See EPIC Improvement,
Eye Care Help For Diabetics
Seniors enrolled in Elderly Pharmaceutical Insurance Coverage (EPIC), the state’s drug discount program, already save some money on their prescription drug costs. Now Democrats in the state senate are proposing a bill to save them even more by putting a cap on their out-of-pocket expenses for prescription drugs.
Bill sponsors include Senators Toby Stavisky (D–Flushing) and Daniel Hevesi (D–Central Queens).
Presently, out-of-pocket expenses paid by seniors under EPIC take from 4 to 7 percent of a member’s annual income, according to Stavisky and Hevesi. Under their legislation, these out-of-pocket expenses will be no more than 5 percent of annual income.
Stavisky said the out-of-pocket expenses cover money spent on EPIC program fees, deductibles and co-payments before the state-contributed benefits.
"Given that many seniors already spend more than 10 percent of their income on prescription drugs," Stavisky pointed out, "this is obviously a crisis in the making—one that is already being felt by far too many people who need expensive medications to maintain and safeguard their health."
Hevesi pointed out, "Right now an individual senior with an income of $35,000 could spend as much as $2,980 in deductibles and co-payments before EPIC pays all prescription drug expenses. Moreover, a couple with an income of $50,000 may very well end up paying over $7,000 in out-of-pocket costs."
Stavisky also said she is opposed to Governor George Pataki’s proposal to cut state reimbursement to pharmacies that participate in the EPIC program. "The plan is extraordinarily short-sighted," she declared. "Why make more seniors eligible for EPIC and then make it harder for them to find participating pharmacies?"
Information and applications for EPIC are available by calling the state’s toll-free EPIC hotline at 1-800-332-3742 or visiting the state Office for the Aging’s web site at www.aging.state.ny.us/nysofa.
PILOT DRUG PROGRAM: Democrats and Republicans in Washington couldn’t seem to get their act together last year to create a program of drug prescription benefits under Medicare. Perhaps thinking it might help to get some movement on the stalemate, the administration of President Bill Clinton just before going out of office moved to establish a three-year pilot project to determine whether prescription drug benefits can help save Medicare money by keeping the elderly healthy and out of the hospital.
The experimental program was announced on Friday, Jan. 19th, by the Department of Health and Human Services. That was a day before President George W. Bush was inaugurated and the term of Clinton ended.
The pilot project will begin July 1st and will include only the retired members of the United Mine Workers of America union. The mine workers’ union was chosen because it had approached government health officials in 1991 about setting up such a program.
HEALTH CARE GUIDE: If you’re in the midst of selecting a health care plan, you should get a copy of the city Department for the Aging’s "A Complete Guide to Health Care Coverage for Older New Yorkers" 2001 edition.
"It’s an indispensable tool for any older person who must decide on a health care plan," DFTA Commissioner Herbert Stupp said. "Choosing a plan that works is often complicated and leaves you thinking that you need to take a college course or two to get it right."
Stupp added, "This guide is a valuable tool that can help seniors pick the plan that fits them best."
The 41-page guide, issued by the DFTA Health Insurance Information Counseling and Assistance Program (HIICAP), is available, free, by calling (212) 442-1111 during business hours, or writing to: New York City Department for the Aging, 2 Lafayette St., 7th Floor, New York, N.Y. 10007.
Specially trained HIICAP volunteers can also answer questions and solve problems in understanding any of the material in the guide. For this type of information, call (212) 442-1000.
HELP FOR DIABETICS: One of the greatest fears of a diabetic is becoming blind. Reports say that diabetics are 25 more times likely to go blind than those without the disease, and that seniors are particularly vulnerable.
The blindness is called diabetic retinopathy, a disorder which slowly destroys the blood vessels at the rear of the eye.
To help Medicare members to avoid becoming victims of this condition, the American Academy of Ophthalmology and the American Optometric Association have joined in an awareness program with the federal Health Care Financing Administration, which runs Medicare.
Under the program, Medicare members who have not had a complete eye exam in three years will be eligible for an examination by an eye specialist who agrees to accept a fee set by Medicare or private insurance in full, waiving any co-payment from the patient.
Diabetics who agree to participate in the program will also receive a year’s worth of care at no additional cost.
To participate in the eye care program, call The National Eye Care Project at 1-800-222-3937 for a referral to an ophthalmologist or the American Optometric Association Diabetics Hotline at 800-262-3947.