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Individuals and businesses will start to see changes in health coverage in the coming months as a result of the health care reform law enacted earlier in 2010.
The bill is expected to help 32 million uninsured Americans get coverage, and for the first time most people will be required to purchase insurance and face penalties if they refuse.
Reforms will be phased in over time with the full bill in force by 2014.
But a federal lawsuit by 20 states could end with some provisions of the bill (namely the insurance purchase mandate and an expansion of Medicaid eligibility) being found unconstitutional. And a number of Republican candidates for the House and Senate have said they'll repeal the law if elected and if Republicans can win a majority in Congress.
Even some proponents of the law weren't fully satisfied with the outcome and have said they will keep working on issues like equalizing Medicare reimbursement rates among the states.
Here's an overview of some of the key changes related to preventative care and senior’s coverage:
A lengthy list of preventive care services will be provided with zero out-of-pocket expenses starting after Sept. 23, 2010 for people on new employer-sponsored plans and Jan. 1, 2011 for people buying individual insurance.
Preventive services include screenings for high blood pressure, diabetes, obesity, depression, HIV, high cholesterol and some kinds of cancer.
Colorectal cancer screenings for adults over 50 will be covered, as will mammograms for women over 40 and cervical cancer screenings for women.
Pregnant women will receive support with breast feeding and folic acid supplements.
Preventive medicine such as aspirin therapy and immunizations will be covered at no cost.
For children, services such as autism and developmental screenings, hearing and vision screenings and alcohol and drug use assessments for adolescents will be covered.
Now, in regard to senior care, there has been a lot of misinformation about Medicare. The bill explicitly says there will be no cuts to guaranteed benefits. The bill actually extends the solvency of the Medicare trust fund over a decade.
The coverage of preventive screenings as an improvement will ensure people are healthier when they come onto Medicare, thereby reducing costs in the long run.
The new law adds the benefit of covering annual screenings for Medicare patients. Now, only the first wellness screening a patient gets is covered. The law also phases out the Medicare Part D coverage gap known as the "doughnut hole" which has left some seniors struggling to pay prescription drug costs.
Part D participants who fall into the hole in 2010 will get a $250 rebate check. And starting in 2011, they'll get a 50 percent discount from drug manufacturers on the cost of brand name drugs. By 2020, the gap will be phased out altogether.
Seniors to be wary of scammers who claim they can help seniors get their rebate checks. Seniors do not need to do anything to get that check. It's automatic.
One thing the law won't do is address disparities in Medicare reimbursement rates from state to state that are causing doctors in to stop taking Medicare patients.
This is an ongoing political debate. This doesn't make it worse but it doesn't solve it. Also, the bill provides for a study of Medicare reimbursement disparities.
Sources:
http://www.thenewstribune.com
MC Ortega is the former publicist for the late Walter Payton, Coca-Cola and Dunkin’ Donuts. Ortega is a senior communications and messaging executive specializing in media relations, social media, program development and crisis communications. Also, Ortega is an avid traveler and international shopper. Ortega resides with her partner, Craig, dog, Fionne and extensive shoe collection. Ortega also enjoys jewelry design/production and flamenco dancing.
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