Good News for Medicare Advantage Seniors
This spring, the University of Pittsburgh Medical Center (UPMC) threatened to lock out Highmark’s Medicare Advantage customers from its hospitals and clinics starting January 1, 2016, unless Highmark agreed to increase cancer payments to the hospital system as well as drop a lawsuit related to those oncology patients. This dispute would have affected about 182,000 Western Pennsylvania seniors who were at risk of losing in-network to access to UPMC unless they left Highmark in favor of another insurance carrier.
After the UPMC announcement in April, the state intervened by filing a complaint with the Commonwealth Court that said UPMC, in severing the Medicare contract, had violated the 2014 consent decree between the two health giants. During this time, the systems agreed that the “vulnerable populations” would continue to have in-network access to UPMC facilities until a deal could be reached.
In the mean time, Commonwealth Court President Judge Dan Pellegrini granted a motion that UPMC must continue to see Highmark’s Medicare Advantage members on an in-member basis as the two sides worked to resolve the outstanding pricing and billing issues.
In late November, the state Supreme Court ruled 3-2 that seniors with Highmark’s Medicare Advantage plan coverage will continue to have in-network access to UPMC hospitals and doctors. As a result, these individuals will not have to pay higher, out-of-network rates through June 2019, which is when the consent decree between Highmark and UPMC is scheduled to end.
The Supreme Court ruling came just at the end of the open enrollment period for Medicare beneficiaries which ran from October 15 and closed yesterday. During the open enrollment period, Medicare Advantage, whose policies are privately administered versions of the federal plan, could switch plans.
I am pleased by the Supreme Court’s decision and even more relieved that the ruling officially ends the arbitration about the decree that has taken place over the last few months between the health care systems. Our region’s senior population is some of our most vulnerable residents and they should have never been used in the first place as leverage in this complicated and complex financial dispute.
Property Tax/Rent Rebate Reminder
I want to remind everyone the Pennsylvania Department of Revenue is accepting applications for the 2014 Property Tax/Rent Rebate program through the end of the year. If you did not receive an application, or did not apply last year and wish to apply this year, applications can be obtained from any of my district offices and my staff would be happy to assist you in preparing your application. The deadline to submit an application is Dec. 31.
The Property Tax/Rent Rebate program benefits eligible Pennsylvanians age 65 and over; widows and widowers age 50 and over; and people with disabilities age 18 and over. Homeowners with a maximum yearly income of $35,000 and renters with a maximum yearly income of $15,000 are eligible for a rebate. Keep in mind that half of Social Security income is excluded.
Due to program changes enacted last year to ensure claimants aren’t disqualified from rebates solely because of Social Security cost-of-living adjustments, homeowners and renters may be eligible for rebates even if their eligibility income is greater than these limits. Any homeowner who collected Social Security, received a property tax rebate in 2013 for claim year 2012 and had annual income last year, discounting half of Social Security, up to $36,129, is encouraged to apply for a rebate for claim year 2014. Any renter in that same situation with an annual income in 2014, discounting half of Social Security, up to $15,484, is also encouraged to apply.
The Pennsylvania Department of Human Services (DHS) is accepting applications for this season’s Low Income Home Energy Assistance Program (LIHEAP). The program helps low income families pay their heating bills. You can apply and check the status of your application on the state’s COMPASS website. You can also pick up an application in my district offices or download one yourself from the DHS LIHEAP website. Completed paper applications should be returned to one of the Allegheny County Assistance Offices.
Funding for LIHEAP is provided by the federal government and eligibility is based on Federal Poverty Income Guidelines. The income limits for this season are as follows:
|For each additional person add
After your application is received you will receive a written notice explaining your eligibility and the amount of assistance you will receive. Payments are generally sent directly to a utility company or fuel provider and will be credited to your heating account. Crisis grants may also be available if you have an emergency situation and are in jeopardy of losing your heat. For more information, please contact the LIHEAP hotline at 1-866-857-7095.
Open Enrollment at HealthCare.gov
The Pennsylvania Insurance Department is reminding consumers that the open enrollment period for 2016 health insurance coverage is taking place. Open enrollment for 2016 health insurance coverage runs through January 31, 2016. In order to avoid a lapse in current coverage and have a plan effective January 1, 2016, the federal government requires that consumers purchase a plan by Dec. 15, 2015.
