By Susan Jaffe | March 30, 2011 | Kaiser Health News produced in collaboration with 
Younger, Disabled Medicare Beneficiaries Have Trouble Getting Supplementary Insurance
By Susan Jaffe KAISER HEALTH NEWS | March 7, 2011 This story was produced in collaboration with 
Joe Hobson, 63, crosses the street in front of his Arlington apartment. (Jessica Marcy / Kaiser Health News).
One night three years ago, Joe Hobson finished reading a book, went to sleep and woke up blind. The problem,a rare hereditary disease, forced him to give up his 20-year communications job, along withits generous health insurance. Now 63, the Arlington man is covered by Medicare, the federal program for elderly and disabled Americans.
Like many people with Medicare, Hobson would like to buy supplemental, or Medigap, insurance to help cover his out-of-pocket costs, such as co-payments and deductibles. But Medigap prices can be prohibitive for disabled beneficiaries younger than 65. The cheapest plan for such people in Northern Virginia is $338 a month, according to Brad Rothermel,an Annandale insurance agent who has helped Hobson look for a policy. That’s three times the premium of a plan with much better benefits that is available to a 65-year-old. And the private insurers that offer Medigap policies are free to reject Hobson or charge him extra because of his preexisting health conditions.[Continued in KHN] andin The Washington Post]
Innovative Day-Care Program Seeks To Keep Frail, Low-Income Seniors In Their Homes
By Susan Jaffe | December 21, 2010 | Kaiser Health News in collaboration with 
Several mornings a week, a white van stops at Geraldine Miller’s house just east of Baltimore to pick her up for ElderPlus, a government-subsidized day-care program for adults on the campus of the Johns Hopkins Bayview Medical Center.
Because 
Miller, who is 75 and uses a walker, has trouble getting down the stairs from her second-floor apartment, the driver comes inside to help. When she feels wobbly, he lends her an arm. When she feels strong, he faces her and steps down backward on the steps so he can catch her if she falls. When it rains, he shelters her with an umbrella. This is the sort of extra care that makes ElderPlus different. ElderPlus is part of PACE, the Program for All-Inclusive Care for the Elderly, which provides comprehensive medical and social services to frail, low-income seniors with serious health problems. [Continued at Kaiser Health News or The Washington Post.] Video: “Picking Up The Pace”
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Little-provision provision of overhaul law requires companies to tell it like it is
By SUSAN JAFFE updated Dec. 16, 2010
KAISER HEALTH NEWS in partnership with 
Choosing a health insurance policy should be easier if consumers use the simple chart and other information that state insurance commissioners approved Thursday.
“It will force the insurance companies to reveal information in a consistent way,” says Bonnie Burns, a policy specialist for California Health Advocates, a consumer health advocacy group. “And it should make it easier for people to understand what they’re getting and not getting.”
Under a little-known provision of the health overhaul law, insurers will be required to provide their benefits information on a standardized chart using the same plain English terms as other companies to help shoppers understand and compare complicated policies. MORE
Medicare rules give full hospital benefits only to those withinpatient status
By Susan Jaffe | September 7, 2010 | Kaiser Health News produced in collaboration with 
After Ann Callan, 85, fell and broke four ribs, she spent six days at Holy Cross Hospital in Silver Spring. Doctors and nurses examined her daily and gave her medications and oxygen to help her breathe. But when she was discharged in early January, her family got a surprise: Medicare would not pay for her follow-up nursing home care, because she did not have the prerequisite three days of inpatient care.
“Where was she?” asks her husband, Paul Callan, 85, a retired U.S. Army colonel. “I was with her all the time. I knew she was a patient there.”
Yet some hospitals keep patients under observation for days, and that decision can have severe consequences. Medicare considers observation services outpatient care, which requires beneficiaries to cover a bigger share of drug costs and other expenses than they would when receiving inpatient care.And unless patients spend at least three consecutive days as an inpatient, Medicare will not cover follow-up nursing home expenses after discharge…. more
What To Do If You’re In Observation Care
By Susan Jaffe | September 7, 2010 | Kaiser Health News produced in collaboration with 
How do I know what my hospital status is? What can I do if the hospital won’t change my observation status to inpatient? If the nursing home or hospital says Medicare won’t cover my nursing home stay, what can I do? Answers to these and other questions here.
