May 2, 2011 – Medicare reform continues to be at the forefront of the political debate as efforts to lower the overall cost of healthcare and provide a high level of care remain at issue. Several key changes to Medicare in 2011 are as follows:
Shrinking donut hole. In 2010 a Medicare beneficiary could receive a $250 rebate check if they fell into the “donut hole” of their Part D drug plan. However, this year the donut hole begins after $310 deductible is met, and when the recipient and their Medicare drug plan together have spent a total of $2,830. The gap in coverage lasts until another $3,610 is spent by the beneficiary. In addition, there’s a 50% discount on brand-name prescriptions and a 7% discount on generics during the “donut hole” period. In the following years, the discounts rise until the share of costs is 25% for all drugs in 2020.
Reduced subsidies for Medicare Advantage plans. Beginning this year, the additional payments that have previously been allocated by the government for private Medicare plans will drop over the next 3-7 years.
Eventually, Medicare Advantage plans will receive approximately the same amount per recipient as does original Medicare. The government will provide certain bonus payments to Advantage plans, rendering high-quality care and services.
Greater free preventive care. All recipients of traditional Medicare are authorized for a free annual wellness check-up with no deductibles, co-insurance, or co-pays. It is the first time since the Medicare program was created that Medicare covers an annual wellness exam with a physician involved, at no cost. The new law also provides the recipients first-dollar coverage of preventive service that will include certain cancer screenings such as mammograms and colonoscopies, flu shots and diabetes testing.
Beginning from 1st January, 2011 Medicare beneficiaries began experiencing the benefits of the Affordable Care Act. As HHS Secretary Sebelius stated, a major progress has been achieved since it has been signed by President Obama. ‘Over 2.8 million people have already received Part D donut hole rebate checks. Premiums for those enrolled in Medicare advantage plans will remain virtually the same for 2011 as they were in 2010, even as beneficiaries enjoy the new benefits.’ Furthermore, according to Medicare.gov, qualifying doctors and other healthcare professionals, providing primary care to people on Medicare will get a 10 % bonus for primary care services. This will help ensure that primary care providers can continue to efficiently work for Medicare patients.