Health Care Reform and Medicare in 2011by Denise Early on Jan. 18, 2011, under Health
Republicans want to repeal the 2010 Affordable Care Act which impacts a broad range of medical and health insurance issues. Many of the reforms are actually quite popular with the public. Here are some changes that will affect Medicare beneficiaries in 2011.
Medicare will increase payments for primary care services by 10 percent. This increase applies to all fees for services provided by primary care physicians as well as nurses, nurse practitioners, and physician assistants.
Preventive health services, such as vaccinations and cancer screenings, will be covered for people on Original Medicare at no cost to the patient. Also, Medicare beneficiaries can now get a free annual “wellness exam” from their doctors. Note: People enrolled in Medicare Advantage plans have had these preventive and wellness benefits for many years. Medicare seems to have learned from the Medicare Advantage model which encourage seniors to get preventive screenings.
The Part D doughnut hole is being changed in 2011. Anyone who falls into the doughnut hole in 2011 will receive a 50% discount on their brand drugs while they are in the gap. Generics will be discounted by 8%. So a person whose brand drug costs are $500 per month would pay $250 instead. This should provide serious relief to people who take expensive brand drugs.
Medicare Advantage plan payments from Medicare will be frozen at 2010 levels, so 2011 Advantage plans have not seen major changes to benefits. Actual reductions in what Medicare pays Advantage plans will begin in 2012, so we’ll have to wait and see what the plans will look like next year.
In the meantime, the Advantage plans will be working hard to upgrade their customer service so they qualify for bonus payments Medicare will offer to plans that get three or more stars on the Medicare.gov rating system. People enrolled in Medicare Advantage plans can expect more attention from their plan this year, which might be a good thing.