If you are enrolled in Tricare Prime at an MTF and live at least 30 minute drive from the MTF you should have received, or will be receiving soon, a letter from the MTF command concerning a travel waiver. If you want to remain enrolled in the MTF you will need to send back a form saying you wish to waive the Tricare Prime distance requirement that all enrollees live within a 30 minute drive of the Primary Care Provider (PCP). If you don’t get a waiver you will need either to be assigned a PCP in the civilian network (if possible), move into the allowed Tricare Prime distance requirement, or disenroll from Prime and start using Tricare Standard/TFL. Only approximately 30% of enrollees who have been sent the waiver letter have replied. If you have received a letter you need to answer it (whatever the answer is). If you have not received one and live at least 30 minutes driving time from your PCP make sure to call your MTF and ask them for one.  [Source: TREA Washington Update 4 Sep 09 ++]

If you have symptoms of a stroke, seek emergency medical care.  Time is of the essence and it is imperative that medical assistance is provided immediately.   Do not ignore the warning signs of a stroke and remember not all of them occur with every stroke.  When you arrive at the hospital make sure you let them know you think you are having a stroke.  If possible, pay attention to the time the symptoms started and let them know that as well.  There is a drug that can save critical brain tissue after a stroke, but it only works well if patients get to the emergency room within a certain period of time. General symptoms of a stroke include:

·         Sudden numbness, paralysis, or weakness in your face, arm, or leg, especially on only one side of your body.

·         New problems with walking or balance.

·         Sudden vision changes.

·         Drooling or slurred speech.

·         New problems speaking or understanding simple statements, or feeling confused.

·         A sudden, severe headache that is different from past headaches.

Symptoms vary depending on whether the stroke is caused by a clot or bleeding. The location of the blood clot or bleeding and the extent of brain damage can also affect symptoms.

·        Symptoms of an ischemic stroke (caused by a clot blocking a blood vessel) usually occur in the side of the body opposite from the side of the brain where the clot occurred. For example, a stroke in the right side of the brain affects the left side of the body. Symptoms occur suddenly, within seconds.

·       Symptoms of a hemorrhagic stroke (caused by bleeding in the brain) can be similar to those of an ischemic stroke but may be distinguished by symptoms relating to higher pressure in the brain, including severe headache, nausea and vomiting, neck stiffness, dizziness, seizures, irritability, confusion, and possibly unconsciousness. Symptoms of a stroke may progress over minutes, hours, or days, often in a stepwise fashion. For example, mild weakness may progress to an inability to move the arm and leg on one side of the body. 
·        When an artery that is narrowed by atherosclerosis becomes blocked, stroke symptoms usually develop gradually over minutes to hours, or (in rare cases) days. If several smaller strokes occur over time, the person may have a more gradual change in walking, balance, thinking, or behavior (multi-infarct dementia). It is not always easy for people to recognize symptoms of a small stroke. They may mistakenly think the symptoms can be attributed to aging, or the symptoms may be confused with those of other conditions that cause similar symptoms.

[Source: Yahoo Health Monica Rhodes article 1 JAN 09 ++]

STROKE Update 05:      Prompt treatment of stroke and medical problems related to stroke, such as high blood sugar and pressure on the brain, may minimize brain damage and improve the chances of survival. Starting a rehabilitation program as soon as possible after a stroke increases your chances of recovering some of the abilities you lost.  Initial treatment for a stroke varies depending on whether it's caused by a blood clot (ischemic) or by bleeding in the brain (hemorrhagic). Before starting treatment, your doctor will use a computed tomography (CT) scan of your head and possibly magnetic resonance imaging (MRI) to diagnose the type of stroke you've had. Further tests may be done to find the location of the clot or bleeding and to assess the amount of brain damage. While treatment options are being determined, your blood pressure and breathing ability will be closely monitored, and you may receive oxygen. Initial treatment focuses on restoring blood flow for an ischemic stroke or controlling bleeding for a hemorrhagic stroke. As with a heart attack, permanent damage from a stroke often occurs within the first few hours. The quicker you receive treatment, the less damage will occur.