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BULLETIN | July 5, 2010Medicare Steps Up Efforts To Monitor Seniors’ Prescriptions
By Susan Jaffe | KAISER HEALTH NEWS | March 23, 2010
This story was produced in collaboration with
Irene Mooney survived four heart attacks and still copes with high cholesterol, persistent indigestion and heart problems. Recently, she developed some dangerous new symptoms – suspicious bruising all over her body and severe fatigue. “I could barely put one foot in front of the other,” she says. A pharmacist discovered the culprit: Some of the very medications Mooney was taking to manage her medical conditions.
The pharmacist met with Mooney, examined her 13 medications and then contacted her doctor, who cut the dosage of one drug and replaced another, reducing her risk of uncontrollable bleeding. Mooney, 82, one of the devoted card players at her seniors’ complex, soon noticed the change. “I’ve been so much better,” she says.
The help Mooney got – called “medication therapy management” – was provided by Senior PharmAssist, a Durham, N.C., non-profit group that makes sure seniors use the right prescription drugs and take them correctly to prevent harmful side effects or drug interactions.
Now, medication management is coming to nearly 7 million seniors and disabled Americans enrolled in Medicare drug plans. [Continued at Kaiser Health News and USA Today
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By Susan Jaffe | March 22, 2010
KAISER HEALTH NEWS in partnership with 
Medication management is coming to nearly 7 million seniors and disabled Americans
enrolled in Medicare drug plans. Under new, tougher Medicare rules that took effect in January, private insurers that offer drug coverage must automatically enroll members who have at least $3,000 in total annual drug costs, take several drugs and have chronic health conditions such as diabetes, hypertension or heart disease. MORE
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Dialysis crisis followed shift by Medicaid
By Susan Jaffe | Plain Dealer Reporter | February 12, 2007
For the past year, a dialysis machine has been keeping Karletta Edwards’ mother alive, substituting for her kidneys to cleanse her blood three times a week.
But in January, shortly after Ohio’s Medicaid program transferred her, along with more
than 25,000 other low-income people in Northeast Ohio, into an HMO, something went wrong.
The state’s contracts with insurance companies are expected to save Medicaid $24 million this year, by the time some 125,000 blind, disabled or older people are placed in privately run managed care plans.
Even though the companies are paid 6.6 percent less, Medicaid’s average cost to care for the same population, state officials say the health coverage will remain the same…. Four weeks ago, Edwards received a desperate call from her mother. The transportation service that picked up Emma Hansen from her East Cleveland home and brought her to the dialysis center didn’t show up. [Continued here]
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Consumer guide to prescription drug plans in Northeast Ohio
Health insurance companies with contracts from Medicare have been approved to sell a total of 93 plans in Ohio. Some policies cover only drugs, while others 
include health insurance. This special section provides a consumer guide including the plan basics, some questions to ask before choosing a plan, a translation of the technical jargon companies use, and where to go for assistance.[four-page section here]
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Advocates for Medicaid seniors wary of assigned drug coverage
By Susan Jaffe | Plain Dealer Reporter | December 29, 2005
Under the Medicare prescription drug benefit, the federal government enrolled millions of the nation’s poorest and sickest seniors into private drug plans that may not cover all their drugs. [Continued here.]
Medicare drug plan backfires on states
Seniors’ switch from Medicaid will boost costs by millions
By Susan Jaffe | Plain Dealer Reporter | March 9, 2005
The Medicare prescription drug benefit is backfiring on states–running up millions of dollars in extra drug bills instead of the savings promised by its Republican supporters. [Continued here ]
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Switch to Medicare to cost state millions
By Susan Jaffe | Plain Dealer Reporter | October 20, 2005
Ohio’s financially strapped Medicaid program will pay millions more when low-income seniors switch to Medicare for their prescription drugs next year. The federal law that established the new Medicare drug benefit requires the nearly 200,000 seniors in Medicaid – the state health-care program for low-income people – to transfer to Medicare for drug coverage. The law also says that states must reimburse the federal government for 90 percent of those seniors’ drug costs. But any savings that states expected have vanished because of the controversial formula Medicare used to figure how much they owe. The switch will cost Ohio $35 million more in 2007 than if the seniors now in Medicaid had stayed there. [Continued here.]
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Medicare dangles Rx carrot
By Susan Jaffe | Plain Dealer Reporter | February 12, 2005
Many of the nation’s major corporations providing retiree drug coverage will get help paying the bill – subsidies worth several billion dollars a year from federal taxpayers. The money totals roughly $71 billion tax-free through 2013 and is part of the Medicare Modernization Act, which added a drug benefit to Medicare. It is aimed at encouraging employers to maintain their coverage instead of forcing retirees onto Medicare’s tab. [Continued here]