Golden OpportunitiesHealth Reform Medicare benefits are kicking inJEFFREY A. MARSHALLHealth ReformʼsAffordable Care Act isunder attack.It is disparaged bypolitical critics as“Obamacare.”Republicans inCongress threaten to“defund” it. And itsprovisions mandatingthe purchase of healthinsurance in 2014appear headed to anuncertain fate in theU.S. Supreme Court.Nevertheless, anumber of HealthReformʼs new ruleshave kicked in thisyear and will help seniors.Notable isincreased help forthose caught inMedicareʼs prescriptiondrug “donut hole.”Other new rules offerseniors more preventativeand wellness care,and increase Medicarereimbursements forprimary-care physiciansand general surgeons.HELP WITH THEDONUT HOLEMedicare Part Dprovides limited pre-The coveragecomes with a $310 initialdeductible. Afteryouʼve spent $310yourself, you payabout 25 percent ofyour prescription costsuntil the total cost ofall the covered medicineyou have receivedthis year reaches$2,840. At this pointyou will have spentabout $942 out ofpocket ($310 + $632)of your first $2,840 indrug costs. MedicarePart D will have pickedup the other $1,898.Once you exceed$2,840 you are in thedonut hole. The donuthole continues for thenext $3,608 of yourdrug costs.Before theAffordable Care Actyou had to pay 100percent of your drugcosts while you werein the donut hole. Thisleft seniors with apotential out-of-pocketdrug cost of $4,550($942 + $3,608) beforeMedicare coveragepicks up again.But this year, as aresult of HealthReform, seniors withPart D coverage willsave 50 percent onbrand-name drugs and7 percent on genericswhile they are in thedonut hole. This canreduce prescriptiondrug costs for seniorsby as much as $1,804.Unless HealthReform is completelyundone by its attackers,the donut hole willbe reduced additionallyover the followingeight years. By 2020 itwill be completelygone.Low-income seniorswho canʼt affordtheir drugs should seeif they qualify for“Extra Help” by visitingwww.ssa.gov/prescriptionhelp.Once you reach$6,448 in total prescriptioncosts, youenter the catastrophiczone and your out-ofpocketcost drops toonly 5 percent (or$2.50) for genericsand $6.30 for brandnamedrugs.Part D enrolleeswill then be responsiblefor only the standard25 percent of thecost of both brandnamedrugs andgenerics until theyreach the catastrophiclimit where their copayis dramaticallyless.FREEPREVENTATIVESERVICESAnother of thisyearʼs new benefitsunder Health Reformis free preventive servicesfor Medicarerecipients.Under theAffordable Care Act,people with regularMedicare will no longerhave to pay a co-pay,co-insurance ordeductible to receivepreventive servicesthat are highly recommendedby the U.S.Preventive ServicesTask Force — servicesthat include screeningsfor breast cancer,colon cancer, diabetesand heart disease, aswell as smoking cessationcounseling.Private Medicare plans(also known asMedicare Advantageplans) may still chargefor these services, butmany do not.Preventing somediseases entirely anddetecting others inearlier, more treatablestages, are importantaspects of HealthReform. Prevention isa “win-win:” it savesmoney while improvingthe lives of Medicarebeneficiaries.The MedicareRights Center providesa detailed list of preventiveservices thatwill no longer requireout-of-pocket payments.ANNUALWELLNESSVISITSAs a result of theHealth Reform law,Medicare Part B beneficiariesare now entitledto an annual wellnessvisit free ofcharge. During thisyearly visit, your doctoror other healthpractitioner recognizedby Medicare (such asa nurse practitioner)will update your medicalhistory and currentprescriptions; measureyour height, weight,blood pressure andbody mass index; createa screening schedulefor the next 5 to 10years and screen forcognitive issues. AndMedicare now pays infull, without patient copaysor deductibles,for the initial “Welcometo Medicare” thatMedicare has offeredsince 2005 to beneficiarieswithin 12 monthsof their becoming coveredunder MedicarePart B.BONUS TOPHYSICIANSQualifying doctorsand other health careprofessionals who provideprimary care topeople on Medicarewill get a 10 percentbonus for primary careservices. This will helpensure that primarycareproviders willcontinue to be therefor Medicare patients.The above are justsome of the notableenhancements toMedicare under theAffordable Care Act.For more information,about these new benefits,seniors can callMedicare toll free at 1-800-MEDICARE (1-800-633-4227) or visitwww.medicare.gov.———Jeffrey Marshall is aCertified Elder LawAttorney through theNational Elder LawFoundation. He is thefounding partner of thelaw firm of Marshall,Parker & Associateswhich specializes inhelping families planand pay for long-termcare. He can be contactedat 1-800-401-4552 or www.paelderlaw.com.Insurance Consultant/Financial AdvisorAttention Seniors:• Medicare Supplements• Medicare Choice/Advantage Plans• Medicare “Part D” Rx Coverage• Long & Short Term Care Coverage• Tax Deferred AnnuitiesKent A. BennettCall (570) 327-1006 orToll Free (800) 548-9119ASSOCIATES, INC.SERVING SENIORS SINCE 1978249 Broad Street • Montoursville, PA 177547 - The Express - Golden Opportunities - WEDNESDAY, February 23, 2011