRISE
Donna Uhler, Coordinator
610-834-1040, Ext. 20
donnau@rsvpmc.org

About APPRISE

APPRISE is a program funded by the Pennsylvania Department of Aging (PDA) and other agencies designed to help Medicare beneficiaries understand their Medicare and health choice options, and make sound, educated decisions about what is best for them.

APPRISE counselors are trained volunteers who provide free assistance without bias. Local counseling centers are available throughout Montgomery County. If you have a question about prescription coverage, Medicare benefits, Medicare Advantage and supplemental plans, Healthy Horizons, Medicaid, or appealing a claim call the center nearest to you.

Recent Updates

MIPPA
The Medicare Improvements for Patients and Providers Act (MIPPA) provides significant changes and opportunities for Medicare beneficiaries, particularly those of low income.

Opportunities

• If your income as a single is less than $1361 and your resources are less then $12,640 or if married your income is less than $1839 with resources less than $25,260 you may qualify for Extra Help with your Medicare prescription drug coverage. Call the Extra Help Application Center at 800-866-1807 for assistance.
• Low income subsidy (Extra Help) applications no longer count the cash surrender value of life insurance policies or in-kind support toward the resource total.
• With consent of the applicant, the information is transferred to the state for consideration of eligibility for Medicare savings program (MSP) paying the monthly Part B cost that comes out your social security check.
• When you call be sure to tell them the county number 28.
• Call 610-834-1040  ext 20 or visit an Apprise counselor at the senior center or Aging and Adult Service office to see if you qualify for help.

The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, signed into law in March of 2010, encompasses significant changes and opportunities for Medicare beneficiaries, particularly those who are low income. In 2010 we saw the $250 rebate during the donut hole period for beneficiaries. The therapy cap exceptions were allowed when appropriate, higher Part B premium income thresholds were frozen through 2019 and the special needs plan program were extended until 2014.

In 2011 all cost-sharing amounts for certain preventive and screening services were eliminated. Coverage is provided for an annual wellness visit during which the beneficiary is provided a personalized prevention. Medicare Advantage plans were not eliminated but different restrictions were placed upon them. There is now a prohibition for MA plans imposing higher cost-sharing requirement for some Medicare covered benefits including chemotherapy, dialysis services and skilled nursing care than those charge under Original Medicare. Jan1 – Feb 15 will now be a period for MA enrollees to disenroll from their plan if they wish and return to Original Medicare and choose a qualified prescription drug plan. This will no longer be a time period to change to a different Medicare advantage plan. The payment rates to MA plans for 2011 will be the same as the rates for 2010. In 2011 the Annual Enrollment period will be from October 15th through December 7th. The coverage gap or donut hole will include new cost-sharing opportunities for the beneficiary. Effective January 1, 2011 drug manufacturers will provide a 50% discount on brand name drugs at the point of sale and the government will provide a 7% discount on generic drugs during this gap period for beneficiaries. The discount for the 50% provided by the manufacturer will count toward the total out of pocket cost. The Act also provided that nothing in the Act would result in a reduction of guaranteed benefits under Medicare. It required that savings generated for Medicare under the Act be used to extend the solvency of Medicare trust funds.

PACE / Pacenet 2011 Medicare Part D Partner Plans Are:
(Medicare Part D Partner Plans effective January 1, 2011 through December 31, 2011)

APPRISE Counseling Sites

RSVP’s central office is in Blue Bell at 610-834-1040, ext.20.
For additional information call Donna Uhler at 610-834-1040  ext. 20, or e-mail at donnau@rsvpmc.org