Emergency treatment for an ischemic stroke depends on the location and cause of the clot. Measures will be taken to stabilize your vital signs, including giving you medicines.  If your stroke is diagnosed within 3 hours of the start of symptoms, you may be given a clot-dissolving medicine called tissue plasminogen activator (t-PA), which can increase your chances of survival and recovery. But t-PA is not safe for everyone. If you have had a hemorrhagic stroke, use of t-PA would be life-threatening. Your eligibility for t-PA will be quickly assessed in the emergency room.  You may also receive aspirin or aspirin combined with another antiplatelet medicine. But aspirin is not recommended within 24 hours of treatment with t-PA. Other medicines may be given to control blood sugar levels, fever, and seizures. In general, high blood pressure won't be treated immediately unless systolic pressure is over 220 millimeters of mercury (mm Hg) and diastolic is more than 120 mm Hg (220/120, which is also called 220

Initial treatment for hemorrhagic stroke is difficult. Efforts are made to control bleeding, reduce pressure in the brain, and stabilize vital signs, especially blood pressure. There are few medicines available to treat hemorrhagic stroke. In some cases, medicines may be given to control blood pressure, brain swelling, blood sugar levels, fever, and seizures. You will be closely monitored for signs of increased pressure on the brain, such as restlessness, confusion, difficulty following commands, and headache. Other measures will be taken to keep you from straining from excessive coughing, vomiting, or lifting, or straining to pass stool or change position. Surgery generally is not used to control mild to moderate bleeding resulting from a hemorrhagic stroke. But if a large amount of bleeding has occurred and the person is rapidly getting worse, surgery may be needed to remove the blood that has built up inside the brain and to lower pressure inside the head. If the bleeding is due to a ruptured brain aneurysm, surgery to repair the aneurysm may be done. Repair may include using a metal clip to clamp off the aneurysm to prevent renewed bleeding. Another procedure (Endovascular coil embolization) involves inserting a small coil into the aneurysm to block it off. Whether these surgeries can be done depends on the location of the aneurysm and your condition following the stroke.

After emergency treatment for stroke, and when your condition has stabilized, treatment focuses on rehabilitation and preventing another stroke. It will be important to control your risk factors for stroke, such as high blood pressure, atrial fibrillation, high cholesterol, or diabetes. Your doctor will probably want you to take aspirin or other antiplatelet medicines. If you had an ischemic stroke you may need to take anticoagulants to prevent another stroke. You may also need to take medicines, such as statins, to lower high cholesterol or medicines to control your blood pressure. Medicines to lower high blood pressure include Angiotensin-converting enzyme (ACE) inhibitors, Angiotensin II receptor blockers (ARBs), Beta-blockers, Diuretics, and/or Calcium channel blockers. Your doctor may also recommend carotid endarterectomy surgery to remove plaque buildup in the carotid arteries. This procedure is much like coronary angioplasty, which is commonly used to open blocked arteries in the heart. During this procedure, a doctor inserts a metal tube called a stent inside your carotid artery to increase blood flow in areas blocked by plaque. The doctor may use a stent that is coated with medicine to help prevent future blockage.

