News & Events
News
Senior PharmAssist and Executive Director Gina Upchurch are the cover story in the August issue of Pharmacy Today, a national journal of the American Pharmacists Association that highlights medication therapy management models. You can read this profile online by going to the home page of Pharmacy Today and clicking on the cover of the latest issue featuring a picture of Gina. The home page also includes a link to a short podcast of Gina being interviewed.
Our 10-page Summer/Fall Newsletter plus FY10 Annual Report will be in your mailbox soon (if you're on our mailing list), but you can read them both now by clicking 2010 Summer/Fall Issue and FY 2010 Annual Report. If you would like to be added to our mailing list please contact Joe Daly at (919) 956-5812 or joe@seniorpharmassist.org.
As of July 1st, Senior PharmAssist is the only coordinating site in Durham County for the state Seniors' Health Insurance Information Program (SHIIP). This means we're collaborating with state officials to train staff and volunteer counselors so they can help Durham County residents understand the basics of Medicare, and also help individuals review Medicare Supplemental Insurance and Medicare Advantage plans, if they're interested in doing so.
NC SHIIP is a division of the state Department of Insurance and offers free, unbiased counseling to North Carolina residents regarding Medicare and other health insurance coverage. Senior PharmAssist has worked closely with the state SHIIP office - since the inception of Medicare Part D in 2006 - to provide sound advice to Durham residents regarding Medicare-approved drug benefits and related governmental subsidies. Last year, at the request of NC SHIIP, our program became a coordinating site that would deal solely with drug coverage issues.
Until recently, we had referred most other insurance questions from older adults to SHIIP coordinators at other local agencies. When it became clear there would no longer be a site in Durham to manage these services, Senior PharmAssist stepped up to the plate - in part, because we know of too many seniors who have enrolled in insurance coverage they don't understand and often cannot use.
As we ramp up to provide these new services, we look forward to helping individuals make informed decisions about Medicare - beyond Part D - and related healthcare coverage.
While the changes enacted by healthcare reform legislation will roll out over the next several years, some significant developments can be expected this year and early in 2011. And many of these changes will benefit seniors. This year, Medicare Part D enrollees who land in the coverage gap (doughnut hole) and do not qualify for the federal Low-Income Subsidy or Medicaid will receive a $250 rebate check from the U.S. Department of Health and Human Services. A word of caution: If you qualify for this one-time rebate, a check should come to you automatically - approximately 45 days after you reach the coverage gap. BE ON THE ALERT for anyone who calls or shows up at your door requesting personal information like your social security number to "certify your eligibility."
Starting next year, Medicare beneficiaries will receive a 50% discount on brand-name medications and a 7% discount on generics covered by their Part D plan - while in the coverage gap. Over the next decade, these discounts will gradually increase until by 2020, beneficiaries' co-insurance rate in the gap will be 25%. This means that after their annual deductible is met, individuals will pay 25% of the cost of their covered drugs until and if they reach catastrophic coverage, at which point they would owe 5%.
Beginning in 2011, Medicare will place greater emphasis on preventive care by paying 100% for annual wellness visits, as well as colon, prostate, and breast cancer screening. Next year will also mark the advent of significant changes affecting Medicare Advantage plans. Senior PharmAssist will continue to help older adults and younger Medicare beneficiaries in Durham County navigate the shifting Medicare currents.
At the state level, North Carolina has begun to examine how it should best implement healthcare reform, and Senior PharmAssist Executive Director Gina Upchurch has joined that effort by participating in a "New Models of Care" workgroup. This committee and seven others are looking to identify how our state can maximize new opportunities to improve health, access to care, and healthcare quality. We hope that Senior PharmAssist's experience can add value to the conversation of how to provide optimum healthcare in North Carolina.
Senior PharmAssist was featured in an article in the March 23rd issue of USA Today. You can read that piece, which focuses on medication therapy management (MTM), by going to the website of either USA Today or Kaiser Health News. The story highlights the experiences of two of our participants who have benefited from MTM but more broadly examines how Medicare has recently toughened rules requiring private insurance companies that provide Medicare drug benefits to enroll some beneficiaries in MTM services. Senior PharmAssist Executive Director Gina Upchurch and other healthcare professionals lend their perspectives to the article, which we think you'll find interesting.
Durham residents drowning in Medicare's "alphabet soup" received a helping hand recently courtesy of a guest column in The Herald-Sun written by Senior PharmAssist Executive Director Gina Upchurch. Gina provided readers with a basic framework for understanding Medicare and reminded folks about some of the many resources available in Durham County to help guide them. You can link to that column by clicking here.
Events
Save the Date Durham Pharmacists and Pharmacy Technicians! On Tuesday, Oct. 26, 2010, from 5:30 to 8 p.m., Senior PharmAssist will host a continuing education session to help prepare you for Medicare Part D in 2011. Senior PharmAssist Executive Director Gina Upchurch will lead this training, which costs $25 (including dinner) and is worth two credit hours. Those attending will cover the following: Part D changes for 2011; up-to-date overviews of state initiatives NCRx and ChecKmeds NC; the latest on E1 queries, POS enrollment, and the "first fill" policy from CMS; Medicare Advantage products and how they can impact Medicare drug benefits; and information about local, statewide, and federal resources that can help with Medicare Part D, including NC SHIIP (Seniors' Health Insurance Information Program).
To reserve your spot, contact Executive Assistant Lesley Williams before Oct. 15th at lesley@seniorpharmassist.org or by calling (919) 682-4962. More details will be posted here as the event draws nearer.
Senior PharmAssist hosts quarterly meetings of the Durham Medicare Rx Network. In addition to our program, this partnership of front-line providers includes local SHIIP workers at the Council for Senior Citizens and the Durham Cooperative Extension, staff at the Durham Center, the Department of Social Services, the local Social Security office, Lincoln Community Health Center, discharge planners and social workers at the local hospitals, and others.
The group's next meeting is Thursday, Aug. 19th, from noon to 1:30 p.m. We will be reviewing Medicare, Medicare Advantage, the practical implications of healthcare reform on Medicare, and the new drug plan finder tool website. Barry Mowbray with the NC SHIIP program will lead our discussion. Lunch will be provided if you RSVP to Senior PharmAssist Executive Assistant Lesley Williams by Tuesday, Aug. 17th, at noon. To reserve your space or learn more, please contact Lesley at (919) 682-4962 or lesley@seniorpharmassist.org.