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Health Care Reform—How It Affects Older Adults

The new health care reform laws will affect many Americans, and will grant 32 million citizens access to health insurance.  Many of the details are still being worked out, but the new laws are geared towards helping Medicare remain financially solvent for the next decade, while reducing the US deficit by an estimated $143 Billion.  That sounds promising, but how will it really affect your older loved ones? 

The new law guarantees that existing benefits, whether through traditional Medicare or a Medicare Advantage plan, will not be affected.  Eligibility requirements will remain the same.  Beginning in 2011 additional coverage will be available for many preventative services that were not previously part of the plans.

Immediately some older adults will start benefiting from the new law, as those who receive drug coverage through Medicare will be issued a $250 refund if they enter the coverage gap, or “donut hole,” at any time during the year.  This excludes individuals who receive Medicare Extra Help with their part D costs.  Next year, those individuals entering the coverage gap will receive a 50% discount for Medicare-covered name brand prescriptions.  They are working towards completely eliminating the coverage gap by 2020, and over the course of the next 10 years individuals who are affected will continue to see increased savings until that goal has been reached. 

Another positive aspect of the new law is that it increases the number of Medicare providers.  There will be more primary physicians, nurses, and nurses assistants available to beneficiaries, increasing overall access to the benefits for everyone.  As an incentive, the law will include bonus opportunities, student loan forgiveness plans, and expanded training programs for health care providers accepting Medicare. 

Hopefully, over time we will see many other positive changes for older adults receiving Medicare benefits.  However, monthly premiums for both part B and part D will likely increase for some individuals.  For the first time, people with higher incomes may have to pay higher premiums for this coverage. 

There are positive changes for others affected by the new law as well.  Individuals with pre-existing conditions will be granted access to more affordable health care immediately.  Insurance companies will not be able to deny coverage to children with a pre-existing condition beginning in September, and to people of all ages with a pre-existing condition beginning in 2014. Young adults will be able to remain under their parents’ health care coverage up to the age of 26.  And the new laws should help cut down on fraudulent spending, payment errors, and system abuse. 

This information was obtained from the Center for Medicare and Medicaid Services.  If you would like additional information please contact your ElderCare Specialist or visit the www.medicare.gov section on Health Care Reform. 

The compassionate staff at St. Andrew’s Senior Solutions serves and supports older adults and their families by providing respite care, care management, and nursing services. For more information please contact our care manager at 314-726-5766 or kspencer@standrews1.co.