Early aggressive rehabilitation may allow you to regain some normal functioning. Your rehabilitation will be based on the physical abilities that were lost, your general health before the stroke, and your ability to participate. Rehabilitation begins with helping you resume activities of daily living, such as eating, bathing, and dressing. If you get worse, it may be necessary to move you to a care facility that can meet your needs, especially if your caregiver has his or her own health problems that make it difficult to properly care for you. It is common for caregivers to neglect their own health when they are caring for a loved one who has had a stroke. If your caregiver's health declines, the risk of injury to you and your caregiver may increase. [Source: Yahoo Health Monica Rhodes article 1 JAN 09 ++]

Camp Jejeune Toxic Exposure Update 07: North Carolina's senior U.S. senator introduced a bill 28 JUL calling for the Department of Veterans Affairs to provide health care to veterans and their relatives who were exposed to contaminated water at Camp Jejeune. Sen. Richard Burr's bill, "Caring for Camp Jejeune Veterans Act of 2009 (S.1518)," would grant care at a VA facility to any veteran or family member who was based at Camp Jejune and suffers from adverse health effects. Burr's office did not specify what kind of health problems, only that they are connected to exposure to contaminated water. A Marine Corps spokesman, 1st Lt. Brian Block, said the service would study the bill before making a statement. "As far as pending legislation, it is something we'd be very interested in seeing because anything that impacts our former residents and Marines is very important to us," he said. "Our first concern is taking care of our Marines and their family members." Department of Veterans Affairs spokeswoman Katie Roberts said the VA can't comment on pending legislation. Water was contaminated by dry cleaning solvents and other sources at the base's major family housing areas: Tarawa Terrace and Had not Point. It is impossible to know how many people would qualify, Burr's office said. Health officials believe as many as 1 million people may have been exposed to the toxins trichloroethylene (TCE) or perchloroethylene (PCE) before the wells were closed 22 years ago.

Camp Jejune veterans and their families deserve closure on this tragic situation," Burr said in a statement. He is a member of the Senate Armed Services Committee and is the ranking member of the Veterans Affairs Committee. Jerry Ensminger, a retired Marine master sergeant who lived at the base, applauded the bill. He said veterans from the base are being diagnosed with cancer and the VA is turning down their claim because it is not service connected. "At least this is a start. We haven't had that up to this point," said Ensminger, whose daughter was conceived at Camp Lejeune and died of childhood leukemia in 1985 at age 9. "This legislation is great for providing help to those who need it but it does not by any means exonerate the Department of the Navy and Marine Corps of their culpability on this issue." He would still like to see a hearing on the issue in front of the full Senate Armed Services Committee. It was not immediately clear how the care offered in Burr's bill would be funded. Burr's office said the bill will offer veterans and their families some relief while the problem is studied. "This is kind of a first step in providing the care these folks need," said David Ward, a Burr spokesman.

People who lived at the base have claimed everything from child leukemia to skin lesions and rashes. A report released earlier this month by the National Academy of Sciences said there are severe challenges in trying to connect the contaminants to any birth defects, cancer and many other ailments suffered by people who lived and worked on base. The 341-page report reviewed past studies of the base's water and called into question the value of further studies. Burr's office stressed that the National Research Council report is not the final word on the issue, and he looks forward to seeing the results of the ongoing study of water by the Agency for Toxic Substances and Disease Registry. Burr and Sen. Kay Hagan (D-NC) have also asked the Navy for details about gaps in information. Hagan plans to meet with Navy Secretary Ray Mabus in September, according to her office. Veterans who have not already done so should register on the official Camp Lejeune Historic Drinking Water Registry at https://clnr.hqi.usmc.mil/clwater if they believe there is a possibility they or their family were exposed to the toxins.

Source: AP article 28 Jul 09

On 16 JUL the Veteran Affairs Disability Assistance and Memorial Affairs approved several veterans’ bills. All the bills will now go to the full Veteran Affairs Committee for their consideration. The bills were:

