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About The Oregon state employee news. (Salem, Oregon) 1959-1969 | View Entire Issue (Feb. 1, 1966)
February, 1966 OREGON STATE EMPLOYEE NEWS Social Security Health Insurance (Editor’s Note: The Social Se medical insurance plan provides curity Amendments of 1965 were protection against much of the so extensive that they have been costs of physician’s and other med compared in significance to the ical serv ices. This plan is financed adoption of the original Social Se through a flat monthly premium curity bill of 1935 in the na rate of $3.00 paid by the indi tion’s progress toward achieve vidual participants, age 65 or over, ment of security in old-age. B e and matched by an equal payment cause these changes will directly from the federal government gen or indirectly affect every Ameri eral revenues. Going back to the basic hospital can family, the Oregon State Em ployee News w ill print three brief insurance plan, it provides pro reports on these amendments to tection against the cost of ordinary help OSEA m em bers become fam in-patient hospital services. This iliar with them. The reports were would include sem i-private room prepared by C. I. Flaten, D istrict and board, regular nursing care, Manager of Social Security Ad drugs for the use of the patient in the hospital, and other medical ministration in Salem .)' This coming July nearly 20 m ill supplies which are a necessary ion of the nation’s elderly will part of the patient’s treatment begin participating in a compre while in the hospital. hensive program of government Patient Will Pay health insurance, commonly re The patient will pay for the first ferred to as “ M edicare.” This is a new program for government un- ' $40 of the hospital bill. The rest, dertaking, but the concept of pre for most services normally pro paid health insurance is hardly vided, is fully paid up to 60 days new. Many Oregonians carry such in one spell of illn ess. If the pat a policy either individually or on ient is in the hospital more than 60 days, the insurance pays all but a group b asis. $10 a day for an additional 30 days. (A spell of illn ess is aperiod Government Contracts Medicare w ill be much like this of consecutive days —- beginning commercial insurance. Payment with the first day on which an in to hospitals, nursing homes, hom e- dividual is furnished in-patient health agencies, doctors, and oth hospital serv ices or extended care ers will in m ost cases not be made services and ends with the close directly by the Social Security of the fir st period of 60 consecu Administration, which has the tive days without such services.) over-all responsibility for carry ing out this law. Instead, the gov All Reasonable Costs ernment w ill enter into contracts, on a c o s t b a s is , w ith p r iv a te in t e r m e d ia r ie s who w ill p e r fo r m the day-to-day work of determin ing reasonable costs and reason able charges and making payment in settling claim s. In Oregon, the Aetna Life Insurance Company has been selected as the contractor to pay doctor b ills under the medical insurance program. Two Kinds The new Health Insurance pro gram, which is now a part of the Social Security law, establishes two separate kinds of health in surance protection for alm ost all people age 65 or over — Hospital Insurance and Supplemental Medi cal Insurance for those who choose to take it. Hospital Insurance The basic hospital insurance plan provides protection against most of the costs of hospital and related care. The hospital insur ance part of the program w ill be financed through a separate payroll tax which w ill go into a trust fund that will be kept entirely apart from other funds of the system, and it w ill be shown, as a separ ate item on the employee’s W-2 form. This special tax contribution starts this year at just over o n e- third of one percent each for the employee, his employer, or the self-em ployed. The tax gradually increases until in 1987 and after ward it i s eight-tenths of one per cent each for employee, employer, or the self-em ployed. The Medical Insurance voluntary supplemental F o llo w in g a t l e a s t a t h r e e day hospital stay and when ordered by the doctor, the patient may be transferred to an intensive care facility, a nursing home whichpro- vides m ore than custodial care, for his continued recuperation or treatment. As many as 100 days will be provided in such an in stitution during a spell of illn ess with the plan paying all reasonable costs during the first 20 days and the patient paying $5.00 a day for the additional 80 days. These ser vices in post-hospital extended care facilities are not covered under the program until January 1, 1967. After relea se from a hospital, the patient may be sent home and may have as many as 100 free home health v isits by a visiting nurse, therapist, or other home health worker. Diagnostic studies by a partici pating hospital are also provided by the hospital plan. During a 20 day period of such tests, the pat ient w ill pay the first $20 of the cost and 20 percent of the re mainder. The rest will be paid by Medicare. Doctor B ills A principal benefit to the sub scriber under the medical insur ance plan is the coverage of doctor b ills. All of the services of a surgeon or physician (including a practitioner o f osteopathy) w ill be covered, whether performed in the doctor’s office, the patient’s home, a hospital, nursing home, or what ever. The physician and surgeon fees are not covered under the hos p ital insurance plan. O N G F O R D M O TEL APTS. 1417 S. W . 