New Health Care Benefits: Affordable Care Act

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Medicare Enrollment
“Ringing in the New Year with New Health Care Benefits”
Some of the most important provisions of the Affordable Care Act will take effect in 2011. Starting this year, the vast majority of people with Medicare will see several new benefits, including free annual wellness check-ups, recommended preventive services without cost-sharing and discounts on prescription drugs in the Medicare Part D “donut hole” (Sebelius, Health Care, 2011). In addition, new rules will hold insurance companies accountable so more of your premium dollars go to health care, and you’re more protected from unreasonable rate hikes (Sebelius, Health Care, 2011). •Medicare will no longer have out-of-pocket costs for the “Welcome to Medicare” physical exam starting on January 1, 2011 and, for the first time since the Medicare program was created in 1965, Medicare will cover an annual wellness visit with a participating doctor, also at no cost (Sebelius, Health Care, 2011). •Most people with Medicare will be able to receive free preventive services, including flu shots, cancer screenings and diabetes testing (Sebelius, Health Care, 2011). •Seniors who reach the coverage gap will receive a 50 percent discount when buying brand-name prescription drugs covered by Medicare Part D (Sebelius, Health Care, 2011). Over the next ten years, seniors will receive additional savings on brand-name and generic drugs until the coverage gap is closed in 2020 (Sebelius, Health Care, 2011). •Many doctors and other health care professionals who provide primary care to people with Medicare will get a 10 percent bonus (Sebelius, Health Care, 2011). This will help ensure that primary care providers can continue to be there for Medicare patients (Sebelius, Health Care, 2011). •Insurance companies will be required to spend most of your premium dollars on health care and quality improvement, instead of administrative costs, big salaries, or marketing, or provide you with a rebate (Sebelius, Health Care, 2011). •New proposed rules would require many insurers in all states to publicly justify unreasonable rate increases (Sebelius, Health Care, 2011). Under this proposed rules, rate increases of 10 percent or higher would be thoroughly reviewed to determine if the rate increase is unreasonable (Sebelius, Health Care, 2011).

Chapter 11
Health Services for Special Populations.
“Connecting Kids to Coverage”
This week we at HHS are awarding $206 million to 15 states that have met the criteria for performance bonuses made available under the Children’s Health Insurance Program Reauthorization Act (CHIPRA), signed into law by President Obama in 2009 (Sebelius, U.S.Department of Health & Human Services., 2010) .Together these states (Alabama, Alaska, Colorado, Illinois, Iowa, Kansas, Louisiana, Maryland, Michigan, New Jersey, New Mexico, Ohio, Oregon, Washington and Wisconsin) have enrolled nearly 900,000 children in their Medicaid programs, meeting challenging enrollment goals that aim to reach the children most in need of assistance (Sebelius, U.S.Department of Health & Human Services., 2010). They also have streamlined access to Medicaid and the Children’s Health Insurance Program (CHIP) for all eligible children by making the enrollment and renewal process less cumbersome, reducing barriers to coverage and care (Sebelius, U.S.Department of Health & Human Services., 2010). •These states allow families to mail in their applications or apply by phone or on-line – no in-person interview is needed, a feature that is especially important to working families (Sebelius, U.S.Department of Health & Human Services., 2010). •These states also have made it easier for families to renew their children’s coverage, and most now guarantee eligible children a full year of coverage, so families don’t have to worry about unnecessary and potentially harmful disruptions in care (Sebelius, U.S.Department of Health & Human Services., 2010). •These measures...
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