Burn Pit Toxic Emissions Update 10: When epidemiologist Shira Kramer first saw data about some 400 service members who say they were sickened by open-air burn pits in Afghanistan and Iraq, she said she was shocked to see how well their symptoms matched up with symptoms associated with toxic exposure. "I was appalled but not surprised to learn that there were so many serious adverse health effects," she said. "We know open pit burning is very dangerous." Kramer, who has a doctorate in epidemiology and co-authored a textbook about it, was invited by lawyer Elizabeth Burke to research the burn pits to compile evidence for several class-action lawsuits against military contractor KBR. The military typically disposes of waste in burn pits during contingency operations, but KBR took over burn-pit operations for the largest of the pits at Joint Base Balad, Iraq. In a memo dated 20 DEC 06, Air Force Lt. Col. Darrin Curtis, former bioenvironmental flight commander at Balad, said the chemicals to which troops there may have been exposed include: dioxin, the same chemical that made Agent Orange so toxic; benzene, an aircraft fuel known to cause leukemia; arsenic; dichlorofluoromethane, or Freon; carbon monoxide; ethyl benzene; formaldehyde; hydrogen cyanide; nitrogen dioxide; sulfuric acid; and xylene.

     Kramer said the mix of chemicals, and their combination with particulates such as ash and sand, may have made the problem worse. "You have a toxic brew that is...much more dangerous than individual chemicals alone," she said. "The absorption onto particulate matter then allows these chemicals not only to deeply penetrate into the lungs, but also to have a dwell time in the lungs." Air Force officials say the burn pit at Balad has been cleaned up the 90,000 water bottles a day that were being burned are now recycled, and hazardous materials are no longer making their way to the pit. But even if the pit burned only wood and paper, the troops would still be at risk, Kramer said, noting that burning wood produces dioxin. "Uncontrolled, open burning of any of these materials represents a hazard. The symptoms can be signs of acute respiratory problems and blood cancers… Troops stationed near burn pits who began coughing and spitting up black stuff..."plume crud," they call it...should have served as a warning to military officials. The acute effects are a tip-off that something quite troubling is going on. Military data showing that chronic obstructive pulmonary disease cases have risen by 12,000 a year since the wars in Iraq and Afghanistan began are especially troubling. You would not expect to see COPD in a young, healthy population…in this age range," she said. "It's extremely unusual and unexpected."

Source: NavyTimes Kelly Kennedy article 13 Jul 09
 

VA Foreclosed Homes:

The Department of Veterans Affairs (VA) acquires properties as a result of foreclosures on VA-guaranteed and VA-financed loans. These acquired properties are marketed for sale through a property management services contract that was awarded to BAC Home Loan Servicing, LP. Properties are listed for sale at

https://va.reotrans.com/index.cfm?

and through local Multi Listing Systems (MLS) by local listing agents. By clicking a state on the site's map the search will return every property in that state. When you have your list, select view to see price and details of the properties selected. You may then email questions directly to the listing agent that is managing the property. You may also contact the real estate broker of your choice to see the property.

     The VA has re-opened Vendee Financing to purchasers of Vendee eligible VA REO Properties. Vendee financing offers very reasonable down payment requirements, with an interest rate established by the VA based on market conditions. Any prospective purchaser who requests VA financing to purchase a VA-owned property must have sufficient income to meet the loan payments, maintain the property and pay all taxes, insurance, utilities and other obligations, as well as be an acceptable credit risk. The purchaser must also have enough funds remaining for family support. Any purchaser can apply for Vendee Financing. You do not have to be a Veteran. Vendee financing is a loan product offered to help finance the purchase of VA REO Properties for either owner or non-owner occupied properties. It offers low interest rates, 2.25% VA funding fee, no pre-payment penalties, and no appraisal requirement for underwriting. Some of the guidelines for VA Vendee Financing are:

* Seller may contribute up to 6% of the contract sales price to pay for funding fee, closing costs, prepaid and other expenses.

* Vendee mortgages are assumable by qualification.

* Vendee Financing is not a credit score driven product.

* There are two available terms, a 15 and 30 year fixed rate.

* Owner Occupied Purchase can be financed with as little as 0% down. The loan amount may be increased up to 2% to finance closing costs, prepaids or other expenses. Funding fee may not be financed.

