Bristol-Myers was . . . → Read More: Yes, It’s Official… Plavix Goes Generic Today!]]> Bristol-Myers Squibb may have tried everything to block generic Plavix from hitting the market, but it’s over now. As of this week, Bristol-Myers’ patent on Plavix expires, and generic versions of Plavix are set to ship. Wal-Mart and Sam’s Club have already announced that they expect to carry generic Plavix by May 19th.

Bristol-Myers was due to lose its patent protection on Plavix in November of last year, but was able to extend its patent on Plavix in the U.S. for another six months. With four of its top money-making prescription drugs losing their patents over the next five years (schizophrenia drug Abilify, blood pressure medication Avapro and the HIV treatment Sustiva, in addition to Plavix), it is no wonder that Bristol-Myers Squibb was fighting tooth and nail to hold onto its exclusive rights for as long as possible.

But it’s all over now! Brand-name Plavix generally retailed for over $175 for a 30 day supply, so it’s only good news for heart patients!

Have you been looking forward to generic Plavix? Tell us about it in our prescription drug forum!

Medicaid is the country’s largest public payer of long-term care. If you are . . . → Read More: Do We Really Have To Go Broke To Go On Medicaid Long-Term Care?]]> That’s one of the biggest questions we get once folks find out that Medicare doesn’t cover long-term care. Do we really have to go broke to broke in order to get Medicaid assistance for long-term care? Well, the answer is Sort of…

Medicaid is the country’s largest public payer of long-term care. If you are eligible for Medicaid, it will cover nursing home care and other expenses that Medicare does not cover. Medicaid may also cover some home healthcare services.

Medicaid eligibility rules vary by state, so be sure to check the rules in the state where you live. However, generally, if your income is higher than the state’s Medicaid eligibility level, you may still be eligible for Medicaid coverage. In several states, people can qualify for Medicaid after spending their income and assets on nursing home and other health care expenses. This is called Medicaid “spend down.” In addition, some people enter a nursing home as private-pay patients, but become eligible for Medicaid over time because of the high cost of such care. Generally, states let nursing home residents covered by Medicaid keep $2,000 in assets and an income of about $30 per month.

But in The Huffington Post, elder law attorney Ann Margaret Carrozza points out a little-known provision which could save many families from going broke on long-term care:

In an effort to protect the well spouse from complete financial ruin, anti-spousal impoverishment laws were enacted on the federal level in the late 1980s. In 2012, the well spouse (or community spouse) is permitted to retain up to $113,640 in assets while his or her spouse is covered under the Medicaid program. What if an individual has more than this? Enter- Spousal Refusal.

Spousal Refusal laws prevent the Medicaid program from refusing to provide coverage to an eligible individual just because his or her spouse is ‘refusing’ to cover the cost of the necessary care. This is not the end of the story! Each state’s Medicaid law requires an applicant to assign to the program his or her rights to enforce support obligations against all responsible parties including a spouse.

The reality of spousal refusal is very different from the politically motivated sound bites decrying multi-millionaires on Medicaid. If, for example, my husband has a stroke and we apply for Medicaid for him, I may decide to declare spousal refusal in order to protect my nest egg of $300,000. Am I doing this because I am a mean witch? Not necessarily. In every case I see, spousal refusal is declared because the well spouse is sick to her stomach at the very real prospect of hemorrhaging through the couple’s life savings.

Spousal Refusal: I Take Thee In Sickness And In Health, Except…

Spousal refusal isn’t available under every state Medicaid, but if you’re facing the prospect of going broke in order to get Medicaid long-term care for your spouse, it’s certainly worth a try!

Is someone in your family on Medicaid long-term care? Tell us about it in our Medicaid discussion forum!

Well, it looks like our happiness over getting some health insurance money back may have been premature, at least according to the health insurers and their henchmen:

However, . . . → Read More: Will There Really Be $1.3 Billion in Health Insurance Rebates? Maybe Not…]]> We were as excited as anyone when the studies came out saying that health insurers would be returning $1.3 billion in health insurance rebates this year.

Well, it looks like our happiness over getting some health insurance money back may have been premature, at least according to the health insurers and their henchmen:

However, most major health insurance carriers say they will not have to pay any rebates and any rebates that are paid will likely be small, according to Jon Rauser, president of Milwaukee-based The Rauser Agency Inc., a benefits management firm.

“None of the carriers that I have talked to expect to refund a penny,” Rauser said. “At this point the loss ratios are within the targets.”

The insurance market is competitively priced, and any insurer that charges an excessive amount to generate a higher profit would lose business to lower priced competitors, Rauser said. Health insurance companies have skilled actuaries who are able to use statistical analysis to predict the amount of claims that will be paid out to their customers, which helps them hit the payout targets, he said.

