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Five Quick Facts about Senior Health Reform

Health Reform, as it has been portrayed in the news, largely forgets to address seniors. That's why we've gathered the five most important facts about health care reform for seniors.

1. The Medicare Donut Hole Fix

The first change seniors may have noticed was a fix for the so-called 'donut hole' of Medicare coverage. In 2010, Medicare enrollees participating in Part D Prescription Coverage received $250 to help pay for prescriptions that fell into a no coverage zone, when drug costs topped $2,830 and were not covered again until the 'catastrophic limit' of $6,440 was reached. The legislation phases out that 'no coverage' zone by 2020, by which time Medicare recipients will only be required to by a 25% copay for all drugs.

2. Free Senior Preventative and Wellness Services

Effective January 2, 2011, Health Care Reform eliminates co-payments and deductibles for annual physicals, mammograms, colonoscopies and other preventive screenings for those participating in Medicare or Medicaid.

Private insurance plans must offer these benefits immediately via new plans, so participants will need to wait until open enrollment to change coverage to gain this benefit.

3. CLASS Long-term Care Program

The CLASS Act program is a voluntary long-term care insurance provision, but those who sign up for it must pay premiums for five years before becoming eligible for benefit payments. Only individuals with jobs, either full-time or part-time, may purchase CLASS insurance. This program is expected to begin in 2011 or 2012, but the premiums are expected to be to somewhat expensive.

4. Strengthening Medicare for Seniors

Many of the reforms that are aimed toward strengthening Medicare will impact Medicare Advantage plans. No matter how you look at it, Medicare needs help; the program is slated to reach the point of insolvency within the next 10 years.

One of the goals of the Affordable Care Act is to strengthen the Medicare Trust Fund by:

• Ending excess subsidies to the private insurers of Medicare Advantage Programs and reducing their profits,
• Reducing waste, abuse and fraud within the system; and
• Coordinating care more efficiently.

5. 2014 is a Pivotal Year for Health Care Reform

The most sweeping changes to health care insurance arrive in 2014, and they include:

• State-run insurance marketplaces called exchanges;
• Tax credits for subsidized coverage; and
• A minimum package of benefits defined by the Federal government.

For seniors, especially, the latter change will be the most important. Of course, the 'devil is in the details,' and you should stay up to date with the changes in Medicare and the health insurance marketplace in general.