Health Reform for Seniors

SENIORS

Preventive Services: From annual checkups to cancer screenings, many preventive services will be free for those who receive Medicare. No co-pays or deductibles will be required. By fall of 2011, Medicare patients will have access to a comprehensive health risk assessment and a free personalized prevention plan to help them and their doctors continue to focus on wellness instead of just illness.

Prescription Drug Benefits: Currently, Medicare helps pay up to $2,830 a year for drugs. The coverage stops at that level until the bill for drugs reaches $6,440. This design leaves the recipient responsible for all drug costs between $2,830 and $6,440 annually, leaving a “doughnut hole” in the reimbursement scheme. The new law will close this gap for Medicare prescription drug plans by 2020 through a series of reforms, beginning in July 2010. This year, seniors who fall into the “doughnut hole” will receive a $250 rebate from the federal government. In 2011, they will receive a 50 percent discount on brand-name drugs. Also, seniors will receive a 7 percent discount on generic drugs, which will increase 7 percent every year thereafter. About 80,700 Massachusetts seniors will see their prescription drug coverage improve. .

Medicare Advantage: Beginning in 2012, the law reduces overpayments to Medicare Advantage insurance plans by $132 million over 10 years. This change could cause some insurers to reduce some of the benefits they offer – gym memberships, free eyeglasses and other perks. Others may choose to leave this market, which would require some seniors to have to switch coverage. There are about 198,000 Massachusetts residents enrolled in Medicare Advantage. If you are concerned about changes in your coverage, please call the numbers listed at the bottom of this fact sheet for assistance.
For more information:



BPHC Fact Sheet: Health Reform for Seniors






EARLY