- About Health Care Law
- Our Position
- Key Provisions
- Frequently Asked Questions
- For Individuals and Members
- For Businesses
- For Providers
- Glossary of Key Terms
Frequently Asked Questions Medicare
1. Will my Medicare benefits change?
If you’re a Medicare beneficiary, it’s important for you to know that the health care law doesn’t cut or eliminate any of your Medicare benefits. In fact, the law enhances your benefits in several key areas, and it establishes a new Centers for Medicare & Medicaid Innovation to find new methods of improving services, outcomes, costs, and more.
2. Does the law affect my drug coverage?
The law shrinks and eventually eliminates the coverage gap known as the donut hole for Medicare and Medicare Advantage beneficiaries enrolled in Medicare Part D prescription drug plans. This coverage gap occurred during the period of time when Part D medication costs for a person enrolled in a Medicare Part D prescription plan in a specific calendar year go over $2,830; it continued in that same specific calendar year until your out-of-pocket costs reached $4,550.
By 2020, the donut hole will be eliminated; you will then pay 25 percent of the cost of all your prescription drugs, no matter when you purchase them.
3. Does the law affect Medicare Advantage?
The law cuts reimbursement for Medicare Advantage (MA) plans. Unlike traditional Medicare, MA plans focus on prevention and care coordination to keep members well. Studies show that MA members spent fewer days in the hospital, were readmitted less frequently, and were more likely to avoid hospitalization for common conditions like uncontrolled diabetes.
4. Does the law change my preventive health services?
The health care law makes preventives services more affordable. If you have Medicare, you no longer have to pay any cost-sharing fees, such as copays, for most preventive services required by the CMS. That means you do not pay for routine physical exams, certain cancer screenings (such as breast, prostate, cervical, and colon cancer screenings), bone mass measurements, and more.