What the New Patient Protection and Affordable Care Act Means for Seniors


Have you received the new Medicare brochure, “Medicare and the New Health Law – What it Means to You” in your mailbox yet? If you haven’t, or even if you have, you may be unsure of what it all means.

“One thing that seniors may want to do to help themselves better understand what this means,” suggests says Alan Weinstock, insurance broker with http://www.MedicareSupplementPlans.com, “is to log on to http://www.medicare.gov or call 1-800-MEDICARE to get their questions about Medicare or the Affordable Care Act answered.”

Benefits for Seniors Due to Affordable Care Act

The mailing that is being sent out from the Centers for Medicare and Medicaid Services (CMS) outlines the primary provisions of the Patient Protection and Affordable Care Act. But exactly what does that mean?

Your Medicare benefits are not changing. Whether you have Original Medicare with or without a Medicare supplemental insurance plan or whether you have a Medicare Advantage plan, you can retain the exact insurance plan you have now. The only changes you might see are in new benefits and cost savings. For instance, Medicare beneficiaries who fall into the prescription medication doughnut hole will now see a closing of that gap.

Historically, seniors enrolled in a Medicare Part D Plan had a $ 310 deductible and a 25% coinsurance for prescription drugs until their total prescription medication bill reached $ 2,830. At that point, they had to pay full cost of their prescription medications until their total out-of-pocket spending reached the catastrophic threshold. For 2010 that threshold is $ 6,440. At that point Medicare beneficiaries paid 5% of drug costs for the rest of the year.

Seniors affected by this gap can now look forward to seeing a one-time check for $ 250, if they enter the Part D donut hole and are not eligible for Medicare Extra Help. In addition, starting in 2011, Part D enrollees will be provided discounts of 50% for brand-name drugs during the coverage gap.

Plus Medicare beneficiaries will now have access to free preventive care services such as colorectal cancer screening and mammograms as well as a free annual wellness visit. And by 2018, seniors can expect to save an average of $ 200 per year in premiums and over $ 200 per year in co-insurance compared to what they would have paid without the Affordable Care Act.

Fight Against Medicare Fraud Due to Affordable Care Act

The new law is focused on fighting Medicare care fraud, too. Although the exact amount of money lost to health care fraud is not known, the estimates range from 3% to 10% of all health care expenditures annually. The intent is to eliminate Medicare waste, fraud and abuse thereby extending the life of the Medicare program.
The Affordable Care Act offers new technology and sophisticated data analysis for reducing health care fraud that will build on programs that helped Medicare and Medicaid recover billions of dollars in 2009, according to the government’s annual Health Care Fraud and Abuse Control Program (HCFAC) report.

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