The Changes, They Are a Coming

Since the passage of the health care reform bill, there will be many changes coming. Many of them will be phased in over time, some will happen quickly.

From the looks of things, under the health care reform bill, insurance companies in 2010 will be banned from dropping people when they get sick and lifetime coverage limits will be gone. Annual limits will be restricted. These things will ultimately help Joe and Josephine Average who have been struggling with their health insurance coverage.

More good news for families indicates that insurers will be barred from excluding children due to pre-existing conditions and those under the age of 26-years-old will still be to stay on their parents’ health plans. Right now, most health plans drop kids when they turn 19 or complete college.

Those who happen to be on Medicare and who fall into what is referred to as the donut hole coverage gap, will actually get a $250 rebate. We’re not sure where the money is coming from to cover this, but it should be interesting to wait and see. The health care reform bill more or less closes the donut hole, which right now starts after $2,700 is shelled out for drugs. Once you hit $6,154, the coverage kicks in again. The difference is quite substantial, some $3,454, and makes one wonder how far a $250 rebate will go in the grander scheme of things.

Those who are pre-Medicare applicants will find themselves with a temporary reinsurance program to help companies keep offering coverage for early retirees between 55 and 64 years old. This however will expire in 2014. And, if you don’t have Medicare or any other kind of insurance to call your own, and have a pre-existing condition, you will be able to get health insurance under the auspices of a new program that ends in 2014, when insurance exchanges start operating.

There seems to be some more good news for Medicare come 2011. According to the health care reform bill, it will provide a 10% bonus payment to primary care doctors and general surgeons. You will be able to get free annual wellness visits and a unique personalized health plan specifically suited to you, and any new health plans will have to cover preventive services at no cost or a minimal fee.

The new Medicaid program for the poor doesn’t kick in until October 2011 and when it does, it lets states offer community based and home care for disabled individuals who would otherwise be in a nursing home.

By the time 2011 rolls around, payments to insurers still offering Medicare Advantage will be frozen at 2010 levels. This is in fact a major reason why many larger insurers will no longer be offering Medicare Advantage. Over time, the payments are to be scaled back and brought more in line with traditional Medicare.

There is more in the works, and the health care reform bill has other built-in timetables that will see other services kick in starting in 2012 and continuing until 2018. It may be interesting to read “ahead” to see what may be in store for your Medicare services. Better to find out now and start asking questions. Knowledge is power when it comes to understanding your Medicare benefits.

Richard Cantu is with Medicare supplements resource, To learn more about Medicare, Medicare supplements, or Medicare supplement insurance visit

Tagged with: , ,