Small businesses, which are lumped in by insurers with thousands of other small companies, are the least likely to receive rebates because that grouping creates a large statistical sample for which claims can be accurately predicted, Rauser said. A few large employers may receive rebates, but most rebates will likely go to the individual market, he said. And any rebates will likely be small because if insurance companies miss their targets, it’s unlikely they will have missed by very much, Rauser said.

“The actuaries know what they’re doing, believe me,” he said.

Don’t hold breath for health insurance rebates

We don’t know what the real story is on those health insurance rebates is yet, but you can be sure that we’ll be keeping an eye on this one!

Are you expecting a health insurance rebate this year? Tell us about it in our discussion forum!

How much can you be off? CBS News reported on a . . . → Read More: Have You Saved $240,000 For Your Retirement Medical Expenses?]]> If you’ve wondered how much money you have to save for your medical expenses in retirement, well… it’s probably a lot more than you think. Medical expenses are way, way, WAY outpacing inflation, so unfortunately, chances are pretty good that you haven’t budgeted enough.

How much can you be off? CBS News reported on a new study on the costs of retirement medical expenses, and you may want to sit down for this one:

The projected cost folks are expected to spend on medical expenses in retirement is staggering.

According to a new study by Fidelity Investments, a 65-year-old couple retiring in 2012 is estimated to need about $240,000 to cover medical expenses during their retirement years. And according to the study, households relying on Social Security benefits to cover health care costs should expect medical bills to consume 61% of their Social Security payments by 2027.

For many folks, it doesn’t look like they will be prepared. According to a new survey by LIMRA, nearly half of Americans are not saving for retirement. And 49 percent of Americans responded that they are not contributing to a retirement plan (56 percent of people ages 18 to 34 were in the group not saving for retirement). The survey found that only one-quarter of all Americans and less than one-third of Americans older than age 50 worked with a financial professional to plan for retirement.

Chronically Ill Await Provision of Law

Have you started saving for your retirement? Tell us about it in our discussion forum!

There is a simple reason health care in the United States costs more than it does anywhere else: The prices are higher.

That may sound obvious. But it is, in fact, key to understanding one of the most pressing problems facing our economy. In 2009, Americans spent $7,960 per . . . → Read More: How Much More Does an MRI Cost in American Than Anywhere Else?]]> Something to think about this morning:

There is a simple reason health care in the United States costs more than it does anywhere else: The prices are higher.

That may sound obvious. But it is, in fact, key to understanding one of the most pressing problems facing our economy. In 2009, Americans spent $7,960 per person on health care. Our neighbors in Canada spent $4,808. The Germans spent $4,218. The French, $3,978. If we had the per-person costs of any of those countries, America’s deficits would vanish. Workers would have much more money in their pockets. Our economy would grow more quickly, as our exports would be more competitive.

There are many possible explanations for why Americans pay so much more. It could be that we’re sicker. Or that we go to the doctor more frequently. But health researchers have largely discarded these theories. As Gerard Anderson, Uwe Reinhardt, Peter Hussey and Varduhi Petrosyan put it in the title of their influential 2003 study on international health-care costs, “it’s the prices, stupid.”

Why an MRI costs $1,080 in America and $280 in France

Have you ever traveled outside the U.S. for medical care? Tell us about it in our discussion forum!

The parking . . . → Read More: Remote Area Medical Brings Free Medical, Dental, Vision Care to Tennessee May 19th, 20th]]> Just a reminder to our friends in Tennessee. The Remote Area Medical (RAM) mobile clinic will be visiting the University of the South in Sewanee, Tennessee from May 19-20, providing free medical, dental and vision care to the uninsured, underinsured, unemployed and anyone else who cannot pay for care, both adults and children.

The parking lot will open to patients at midnight before each clinic day. Numbers will be given out around 3:30 a.m. each day. Services begin at 6 a.m. each day – first come, first served.

Services available include:

Dental – Cleanings, fillings, extractions
Vision – Free Eye Exam & Free Eyeglasses (as time and supplies permit)
Medical – General Medical, Women’s Health

If you are interested in receiving free healthcare at the RAM event at the University of the South, plan to get there early. During RAM‘s week-long free healthcare clinic in Los Angeles last year, thousands lined up for days in advance in order to receive free medical treatment. Volunteers were able to treat 7,000 patients, many of whom had lost their jobs and their health insurance in the economic downturn. Supplies like prescription eyeglasses are only available until they run out.

Are you planning on getting free healthcare from RAM this year? Tell us about it in our discussion forum!