* Non-Owner Occupied Purchase can be financed with as little as 5% down. Investors may use 75% of anticipated rent based on appraiser's estimate to offset against the subject property monthly payment. Investors must have experience managing rental properties to include anticipated rent on subject property in underwriting. There is no maximum number of investment properties one can acquire.

     For additional info or for a no cost pre-qualification call (800) 816-4346 to speak with a qualified Vendee Representative.

[Source: http://www.homeloans.va.gov Jul 09 ++]

VA Women Vet Programs Update 06: Citing problems large and small, female veterans say they often feel that the Veterans Affairs Department is not for them. Two days of hearings before the Senate and House Veterans’ Affairs committees revealed a host of hurdles for women seeking benefits and health care from VA. The testimony could be a sign that VA isn’t ready for the flood of women seeking help...and that women aren’t ready to trust VA. A report by the Government Accountability Office, the investigative arm of Congress, says that women often find that not all services are available at all sites, scarce child care makes it hard to keep appointments and privacy isn’t always a priority. And out of 19 VA hospitals and outpatient clinics surveyed in the report, 17 had no sanitary napkins or tampons in their restrooms. Retired Army Capt. Dawn Hal­faker of the Wounded Warrior Pro­ject, wounded in Iraq in 2004, said many female veterans are unaware VA has a women’s health plan or that they are eligible for benefits. Some view VA as being for older veterans...the average male veteran is 61, while the average female vet is 48, and of the 102,000 women who served in Iraq and Afghanistan, almost all are younger than 40.

     Former Marine Capt. Anuradha Bhagwati, executive director of the Service Women’s Action Net­work, called VA treatment for women who have suffered sexual trauma “inconsistent at best.” She said there is a shortage of female doctors and counselors, high turnover of residents and often a “poorly trained, apathetic and unprofessional medical staff.” Getting disability compensation for sexual trauma also can be difficult because there are rarely official records to back up such claims, she said. VA health and benefits officials said they expect a 30% increase in the next five years in women seeking VA services. “We recognize more needs to be accomplished,” said Dr. Lawrence Deyton, the VA’s chief public health officer. Some of the problems faced by women in the VA health care system that were cited at the 16 JUL hearing were:

* Some gynecological exam tables in rooms with no privacy curtains face doors that open to waiting rooms or busy hallways.

* A female Iraq veteran in an inpatient psychiatric ward was forced to share a bathroom with male veterans, including one who was a Peeping Tom.

* A female veteran receiving an annual pap smear from a male gynecologist says she asked to have a female staff member present, at which point the doctor left the room and yelled down the hall, “We’ve got another one!”

* Clinic hours for women are often less than for men, with no evening or weekend hours convenient for those who work.

* On-site child care is rarely available, and some clinics refuse to treat women who bring children with them.

[Source: NavyTimes Rick Maze article 27 Jul 09 ++]

Chapter 61 Disability Pay Update 05: This information is based on the H.R.2990 proposed legislation at this point. Everything is subject to change until the draft is signed into law. Based on conversations with potentially affected military members, it helps to start with a few ground rules to make this program easier to understand:

     First, forget all you know about your Service pay and concurrent receipt AKA Concurrent Retirement and Disability Pay (CRDP). If you start with a clean slate it’s easier to comprehend. The barracks lawyers are putting out misinformation.

Next, you have to understand the definition of CRDP. This is critical. CRDP only restores Service pay based on your service time. That’s all it has ever restored. It does not restore Service disability pay. The law prohibiting two disability checks is still in force.

Third. Your Chapter 61 Service pay, for CRDP purposes, has two components. Part disability pay and part Service longevity pay; the part based on your years of service. The part based on your service time is figured like any retiree’s retired pay; 2.5% times years of service.

Fourth. Depending on your personal situation under this proposal you may already be getting what CRDP would provide you (in other words, you get nothing extra, no CRDP) or you may get something extra.

