More than 600,000 Colorado seniors will get a free wellness visit and preventive care, in addition to solutions to the hated prescription “doughnut hole,” under health care reform act changes arriving Jan. 1, Medicare officials said Friday.
Government agencies and consumer advocates previously touted health reform bonuses for children and working families. Now they’re turning attention to Medicare recipients, with the annual open enrollment period for Medicare plans beginning Monday.
The Affordable Care Act adds a free annual wellness checkup for Medicare users, preventive care without copays, and drug benefits such as 50 percent discounts on brand-name drugs for those stuck in the “doughnut hole” coverage gap.
Seniors currently suffering in that payment gap will save an average of $553 from the changes in 2011, rising to $2,217 in 2020 when the gap is completely closed, according to a study by Health and Human Services released Thursday.
“Because of the new health care law, there’s more in Medicare,” said Dr. Donald Berwick, Centers for Medicare and Medicaid Services administrator.
Medicare patient advocates say the wellness benefits for the first time promote a free sit-down with a doctor, going over everything from family health history to medications to diet or stress levels.
“The wellness visit is a completely new benefit without any cost-sharing associated,” said Ilene Stein, policy counsel at the Medicare Rights Center in New York. With that and new drug benefits, Stein said, seniors “will acutely feel the difference.”
With many employer-based health plans going through open enrollment periods this fall, government and consumer officials previously highlighted insurance changes such as children covered up to age 26, elimination of pre-existing condition roadblocks, and new preventive-care benefits.
Consumer groups now say Medicare seniors need to use open enrollment to review their new benefits and compare local health plans. At the urging of the government and senior advocates, Medicare Advantage and drug Part D providers have streamlined their confusing array of offerings to simplify choices this year.
Seniors have not seen dramatic benefit reductions or cost increases that reform opponents warned about, said A.W. Schnellbacher, on the executive council of AARP Colorado. (Many seniors are in traditional Medicare; others are in privately run plans called Medicare Advantage.)
“The average premium increase is negative 1 percent, and benefits are virtually unchanged,” said Jon Blum, director of the Center for Medicare. Washington officials on the Medicare conference call with reporters did not offer estimates of the new benefits’ total cost to taxpayers.
Medicare Part B premiums, for doctor visits and other non-hospital costs, will stay the same for most beneficiaries in 2011, at $96.40 or $110.50 a month. Those making more than $85,000 a year may see a 4.4 percent increase.
Michael Booth: 303-954-1686 or mbooth@denverpost.com
Get some enrollment pointers
Government officials and consumer advocates encourage all Medicare beneficiaries or their caretakers to carefully review 2011 coverage during the open enrollment period, which begins Monday and lasts through Dec. 31. Each senior on Medicare is sent a fact sheet and handbook describing his or her current policy choices and what the options might be.
Another available resource is Medicare.gov, which has plan finders with local choices for drug and other coverage.
All Medicare recipients also have the right to one- on-one counseling, starting at 800-MEDICARE (800-633-4227).
AARP also offers help in researching and choosing plans, at AARP.org/health.