10th at COLUMBIA PORTLAND (4 blocks to State O ffice Bldg.) REASONABLE RATES BY DAY, WEEK, OR MONTH Pullman Kitchens Free Parking Phone 227-9591 or 223-6603 AAA No Ceiling To Benefits Under the medical plan, the pat ient will be responsible for the first $50 covered charges dur ing the calendar year and for 20 percent of remaining charges. Medicare w ill pay the rest. There is no ceiling to the benefits an individual may receive during a year, no exclusion for “p re-ex ist ing conditions, ” no cancellation of “ p o licies,” except for non-pay ment of premiums. Home Health V isits In addition to coverage of doctor bills, the individual who elects sup plementary benefits will be eligi ble for 100 home health v isits, in addition to those under the basic plan, but with no requirement that he have prior hospitalization. A host of other services and supplies are also provided including x-ray and radium therapy, splints, ban dages, artificial limbs and eyes, rental of durable health equipment, diagnostic studies which need not be performed in a hospital and am bulance when necessary. Some Services Limited Some services are not provided by either plan, or are lim ited. There is a lim it on payment in a psychiatric or tuberculosis hos pital and for out-patient treatment of mental disorders. G lasses and dentures are not paid for. Drugs administered in a hospital or ex tended care facility will be covered under the hospital plan, as w ill t h o s e d r u g s w h ich can n ot h e s e l f - admiriistered under the m edicare p la n . D r u g s o r b io lo g ic a ls which are self-adm inistered will be paid for by the patient. The hospital plan will not pay for a telephone or television in the room, private duty nurse, nor for a private room unless it is necessary for the safety of the patient or the safety of other patients. No services, under either plan, w ill be provided unless certi fied to be necessary by aphysician. 91 Percent Enrolled Practically everyone 65 or over may become enrolled by filing an application with the Social Security Administration. Those who have signed up for monthly social se curity or railroad retirement benefits are already enrolled for basic hospital benefits. These p er sons have also been mailed an enrollment card for the m edical benefits, for which the $3.00 pre mium w ill be deducted from the social security check. At this point more than 71 percent of these have responded, and more than 91 percent have signed up for volun tary medical insurance coverage. Deadline March 31 Everyone, including people who have never worked under social security, who reached 65 before 1966, must enroll by March 31 if they want coverage of doctor b ills in July when the program begins paying for medical serv ices. H they m iss this opportunity, they will have only one other, late in 1967. Coverage then, at an increase in premium, will not begin until July, 1968. D istrict Offices Any reader who knows someone who has not yet signed up should have them get in touch with the nearest Social Security Office for information and assistance. In Oregon the Social Security Admin istration has district offices in Portland, Salem, Eugene, Medford, K la m a th F alls, and LaGrande; branch offices are located in As toria, The Dalles, Coos Bay and Roseburg. For the exact location or tim e of representatives’ v isits in other communities, informa tion may be obtained from any U. S. Post Office. THREE EMPLOYEES AT THE OREGON STATE HOSPITAL line up to sign OSEA's petition calling for a representative election under the new collective bargaining rules adopted by the Civil Service Commission. From left, Vivian Hoeye,' Mae Jackson, Cora Simpson, Evergreen Chapter 28 President Myrtle Jarvis and Vice-President John Mathias. THE THIRD MEETING OF THE OSEA , OEA SPONSORED Public E m p lo y e e s R e tir e m e n t C o n fe re n c e S te e r in g C o m m itte e to o k p la c e in Salem on February 2. Public employer and employee repre sentatives unanimously backed a proposal by OSEA Retirement Director Jerry Liebertz which would greatly improve the PERS. Seated in the background is OSEA Executive Secretary Thomas C. Enright and OEA Executive Secretary Cecil Posey (without coat). Scholarship Contributions (Editor’s Note: The following 23 chapters have made contri butions to the 1966 OSEA Scholarship and Grants-in-Aid Fund as of February 15. Jack Morton, Chairman of the OSEA Scholar ship Committee, has reminded chapters that the deadline foir submitting scholarship contributions to headquarters is April 15.) CHAPTER AMOUNT DISTRICT NO. 1 Mt. Hood 48 Chinook 58 Tualaty 66 Viking 81 $187.12 20.00 25.00 9.10 DISTRICT NO. 2 Marion 18 WiUamette 21 Oregon 22 Shop and Field 38 OCE 43 Motor Vehicle 86 $ 50.00 100.00 100.00 50.00 29.25 100.00 DISTRICT NO. 3 The Caves 83 Siskiyou 84 $ 15.00 25.00 DISTRICT NO. Bend 3 $ 50.00 DISTRICT NO. Round Up 24 EOSH 52 High Noon 92 $ 10.00 10.00 10.00 DISTRICT NO. Eugene 6 The D alles 9 $ 25.00 DISTRICT NO. $ 50.00 DISTRICT NO. Astoria 8 Tillamook 15 Tongue Point 96 $ 25.00 50.00 50.00 DISTRICT NO. 9 Evergreen 28 Fairview 57 $ 50.00 50.00