Based on the above and the proposed bill here are some examples of how it would impact vets:

*

Example 1
Member with 3 years of service, Service disability rating of 60%, and VA rating of 80%.
Service pay based on $1800 base pay per month at retirement.
60% Service rating provides disability retirement of $1080 ($1800 x 60%).
80% VA rating pays $1400 a month.
Currently, member’s entire Service pay docked due to VA comp at a greater amount.
Under CRDP the member will receive retired pay for years served.
3 years multiplied by a 2.5 percent is 7.5%.
7.5% times the $1800 base pay is $135 a month in retired pay for years served.
Member will get VA comp of $1400 plus $135 Service pay (CRDP).

*

Example 2
Member with 10 years of service, 90% Service rating, and 90% VA rating.
Base pay of $6500.
$6500 base pay at 90% Service rating equals $5850.
VA comp at 90% $1600.
Member is receiving $1600 from VA and $4250 from Service ($5850 – $1600).
Under CRDP there is no change—no CRDP payment since you already receive all of your Service longevity retired pay.
10 years of service times 2.5% equals 25% of base pay or $1625; this is the only amount CRDP restores.
You’re receiving Service pay of $4250 so the VA comp is only docking your Service disability pay and by law the CRDP proposal doesn’t change that.

*

Example 3
Member with 18 years’ service, Service rating 50%, and VA rating 90%.
Base pay $4500 a month.
50% Service rating times base pay equals $2250.
VA comp at 90% is $1600.
Member receiving $650 from Service (2250 – 1600) and $1600 from VA.
Under CRDP you have to calculate Service longevity retired pay of 18 years times 2.5% for 45% times $4500 equals $2025. CRDP ensures the member receives this amount due to his vested service time.
Member is owed $2025 from the Service (CRDP) AND $1600 from the VA.
Finally, please keep in mind, everyone with less than 90% VA rating will be phased in over time. You will see your CRDP later. See our MOAA Legislative Update for the proposed phase in schedule.

[Source: MOAA News Exchange 15 Jul 09 ++]

GI Bill Update 52: On 6 JUL VA under Secretary for Benefits Patrick Dunne and Education Service Director Keith Wilson outlined their ongoing efforts to ensure a successful rollout of the Post-9/11 GI Bill on August. They said the VA is on track to issue the first checks for student-veterans and active duty participants on 3 AUG. Demand for VA "certificates of eligibility" has been heavy. As of early July, 98,000 applicants had submitted on-line applications. VA has issued 65,000 certificates and reports no problems resolving any application discrepancies. Also beginning this week, colleges and universities have been asked to submit student enrollment certifications to assure the VA that veterans had been approved to take college coursework this coming semester on their campuses. Under the Post-9/11 GI Bill, the VA reimburses colleges directly for tuition and fees for a full semester's coursework based on the highest in-state public college or university costs. The VA pays student-veterans a monthly housing stipend set at the DoD housing rate for an E-5 with dependents at the school's zip code, plus an annual book stipend of $1,000 for full-time study. Full-time distance (on-line) students are ineligible for the housing stipend.

     The VA has accepted over 3,400 agreements from private colleges and universities and some public colleges under the Yellow Ribbon program. Yellow Ribbon schools agree to cover up to half the difference between the cost of attending a public college and the participating private school. The VA matches the amount pledged by the school. Veterans who withdraw from college may have to pay back some or all of their Post-9/11 GI Bill benefits, depending on the circumstances involved. The VA will use existing procedures to make recoupment determinations. MOAA recommends that service members who are entitled to Montgomery GI Bill (MGIB) benefits carefully review their situation before making an irrevocable election for the Post-9/11 GI Bill. For example, a MGIB participant who has used up a portion of MGIB entitlement might be better off sticking with that program and then converting to the Post-9/11 GI Bill after exhausting MGIB benefits. ‘Dual eligibility’ rules limit total entitlement to 48 months’ of benefits. But MGIB participants lose their remaining MGIB entitlement if they make an election for the new program.

