By Chuck Smith-Dewey
healthinsurance.org founder
November 11, 2010
Many seniors will get a nice surprise in 2011 – the donut hole in prescription drug coverage left in place during a previous round of Medicare tinkering is starting to be filled in by this year’s historic health care reform. It won’t feel soon enough to seniors, but by 2020, the hole will be eliminated altogether. Less hole, more donut … what’s not to like?
According to a story in the StarTribune of Minneapolis, starting next year, those who hit the donut hole will get half off brand-name drugs and 93 percent off generics. The story calculates that a senior taking six popular drugs will see a 28 percent reduction in costs.
Health reform was demonized by opponents embroiled in a mid-term battle to retake the U.S. House of Representatives. They succeeded, and health reform – or more precisely, unfounded fear and doubt being peddled about health reform – allowed them achieve that goal.
But maybe in this brief respite from campaigning (the 2012 battle for the White House is due to start any minute) everyone should take a second look at the health care bill. We have, and there is plenty to be happy about.
For seniors, in addition to beginning the end of the dreaded “donut hole,” the legislation is projected to extend the viability of the Medicare system at least through 2029. It also includes aggressive measures to drastically cut down on fraud and abuse, and gives seniors new benefits, including preventative care.
For those under Medicare age, reform guarantees access to affordable health insurance to everyone, regardless of pre-existing health conditions. It removes lifetime caps on benefits, so families no longer need to worry about going bankrupt because their coverage is tapped out. It prevents insurance companies from dropping coverage on people when they become sick – a despicable practice known as rescission.
And young people just starting out in the work world can stay on their parents policies until age 26. See a timeline of all changes and when they begin.
Since we’re on the topic of Medicare, folks should remember that the Medicare open enrollment period for 2010 is upon us. If you or someone you know is unhappy with their current Medicare coverage – whether it’s Original Medicare, Medicare Advantage or a prescription drug plan through Medicare Part D – this is the designated time to reevaluate their coverage and even switch plans.
Open enrollment starts November 15 and continues through December 31, 2010.
Tags: donut hole, doughnut hole, health reform, Medicare, medicare advantage, medicare part d, original medicare, prescription drugs, rx costs
Editor's Note: Opinions expressed on these pages are those of the individual author(s) and do not necessarily reflect the views of the management or ownership of healthinsurance.org.
or
Whether you are enrolled in a Medicare Advantage plan, only basic Medicare, or Medicare with a supplement (or gap) plan, there are aspects of Medicare that are hidden and can bite you hard if you don’t pay attention.
Dr. Linda Bergthold has been a health care consultant and researcher for over 25 years. She worked on the Clinton Health Reform plan and was the head of the Obama health care blog team in 2008. She also writes for The Huffington Post on health reform and insurance issues. The arrival of the New Year [...]
Dr. Linda Bergthold has been a health care consultant and researcher for over 25 years. She worked on the Clinton Health Reform plan and was the head of the Obama health care blog team in 2008. She also writes for Huffington Post on health reform and insurance issues. Unless you live in a remote Alaskan village, if [...]
The following is the fifth report from Guest Contributor Glenn Tornell, who’s investigating the “mad, mad, mad, mad Medicare system” as a prospective enrollee and then – with any luck – a beneficiary. His fourth report on Medicare is here. Or read the entire series starting with Part 1. Want the skinny on Medicare Advantage [...]
Here’s a perfect gift for a 65th birthday: a paper shredder. Before you hit that magical Medicare age, you’ll be subjected to a tsunami of birthday greetings from some of your best buddies in the insurance industry. They know where you live and they want your business. Assuming you know the basics of Medicare Part [...]
Overall, out-of-pockets costs have grown steadily for the average Medicare recipient over the years. Medicare spending as a percentage of a person’s income has risen from 11.8 percent in 1998 to 16.2 percent in 2006.