Standing Up for Seniors, Protecting Medicare
For more than 40 years, Medicare has offered critical health and financial stability for our nation’s seniors. Over 45 million beneficiaries have received Medicare coverage. Many seniors and those with disabilities rely on Medicare to improve their quality of life and I will continue to stand-up for your benefits in Washington. The health care reform law, Affordable Care Act, is intended to strengthen your health benefits and ensure Medicare’s stability for the future.
Health Insurance Reform at a Glance
Strengthening Medicare
This health reform law contains substantial payment and delivery system reforms that reward efficient delivery of quality care and change the incentives in today’s health care system to encourage value instead of simply volume. It makes investments that will enable beneficiaries to continue to access high-quality, affordable care, while encouraging prevention and care coordination for those with chronic conditions. These efforts will help modernize the program and strengthen Medicare’s financial health, protecting both beneficiaries and taxpayers.
More seniors and people with disabilities are seeing lower costs with Medicare - whether through discounts on brand-name drugs or preventative services - because of the health care reforms. Those with Medicare are afforded the opportunity to take charge of their health through the provided benefits, better choices and reduced costs.
More Affordable, Better Quality
Medicare average prescription drug premiums will not increase in 2012. Seniors will have increased access to affordable prescription drugs through Medicare Prescription Drug Coverage (also known as Medicare Part D) and access to Medicare Advantage.
Provides a $250 rebate for any Medicare Part D (prescription drug benefit) enrollee who enters the “donut hole” in 2010
Begins filling the donut hole in Part D in 2011 and closing the donut hole completely by 2020
Drug manufacturers will provide 50 percent discounts on brand-name drugs in the donut hole to reduce costs beginning in 2011. Over 76,000 people in Texas have saved a total of $42 million through July 2011 when they hit the prescription drug donut hole.
Free Preventative Care by eliminating out-of-pocket expenses for preventive services in Medicare. Over 1.3 million people in Texas with Original Medicare have used at least one free preventative service through August 2011.
Requires Medicare Advantage plans to spend at least 85 percent of revenue on medical care
Improving Medicare for Seniors
Making sure low-income individuals have information about their Part D plans
Eliminating cost sharing for certain individuals dually eligible for Medicare and Medicaid
Reducing “churning” of low-income Part D enrollees between drug plans each year
Enhances nursing home transparency and accountability requirements related to resident protection and quality of care
Begins value-based purchasing for hospitals and starts other providers on the path toward value based purchasing.
Making Medicare Last for the Future
Improves payment accuracy to ensure that Medicare pays the right amount for health services
Expands funding and authority to fight waste, fraud and abuse
Eliminates overpayments to private Medicare plans
Extends the Medicare Trust Fund to 2026
Medicare beneficiaries, below are key dates to highlight in 2011
Medicare beneficiaries, below are key dates to highlight in 2011
September 2011 - you will receive a "Medicare and You" 2012 handbook for information on your curent health plan or drug plan about changes to expect in 2012
October 2011 - On October 1, you can compare plans at medicare.gov; October 15 open enrollment begins; you may receive in your mail notices on changes within Medicare for 2012
December 2011 - Open enrollment ends on December 7