Subsidies are available to many consumers who purchase coverage through the federal marketplace at www.healthcare.gov and can off-set the costs consumers face on a monthly basis through their premiums and in some cases help cover some of their out-of-pocket costs. Also, please remember that anyone who can afford health insurance must purchase coverage or they may face a tax penalty from the Internal Revenue Service.
For more information and to purchase insurance, please visit the online federal marketplace at www.healthcare.gov. You may also visit https://localhelp.healthcare.gov/ or click here and enter your zip code to locate a navigator nearby who can help you apply. You can also call 1-800-318-2596 with questions about how to enroll.
Did You Know…
Did you know in 2015, a family of four with an income of approximately $95,000 qualified for a subsidy through the Affordable Care Act?
DEP Launches Redesigned Website
The Pennsylvania Department of Environmental Protection (DEP) has launched an updated website and social media accounts to help make the agency more accessible for citizens. The updated website, www.dep.pa.gov, is user-friendly, easy to navigate, mobile-adaptive and serves as a gateway for the public and the regulated community to get information they need from DEP.
The website is organized into four distinct tabs:
- The “Citizens” tab is a new section devoted to consumer information relevant to Pennsylvanians’ lives.
- The “Businesses” tab holds traditional agency content migrated from DEP’s previous website.
- The “Public Participation” tab has information about public meetings; public comments including the new eComment system; and DEP’s more than 30 advisory committees.
- The “Data & Tools” tab gives users access to dozens of reports and data sheets, including oil and gas compliance reports.
In addition to the updated website, DEP has launched its official presence on social media with Twitter, Facebook, and LinkedIn accounts. You can visit the updated site at www.dep.pa.gov to get started and get links to the social media accounts.
Surplus of Equipment Available for Kids
Variety the Children's Charity strives to enable children with disabilities to live life to the fullest with a focus on mobility, communication, and social interaction and inclusion. Due to the generous support of the Jack Buncher Foundation and other incredible donors, Variety currently has more than 150 adaptive strollers and communication devices currently sponsored and available for eligible children through its “My Stroller” and “My Voice” programs. All equipment is presented on a first-come, first-served basis.
Variety's "My Stroller" program provides adaptive strollers to eligible kids with disabilities. Typically, a family must choose between having a wheelchair or adaptive stroller. So, as a wheelchair is more necessary, an adaptive stroller allows for easier on-the-go mobility and participation in daily activities.
Variety's "My Voice" program provides communication devices to eligible children with a communication disorder to give them a voice at all times.
If you have a child with a disability or know of any children who may benefit from these programs, I encourage you to contact Variety at 724-933-0460 to gather additional information, including eligibility requirements. You may also visit them online at www.varietypittsburgh.org.
Patriotic Holiday Concert
Soldiers & Sailors Memorial Hall & Museum is hosting a free patriotic holiday concert, open to the public, on Sunday, Dec. 13 at 3 p.m. Performing at Soldiers & Sailors will be The Brass Roots, a collection of western Pennsylvania’s finest brass musicians. They will provide a dynamic and entertaining afternoon for guests to enjoy. The Brass Roots serve as the Hall’s Ensemble-In-Residence, regularly performing at galas, Hall of Valor inductions, and the annual Memorial Day Celebration. They will be joined at the concert by The Pine Creek Community Band and the 6th Regiment U.S.C.T. Drum Corps will also be appearing.
The concert is free to the public and doors open at 2 p.m. To order tickets you may visit www.soldiersandsailorshall.org and order them online or order them by phone by calling 412-621-4253. Free parking is available for the concert at the UPMC Open Bigelow Lot across from Soldiers & Sailors.
According to the Greater Pittsburgh Arts Council, the regional impact of nonprofit arts and cultural organizations in western Pennsylvania is an estimated $686 million in spending and $74 million generated in tax revenue.
Offices of State Senator Wayne D. Fontana
|| Brookline District
932 Brookline Blvd.
Pittsburgh, PA 15226
Weekdays – 9 am – 5 pm
543 Main Capitol
Harrisburg, PA 17120
Weekdays – 8:30 am – 5 pm
524 Pine Hollow Road
Weekdays – 10 am – 4 pm
|| Beechview Satellite
1660 Broadway Avenue
Pittsburgh, PA 15216
Tuesdays – 10 am – 4 pm
|Strip District (Mobile Office)
Pittsburgh Public Market
2401 Penn Avenue
Pittsburgh, PA 15222
Thursdays – 10 am – 4 pm
|Northside (Mobile Office)
1230 Federal Street
Pittsburgh, PA 15212
Wednesdays – 10 am – 4 pm