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Tuesday, August 9, 2011

Thank you health reform: How Seniors benefit in 2012

Erin Kelly

Staff Writer

For Medicare beneficiaries, there was a host of good news from the federal government last week.

According to the Centers for Medicare and Medicaid Services (CMS), premiums for prescription drug coverage will not rise in 2012, more seniors are now receiving preventive care thanks to the Affordable Care Act, and beneficiaries who have reached the doughnut hole are receiving a 50% discount on prescription drugs.

For seniors and people with disabilities on Medicare and their families, this is big news!

Currently, as of January 1, 2011, most preventive services covered by Medicaid are offered free of charge. This means that services like colonoscopies, vaccines to prevent pneumonia, diabetes screenings, and mammograms are offered to Medicare beneficiaries at no extra cost to the patient. According to CMS, 17 million Americans on Medicaid have received free preventive services so far this year. You read that right—17 million Americans have received preventive screenings, tests, and services with no co-pay or co-insurance.

And there’s more: Prior to the passage of health reform, beneficiaries who fell into the doughnut hole (a gap in prescription drug coverage) had to pay out of pocket for vital prescription drugs until “catastrophic coverage” kicked in. The Affordable Care Act, however, mandates that Medicare beneficiaries receive financial help when they reach the doughnut hole. Since January 1, 2011, those who reach the doughnut hole receive a 50% manufacturer’s discount on brand name drugs—saving seniors and people with disabilities HALF on their medications. In total, almost 900,000 Medicare beneficiaries have taken advantage of this discount.

And while we’re on the subject, Medicare beneficiaries should be happy to know that in 2012, the average premium they will pay for their prescription drug coverage will actually drop slightly! The average premium for a Medicare Part D prescription drug plan will be a modest $30 a month, down from $30.76 this year.

We’ll let Department of Health and Human Services Secretary Kathleen Sebelius sum it up for us: “The Affordable Care Act is delivering on its promise of better health care for people with Medicare.”

Amen to that.