[Source: MOAA Leg Up 10 Jul 09 ++]

Prostate Cancer Update 11: British doctors have developed a third way to treat prostate cancer that takes a middle road between radical treatment and watchful waiting. The procedure, which uses ultrasound to “melt” tumors, is said to be just as effective as radiotherapy or surgery but has a lower risk of causing incontinence, impotence, diarrhea, bleeding, and other side effects. The new technique is called high-intensity focused ultrasound, and men treated with it can be released from the hospital within several hours instead of several days, which is typical with surgery. The technique kills cancer cells by heating them to temperatures from 176 degrees to 194 degrees, which researchers at University College Hospital say can be tolerated by surrounding healthy tissue and also by nerves involved in sexual function. In the initial group of 172 men who took part in the trial, 159 were free of cancer one year later. This rate of cure is virtually the same as the cure rate following surgery and radiotherapy for early prostate cancer. The big difference between the ultrasound technique, surgery, and radiotherapy according to the findings of the study lies in improvement in side effects.

     Only one of the 172 ultrasound patients became incontinent, none had bowel problems, and impotence was at a much-reduced rate of 30 percent to 40 percent. The usual rate for incontinence following surgery and radiotherapy is between 5 percent and 20 percent, and the impotence rate is usually 50 percent. When men are treated with radiotherapy, they also can expect bleeding and diarrhea. Lead researcher Dr. Hashim Ahmed said, “Men are being diagnosed earlier with prostate cancer because of increasing awareness with many patients in their fifties and sixties now. It means we are treating them more successfully, but the side effects are a big issue. Having to wear pads because of incontinence is not very nice and neither is sexual dysfunction, as a lot of these patients are still sexually active." The study suggests that high-intensity focused ultrasound some day might help treat men with early prostate cancer with fewer side effects. According to the most recent figures from the Centers for Disease Control, 185,895 men in the United States developed prostate cancer in 2005, and 28,905 died from it. Statistics show that one in six men will develop it at some point in their lifetime. [Source: Newswatch.com Health Alert 18 Jul 09 ++]

Medicare Rates 2010: Medicare costs are expected to continue to escalate in 2010, but seniors won’t be getting any comparable increase in their annual cost-of-living adjustments (COLAs), government economists say. The Social Security Trustees recently forecast that there would be no COLA in 2010 and 2011 because of extremely low inflation. Due to a special “hold harmless” provision of law, the government estimates that about 30 million Medicare beneficiaries will have no change in their Medicare Part B premium, which is automatically deducted from most people’s Social Security benefits. The little-known provision protects the Social Security benefits of most seniors when the Part B premium increases more than a person’s COLA. If there is no COLA increase in 2010, then there is no Part B premium increase for beneficiaries protected by the hold harmless provision.

     The hold harmless protection, however, does not cover about one-quarter of Part B enrollees, and does not apply at all to Part C Medicare Advantage or Part D plan premiums. The senior citizens League (TSCL) estimates that more than 6.8 million Social Security beneficiaries, about one in every seven, could see their Social Security checks (or direct deposits) reduced next year. If individuals have Medicare Advantage or drug plan premiums automatically deducted from their Social Security and the premium increases, then their benefits will be reduced to cover those rising costs. In addition millions of other seniors pay their plans directly. They would also have to pay a bigger portion of their Social Security to cover rising costs and would have less to live on. Medicare Trustees estimate that basic Part B premiums will rise by about $7.80 per month in 2010 (from $96.40 to $104.20), and would jump to $120.20 by 2011 for seniors subject to the increase. Nationwide Part D premiums climbed about 24% on average in 2009 for most beneficiaries, and have increased about 10% per year, on average, since 2006.

[Source: TSCL Social Security and Medicare Advisor, Vol. 14, No. 6 dtd 27 Jul 09 ++]

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