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MEDICARE Rx BENEFIT COSTS MORE THAN VA, CANADA, COSTCO
The Medicare prescription drug benefit does not offer medications at the lower prices available through the Department of Veterans Affairs, Canadian pharmacies or high-volume U.S. pharmacies such as Costco or Drugstore.com, according to a report by the Democratic staff of the House Government Reform Committee. The report, released Nov. 23, compares the average prices of 10 popular drugs offered to Medicare beneficiaries through 10 well-known insurance plans. The average Medicare prices were 80 percent higher than VA prices, 60 percent higher than Canadian average prices and 3 percent higher than prices at major U.S. pharmacies. CMS spokesperson Gary Karr called the report "selective and misleading."
NEW YEAR TO SEE HARD CAP ON MEDICARE OUTPATIENT THERAPY
Starting Jan. 1, 2006, people with Medicare will be limited to $1,750 in outpatient physical and speech therapy combined, and $1,750 of outpatient occupational therapy. These caps will apply without regard to the gravity of the person�s condition, and Medicare will cover only one initial evaluation. Today, if you need physical, occupational or speech therapy, Medicare will pay for as much as a doctor or therapist deems medically necessary. In addition, your doctor or therapist has to set up your plan of treatment; the doctor must review it periodically; and the therapy must improve your condition or prevent further deterioration. Therapy caps were first established in 1997, but advocates were able to delay their implementation resulting in multiple moratoria. Concerned groups are again working to eliminate this ceiling on rehabilitation therapy before it drops for good. Those held in limbo by the pending cap on therapy services can keep abreast of the caps, or any changes in Medicare coverage, by logging on to Medicare Interactive at AFT�s Web site at http://www.medicareinteractive.org/aft.
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Shield your Heart /AARP / December 2005
Here is what you can do. Healthy immune system, healthy heart.