Health Care Reform and Medicare Changes

The Patient Protection and Affordable Care Act, more commonly known as Health Care Reform, was signed into law in March 2010, and will be implemented in phases through 2014. The legislation calls for a comprehensive system of reforms intended to make health care more accessible and affordable for a greater number of Americans.

Medicare will continue to cover your health care costs, just as it always has, and there are no changes in eligibility. If you are in a Medicare Advantage plan, you will continue to receive benefits. However, health care reform includes changes that affect Medicare beneficiaries in a number of ways — some of which are now in effect and some that will be phased in over the next few years.

Medicare Changes already implemented …

In 2010, Medicare beneficiaries who fell into the Medicare Part D prescription drug plan coverage gap (known as the "doughnut hole") received a $250 rebate check.

Starting in 2011, Medicare beneficiaries who fall into the Medicare Part D prescription drug plan coverage gap receive a 50% discount on brand name drugs.

• What you pay for brand name and generic drugs during the coverage gap will decrease each year until it reaches 25% in 2020.
• For some preventive services, you will pay nothing. You may have to pay coinsurance (a part of the cost) for the office visit when you get these services.

Medicare covers all the costs for a one-time, comprehensive "Welcome to Medicare" preventive visit during the first 12 months that you have Part B. Once you’ve had Part B for longer than 12 months, you can get a yearly "wellness" visit to develop or update a personalized plan to prevent disease based on your current health and risk factors.

Strengthening Medicare

Under the Affordable Care Act, the life of the Medicare Trust Fund will be extended to at least 2024 as a result of reducing waste, fraud, and abuse, and slowing cost growth in Medicare. This will provide you with future cost savings on your premiums and coinsurance.

• The health care law makes an historic, 10-year, $350 million investment to prevent, detect, and fight fraud in Medicare, Medicaid, and the Children’s Health Insurance Program. Visit Stop Medicare Fraud to learn more.
• The coordination of care between doctors and the overall quality of care will improve so that you will be less likely to experience preventable and harmful re-admissions to the hospital for the same condition.
• Hospitals will have new, strong incentives to improve your quality of care.
• Every year, you will pay less for your prescription drugs in the doughnut hole until there’s complete coverage of the doughnut hole in 2020. Between now and then, you will get continuous Medicare coverage for your prescription drugs.
• Starting in 2014, the health care law offers additional protections for Medicare Advantage plan members by taking strong steps that limit the amount these plans spend on administrative costs, insurance company profits, and things other than health care.

Source: http://www.healthcare.gov/law/features/65-older/strengthening-medicare/index.html Posted on: July 1, 2010. Accessed: July 19, 2012

For more information on Health Care Reform and Medicare changes…

You can learn more about Health Care Reform and what it means to those on Medicare through the following resources:

• http://healthreform.kff.org/tags/medicare.aspx