With the new health insurance reforms signed into law under the Patient Protection and Affordable Care Act (PPACA), it is important for seniors to be aware of how this will impact them.
Here are some frequently-asked questions provided by the National Association for Insurance Commissioners and the Centers for Medicare and Medicaid Services to help you understand the changes:
Will my Medicare benefits be cut under the new law?
No. The Patient Protection and Affordable Care Act (PPACA) does not eliminate or reduce benefits provided under Medicare.
I currently have a Medicare Advantage plan. Will I be able to keep it?
Yes. The PPACA does not require individuals to drop their Medicare Advantage coverage. It should be noted, however, that Medicare Advantage plans are not guaranteed renewable. Carriers may pull out of a market at the end of the year, forcing enrollees to change carriers or return to Medicare. The PPACA does cut payments to Medicare Advantage plans, which could result in carriers pulling out of more areas.
My prescription drug costs push me into the "doughnut hole" every year. Will I receive any relief under the new law?
Seniors who reach the gap in prescription drug coverage known as the "doughnut hole" will receive a $250 rebate in 2010. Beginning in 2011, those in the "doughnut hole" will receive a 50 percent discount on prescription drugs and the gap will be phased out until it is eliminated in 2020.
When will the new preventive care improvements begin?
Under the PPACA, all Medicare beneficiaries will receive preventive services without cost-sharing beginning Jan. 1, 2011. In addition, an annual wellness visit to create a personalized prevention plan will now be provided under Medicare.
What changes are being made to Medicare enrollment periods?
The Medicare Part D annual enrollment period, currently spanning from Nov. 15-Dec. 31 each year, will be changed to Oct. 15-Dec. 7 starting in 2011 for plans taking effect in 2012. During this time, beneficiaries can enroll or switch Medicare Advantage plans; they can also change drug plans. Please note: the Part D annual enrollment period remains the same for 2010 Nov. 15-Dec. 31.
The Medicare Advantage open enrollment period will move to Jan. 1-Feb. 14 each year, starting in 2011. Beneficiaries can disenroll from a Medicare Advantage plan and go back to original Medicare during this time, with the option of adding a prescription drug plan. Beneficiaries cannot buy a Medicare Advantage plan or switch to another Medicare Advantage plan during this time.
For those beneficiaries who choose to go back to Original Medicare, the change will take effect the first day of the following month.
The general enrollment period for Medicare Part B is not changing.
I have a Medicare Supplement (Medigap) plan. Must I make any changes to my plan under the new law?
No. The PPACA does not require seniors to change their Medigap coverage. However, the law will be adding cost-sharing requirements to plans C and F that are sold after Jan. 1, 2015.
If you have questions or concerns about Medicare and the new health reform law, call the N.D. Insurance Department at 1-888-575-6611 or visit (www.nd.gov/ndins).
Cindy Sheldon, Bismarck, is director of the N.D. Health Insurance Counseling Program.