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I have Medicare coverage

Will the new law cut my Medicare benefits?
No. Nothing in the Affordable Care Act cuts Medicare benefits.

Does the Affordable Care Act fix the automatic physician payment reductions in Medicare?
No. The law does not address these reductions. The law does provide bonus payments to primary care physicians in underserved areas and increases payments to rural health care providers.

Will I be able to keep my Medicare Advantage plan?
Yes. However, government payments to Medicare Advantage, the private-plan part of Medicare, will be frozen starting in 2011 and cut in the following years. Beginning in 2012, plans with high quality ratings will receive bonus payments. Beginning in 2011 Medicare Advantage plans cannot have higher cost-sharing requirements than regular Medicare for chemotherapy, renal dialysis, skilled nursing care, and other services to be determined. In 2014, Medicare Advantage plans will have to spend at least 85% of federal payments and premium dollars on medical services, limiting the amount that they can spend on administrative expenses, including profits. It is unclear at this time what decisions the plans may make in response to these changes.

How does health reform impact preventive care under Medicare?
Beginning on January 1, 2011, Medicare beneficiaries will no longer have to pay any costs for Medicare-covered preventive services that are rated A or B by the U.S. Preventive Services Task Force. To learn which services are rated A or B by this task force, look at this website: http://www.ahrq.gov/clinic/uspstf/uspsabrecs.htm. Also in 2011 Medicare will begin covering a free annual comprehensive wellness visit and personalized prevention plan. Additionally, the Medicare deductible for colorectal cancer screening tests will be waived.

How does health reform impact the Medicare drug benefit and the doughnut hole?
The Medicare prescription-drug benefit will be improved substantially. This year, seniors who enter the Part D coverage gap, known as the “doughnut hole,” will get $250 to help pay for their medications. Beginning in 2011, drug companies will be required to give a 50% discount on brand-name drugs for prescriptions filled in the doughnut hole. Also beginning in 2011, a reduction in coinsurance for generic drugs filled in the doughnut hole will be phased in. A reduction in coinsurance for brand-name drugs filled in the gap will begin in 2013, and the coinsurance rate for both brand-names and generics filled in the doughnut hole will reduce from 100% in 2010 to 25% in 2020 until enrollees qualify for catastrophic coverage.

And, as under current law, once seniors spend a certain amount on medications, they will get “catastrophic” coverage and pay only 5 percent of the cost of their medications.