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What Does the Healthcare Reform Ruling Mean to You?

Now that healthcare reform has been upheld, a lot of questions about the fate of Medicare and Medicare plans have been answered. Prescription drug coverage has been on the mind of many beneficiaries. The federal subsidies for generic prescriptions for people who lose coverage while in the gap known as the “donut” are still with us. Pharmaceutical manufacturers must provide 50-percent discounts on brand-name prescriptions. Generics are discounted at 14 percent. The CMS says, on average, discounts saved nearly 500,000 people around $545. By last August, 900,000 beneficiaries had received these discounts.

The other very popular healthcare reform that’s been preserved is preventive healthcare with no out-of-pocket costs. The CMS says 20.5 million have already received a free annual wellness visit or some other 100-percent covered preventive service. If you prefer to get your Medicare benefits through an Advantage plan, you’ll get those free services and all of the guaranteed benefits of original Medicare.

Behind the scenes, reform is also improving the care you receive after you leave the hospital. The Community Care Transitions Program’s mission is to improve care coordination so you won’t need to return to the hospital once released. Financial incentives are designed to motivate improvements in care quality, and how well hospitals perform is publicly reported.

While there’s a lot to celebrate, a major problem still lurks in the shadows. When the AARP Public Policy Institute looked at what beneficiaries spend for healthcare, it reported more than four million spent over $8,300 every year. Median spending for those who had Alzheimer’s, cancer or congestive heart failure took about one-fourth of their income. Beneficiaries pay twice as much for healthcare, as a proportion of their total spending, as other Americans do. In 2007, they paid for just over half of their own healthcare.

With good health, Medicare.gov says to expect to spend about $6,800 a year. Health problems drive that up to the worst-case scenario of having a heart attack. That pushes out-of-pocket costs to $10,800 a year. The AARP report noted that 90 percent of beneficiaries have some type of Medicare plan to supplement original Medicare benefits.

We’ll be talking about the future of Medicare plans next Tuesday during a live teleseminar, and we’ll take your questions at that time. You can get the phone number by clicking www.MedigapAdvisors.com/teleseminar.htm. You’ll also definitely want to visit our How to Pay Less Money for Prescription Drugs web page at www.MedigapAdvisors.com/member-benefits-rx.htm. And, you’re welcome to set up a free personal consultation for professional help to compare all of your options at www.MedigapAdvisors.com/instant-quote-med-adv.php.

Jim McFadden has over 11 years of executive-level experience in the health insurance industry, is a youth baseball, softball and football coach, and has one of the worst fantasy football records in the world.

 

 
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