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How does the new healthcare law strengthen Medicare?

Dr. Michael Roizen, MD
Internal Medicine

The new healthcare law puts a little power behind Medicare and expands access to health insurance. Here’s a closer look at how Medicare will become stronger:

  • Bye-bye donut hole. The coverage gap known as the donut hole will shrink until it’s gone. The amount you pay after you and your drug plan have reached the limit, will decrease each year until you have complete coverage by the year 2020.
  • Drug discounts. You can receive a 50% discount on brand-name drugs and a 7% discount on generics if you hit the donut hole.
  • Improved care. There is renewed and enthusiastic focus on coordinating and improving your quality of care.
  • Limits on Medicare advantage. Protections have been put in place to make sure Medicare advantage providers spend more on health care and less on administrative costs and non-essential expenses.
  • Crackdown on fraud. More than $350 million has been allocated to identify and prevent fraud. The savings should be passed on to you.

For more information about how the new healthcare law will strengthen Medicare, contact Medicare at 1-800-633-4227 or www.medicare.gov.

The new health care law strengthens Medicare in the following ways:
 
If you have Medicare Part D prescription drug coverage and reach the coverage gap (“doughnut hole”) in 2010, you will automatically receive a $250 rebate check to help pay drug costs. You will not need to request or apply for the payment. Next year, if you reach the doughnut hole, you will receive discounts on your prescription drugs. You’ll get a 50 percent discount on brand-name drugs and a 7 percent discount on generics while you are in the coverage gap. The Part D coverage gap will gradually narrow until it disappears in 2020.The law expands coverage for preventive care. If you have Medicare, you will qualify for a new annual wellness visit, mammograms and other screenings for cancer and diabetes — at no charge. These new benefits start in 2011. Medicare Advantage plans that give better quality care will receive additional bonus payments. Plans are required to use some of this bonus money to offer you added health benefits. New rules will stop Medicare Advantage plans from charging people more than Original Medicare for certain services. These services include chemotherapy administration, renal dialysis and skilled nursing care. These changes start in 2011. Beginning in 2014, Medicare Advantage plans must limit how much they spend each year on administrative costs. This means plans will have to spend more money on benefits and services that improve the quality of care.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.