Improving Medicare

10 Comment(s) Posted by Tara Bostock

The health reform debate produced a lot of misinformation about how the health reform bill would change Medicare. Much of it focused on false claims of cuts to benefits, the infamous death panels, or hurting granny. Now that the reform bill has been signed by President Obama, it's time to set the record straight on how reform will really affect Medicare and its beneficiaries.

Closes the "Doughnut Hole": Currently, Medicare's prescription program (Medicare Part D) has a gap in coverage. This gap is commonly referred to as the "doughnut hole." How does the doughnut hole work? Well, say your dad (a Medicare recipient) has several medications that he needs to take every day to keep his blood pressure down, to treat his diabetes, or to relieve pain from arthritis. With Medicare Part D, he pays a deductible and then 25 percent for the cost of these drugs until the total costs of the prescriptions reach a certain level (this payment structure is typical, but some plans charge flat copayments instead of a deductible and 25 percent). Then, he enters the doughnut hole, where he has to pay 100 percent of the cost of his drugs even though he is already paying premiums. Under the current system, your dad would have to pay $3,610 out of pocket before Medicare would cover the costs of his drugs again. The health reform legislation shrinks the doughnut hole over time. In 2010, people in the doughnut hole will receive a $250 rebate, and starting in 2011, they will get a 50 percent discount on brand name drugs and other discounts on generics. These discounts will increase each year until the doughnut hole is eliminated by 2020.

Provides Preventive Services: Preventive services can be expensive through Medicare. But they are extremely important in finding illnesses and conditions and preventing them from getting worse. With health reform, preventive services for those with Medicare will be free. Medicare will also finally cover an annual wellness visit (basically an annual physical), which will encourage beneficiaries to visit their doctors to talk about staying well-instead of just making appointments when they get sick.

Secures Medicare's Future:  Without reform, it was projected that Medicare would have insufficient funds as early as 2017. Reform extends the life of Medicare by nearly 10 years without cutting any of beneficiaries' guaranteed benefits.

So reform actually protects grandma-and grandpa, and mom, and dad-and you too.

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Comments

  1. Diane di Prima's avatar

    Diane di Prima

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    It's wonderful that Medicare will finally include preventive care; and this will save many millions of dollars: by catching conditions early when they are more easily treatable. And I'm happy we'll slowly but surely get rid of the "doughnut hole", which was a big mistake from the beginning.

    [But, I am at a loss as to why this information is written in a way that addresses young people only--as if we seniors were incapable of reading or understanding it (i.e., "your grandma. . . and you too"). I find this insulting.]
  2. shelby's avatar

    shelby

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    A friend who lives in SC can not afford her Beta Serum for Progressive MS. Medicare Part D from what we can read does not have any programs plans that she can afford the co-pay. The cheapest was $ 800.00 a month co-pay for Beta Serum. She must pay her rent, utilities, food and basic supplies before she can pay for medicine.
    Do you know of any programs with/without Medicare Part D that are affordable?? Which Medicare Part D plans she can afford to the pay premiums for her MS medicine?
    Her basic overhead expenses live little for anything and she has no life with Progressive MS going untreated year after year.
  3. shelby's avatar

    shelby

    Permalink
    A friend who lives in SC can not afford her Beta Serum for Progressive MS. Medicare Part D from what we can read does not have any programs plans that she can afford the co-pay. The cheapest was $ 800.00 a month co-pay for Beta Serum. She must pay her rent, utilities, food and basic supplies before she can pay for medicine.
    Do you know of any programs with/without Medicare Part D that are affordable?? Which Medicare Part D plans she can afford to the pay premiums for her MS medicine?
    Her basic overhead expenses leave little for anything and she has no life with Progressive MS going untreated year after year.
  4. Beverly's avatar

    Beverly

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    Medicare will be out of money shortly if they keep paying purveyors who commit fraud on a daily basis. I am speaking of The Scooter Store.
    The attorney General filed a lawsuit against the Scooter Store in 2007...The Scooter Store was to pay the government $4 million and give up millions more in reimbursement for pending claims.
    I recently got Medicare to send me ALL bills paid to The Scooter Store since I got my power chair in 2006.
    The chair and repairs over the 5 years added up to over $17,000.
    I have called Medicare MANY times during this 5 years and asked why they were paying these bills when The Scooter Store should have replaced the chair the first MONTH I had it. But I always got a "whatever" attitude from the phone jockies at Medicare and couldn't get any higher up than their supervisor...no one seemed to care.

    Add up all the people (millions according to their own ads) who own equipment from The Scooter Store and the amount would be staggering.
  5. Missy's avatar

    Missy

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    Stop pushing prescription drugs!!! People need to have access to health education, proper nutrition and the importance of movement. They need to be their own advocates for their needs, dont be afraid to communicate or deny any procedure/drug that is unsettling in ANYWAY to you. Fix the problem don't mask the symptoms, you're only doing yourself harm. If you're on prescription medication, think twice. What kind of insurance plan are you on? HMO? medicare? low income? ... have you been taking prescription medication for a while? coinsidence? think $ and be your best advocate.
  6. Sindy's avatar

    Sindy

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    I was in another country to get treated and told the Dr that I was prescribed to take a strong pain killer drug for a knee problem the Dr was in shock when I told him the drug I was prescribed and said: Are the Dr in you're country he crazy ? This pill is way 2 strong even for a horse !!!
  7. David's avatar

    David

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    I think the reason that this article is directed at younger people, is the fact that my generation is undereducated on about every aspect of domestic and world politics. The fact of the matter is that my generation is going to have to un F*#k everything that needs reform. Most older people already know the topics and are well rounded at them. This is just my opinion I could be wrong.
  8. suzanne disse's avatar

    suzanne disse

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    If a person is in a nursinghome in a private room.when they go on medicare.can they make thek move into a semiprivate room.
  9. me's avatar

    me

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    suzanne disse..... dont use big words bitch
  10. me's avatar

    me

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    suzanne disse..... dont use big words bitch

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