New Year rings in health care gains

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Beginning on January 1, 2011, beneficiaries of the Medicare Part D program who enter the coverage gap known as the “doughnut hole” can get a 50 percent discount on eligible brand-name drugs. This improvement to the Medicare prescription drug program is an important provision of the Affordable Care Act and another important step toward the Act’s ultimate goal of closing the coverage gap, according to Families USA.

Other major changes to the nation’s health care system go into effect on Jan. 1. Large-group insurers will now be required to spend 85 percent—and small group insurers 80 percent—of their premium dollars on medical care and quality care improvements.

“Over the past year, the Affordable Care Act has brought improvements in health care to all Americans, and these remarkable changes will grow in 2011,” said Ron Pollack, executive director of Families USA.

In addition to the discount drug benefit in the doughnut hole, Medicare beneficiaries will also be able to obtain cost-free preventive services. This means that Medicare beneficiaries will no longer have to pay a deductible or any copayments for services like mammographies, prostate screenings, colorectal cancer screenings, or bone mass measurements. Medicare beneficiaries can now also get a free annual check-up and personal health evaluation from their personal doctors.

To help expand the availability of Medicare, the program will now provide a 10 percent bonus for primary care services, and it will also give 10 percent bonus payments to surgeons practicing in health professional shortage areas.

“The start of a new year is a cause for celebration for many, but every American and especially people in Medicare, can rejoice at these continued improvements in the quality and affordability of their health care,” Pollack said.

Families USA is the national organization for health care consumers. It is a nonprofit, nonpartisan organization that advocates for high-quality, affordable health care for all Americans.

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