Understanding Asbestos Related Medicare Coverage

Medicare Benefits are now available to people who are diagnosed with an asbestos related disease (ARD). If you already have Medicare benefits you do not need to reapply as they are exactly the same benefits you would already have.

Contact the Social Security Administration, which is the agency responsible for enrolling people for Medicare benefits. They have set up a special phone number just for Libby asbestos claims (1-888-482-3128). If you are in Libby, they have a temporary office at 609 Mineral Avenue until the end of August 2010 (Mon-Fri, 8:00-4:30). What you need to enroll is:

You do not need to get any “proof” of your diagnosis from CARD. We will verify your diagnosis to Social Security once you have started the enrollment process and signed Social Security’s release of information form.

Medicare benefits you would be eligible for include Part A, Part B, and Part D. This is complete healthcare, NOT just asbestos related healthcare. The benefits are exactly the same regardless of which eligibility criteria you met to get them.

Part A: You will receive these benefits free of charge. This covers “inpatient care” which means healthcare you receive in a hospital or skilled nursing facility and some home health and hospice care.

Part B: This benefit is available for a monthly premium (currently $110/month, but there are also financial assistance programs available that are based on your family’s income). This covers “out-patient services” which are doctor’s visits, and other services and supplies not covered by your Part A hospital insurance.

Part D: This benefit, that covers prescription medications, is available and there are many different types of programs that have different premiums and different scopes of coverage. Sandy Romey is the local SHIP counselor who can assist you in picking which plan is best for you (293-8299).

 

1.      Asbestos related disease Medicare benefits are exactly the same as the Medicare benefits you would get when turning 65 or being deemed disabled by the Social Security Administration. This Mean 80% coverage for part A and part B with the individual (you) or a supplemental insurance picking up the 20%.

 

2.      If you enroll in Medicare part A but decline to select part B at this time, your monthly premium will increase ten percent for each twelve month period you were eligible for, but did not enroll in, Medicare part B. Your Medicare part D premium will increase by one percent for each full month you were eligible for, but did not enroll in, Medicare part D. These penalties apply except when you have “creditable coverage” (medical coverage that is as good as, or better, than Medicare) or if you wait until you are 65 which is another “initial enrollment period” for Medicare.

 

3.      At this time, you must pay monthly premiums for part B ($110/month) every 4 months ($440), 3 times a year. The Medicare Savings Plan can provide assistance with premiums, co-pays and deductibles for those that qualify. Contact you local Medicaid office. In Libby Call 293-3791

 

These benefits are the long-term solution but definitely still a work in progress. There are three components to the legislation that passed granting medical coverage to individuals exposed to an environmental health hazard in a public health emergency site such as Libby. The three parts are 1) Medicare benefits, 2) “a pilot program,” and 3) a screening program. The details of the pilot program and screening program are still being figured out within the federal agencies at this time.

All of these programs still exist. LAMP II (state funds) will run out first and FLASH is a two year grant that ends July 31, 2011. The future and timeline of the Grace Libby Medical Plan is unknown. The order to have all of these insurances pay is the same as it was before Medicare benefits became available. (Refer to the “Clip and Save” order of payers that was featured in last month’s newsletter. The cutout cards with this information are also available at the front desk of CARD.)