Medicare will undergo some changes in 2011 as part of the Patient Protection and Affordable Care Act that was passed by Congress in March. Details on a few of those changes follow as well as resources outlining the specifics.
“Doughnut hole” coverage gap changes
Many individuals on Medicare’s Part D drug plan fall into the “doughnut hole,” meaning they experience a gap in coverage whereby they must pay for all prescription drugs out of pocket. The doughnut hole kicks in after the individual has met his or her $310 deductible and after he or she and Medicare have together spent $2,830 on drugs. The gap lasts until the individual has spent another $3,610 out of pocket. Beginning in 2011, the coverage gap will be reduced in stages until it is entirely eliminated in 2020. New for 2011, beneficiaries who fall into the coverage gap will be eligible to purchase brand name prescription drugs at a discount of 50 percent and generics at a discount of seven percent.
Free annual wellness visit
In 2011, Medicare beneficiaries are eligible for a free wellness visit with their primary care physician. They will be required to pay no deductible, copay or coinsurance. In addition, some preventive care procedures like a colonoscopy and other colorectal cancer screening will be available free of charge.
Possible pricing changes to private Medicare plans
The government has been paying subsidies to some private Medicare plans. Beginning in 2011, these payments will decrease. As a result, your Medicare Advantage plan provider may adjust the price of its plans accordingly. You’ll want to be sure to closely review the coverage options before participating in open enrollment for the year.
The Health Affairs journal provides a comprehensive list of additional 2011 Medicare changes. Some additional links to Medicare resources follow.
For a comprehensive one stop shop for Medicare information, visit the Official U.S. Government Site for Medicare.