• Congress Improves and Expands "Welcome to Medicare" Physical Exam and Expands Authority to Develop Preventive Benefits
• November 15th Begins Annual Enrollment Period for Medicare Advantage and Medicare Advantage Drug Plans

• Social Security Administration Announces 5.8% Cost of Living Adjustment

Welcome to Medicare Physical

Since January 1, 2005, new Medicare Part B enrollees have been entitled to a "Welcome to Medicare Physical" within the first six months of enrollment.  Formally known as the Initial Preventive Physical Examination (IPPE), this exam includes a basic physical to check height, weight, blood pressure, and vision, an EKG, a review of the patient's potential risk factors for depression and a review of the patient's functional ability and level of safety. The IPPE also covers education, counseling and referral with respect to preventive benefits covered by Medicare.  See http://www.cms.hhs.gov/WelcometoMedicareExam/

H.R. 6331, the Medicare Improvement for Patients and Providers Act of 2008 (MIPPA), was enacted into law on July 15, 2008.  The provisions applying to Medicare Part B coverage take effect January 1, 2009.  Among the many changes to the Medicare Part B program, MIPPA extends the period for an IPPE from six months to one year following initial enrollment in Part B.

Beginning in January 2009, the IPPE will also cover body mass index determination and end-of-life planning with each beneficiary.  End-of-life planning includes verbal (sic) or written information regarding the individual's ability to prepare an advance directive in case an injury or illness causes the individual to be unable to make health care decisions, as well as whether or not the physician is willing to follow the individual's wishes as expressed in such an advance directive.

MIPPA also affects the cost of the IPPE charged to the beneficiary.  Currently, the beneficiary is charged 20% of the Medicare-approved cost of the IPPE once the annual part B deductible ($135 for 2008 and 2009) has been satisfied.  Since the IPPE may be the individual's first service covered under Medicare, it is noteworthy that MIPPA waives the annual deductible for the IPPE.
 

Summary of Changes to IPPE under MIPPA

Expanded Authority to Develop Preventive Benefits

MIPPA also gives the Secretary of Health and Human Services extended discretion to amend national coverage determinations to encompass additional preventive services recommended by the United States Preventive Services Task Force.  Recommendations are based on whether the services are reasonable and necessary for the prevention or early detection of an illness or disability, and are appropriate for individuals entitled to benefits under Medicare Part A and enrolled in Medicare Part B. The Secretary may assess the relationship between the outcomes and the expenditures for a proposed preventive service, and may take into account the results of this analysis when deciding whether to add the proposed service.  All services added by this process will be subject to the education, counseling and referral services available in the IPPE, discussed above.

November 15th Begins Annual Enrollment Period for Medicare, Medicare Advantage and Medicare Drug Plans

The Annual Enrollment Period for enrolling in or changing Medicare Prescription Drug Plans and Medicare Advantage Plans begins November 15.  Plan Finder and Formulary Finder tools are now available at www.medicare.gov.  Every person with a Prescription Drug Plan or a Medicare Advantage plan should compare their current coverage with what their plan is offering for next year, as plans change their coverage packages from one year to the next.  The Plan Finder and Formulary Finder tools allow you to compare several plans at a time.   While premiums are generally going up this year, beneficiaries should evaluate plans on a host of issues, beyond the cost of the premium.  See http://www.medicareadvocacy.org/FAQ_PartD.htm#guidelines for guidelines in choosing a Part D plan. 

Social Security Announces 5.8% Cost of Living Adjustment (COLA) for SSA benefits.

The COLA adjustment applies to retirement, survivors and disability benefits received by over 50 million individuals and to Supplemental Security Income benefits received by more than seven million individuals.  The 2009 Federal Benefit Rate for an individual receiving SSI only is $674/month; for a couple, the benefit rate is $1,011/month.