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Simplifying health care reform for seniors

Posted by Marcia Dick  January 26, 2011 10:00 AM

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The following was submitted by Dan O'Leary, executive director of Mystic Valley Elder Services, which serves residents of Malden, Melrose, and Medford:

Question:  For almost a year now, ever since the health care reform law passed, I’ve been hearing how it’s going to make my health care and prescriptions even more expensive and how it’s going to interfere with my ability to keep my own doctors.  Last week, when the House of Representatives voted to repeal the health care reform law, I wasn’t sure what to make of it.  As a senior citizen who depends on Medicare for my health care, what should I believe?  Is the health care reform law going to make life easier or harder for me?  Should I support repeal of the law or should I fight to keep it?
 
Answer:  It’s no wonder that you’re having trouble figuring out what health care reform, called “the Affordable Care Act,” can do for you.  Politicians and commentators all present different versions of what will happen under the new law, and the law itself is long (over 900 pages), complex, and written in tiresome legalese. 
 
For those of us who work in elder services, though, the Affordable Care Act is definitely a triumph.  It means new services, improved services, lower health care costs for seniors, and more elders getting the care and attention they need.
 
So that you don’t have to start reading that 900-page law, I’ve put together a list of provisions of the Affordable Care Act that will make life easier, fuller, and better for you:
 
The guaranteed Medicare benefits you receive will stay the same.

Your choice of doctor will be preserved.

You are entitled to a new “Annual Wellness Visit” with your doctor, where you can have a comprehensive health risk assessment and develop a personalized prevention plan.

You can get free preventative services, including free annual wellness visits and free personalized prevention plans, flu shots, nutrition therapy, and screenings for breast cancer, cardiovascular disease, colorectal cancer, diabetes, HIV, and prostate cancer.

A provision of the new law helps you avoid the Medicare drug plan “donut hole,” so that you’ll no longer be paying huge sums toward the cost of prescriptions.  Once you’ve exceeded your Medicare D drug benefit, you’ll receive 50% discounts on your name-brand prescriptions.  Over the next 8 years, your discount will get bigger and bigger (meaning the donut hole will get smaller and smaller) until 2020, when your Medicare will cover all of your prescription drug costs.

The brand new Center for Medicare and Medicaid Innovation will work to increase your quality of care and your overall health by figuring out what’s working (and what’s not) in the existing Medicare structure.

If you’re hospitalized, the new law also helps you return home successfully — and avoid going back—by helping to coordinate your care and connecting you to services and supports in your community.

The new law will lower Medicare premiums for all people enrolled in Medicare by reducing the cost of the Medicare Advantage program — and with a promise to actually improve the quality of the services.

The Elder Justice Act, which was passed as part of health care reform, will help prevent elder abuse and neglect and will improve nursing home quality.
 
In sum, the Affordable Care Act will provide you with better access to health care services, will ensure that those services continue to improve, and will save you money by lowering your health care and prescription costs.  According to the group Mass Home Care (of which Mystic Valley Elder Services is a member), the Affordable Health Care Act will save the average person on Medicare $3,500 over the next 10 years.  Elders with high-cost prescription drugs could end up saving over $12,500 over the next 10 years.
 
Personally, I think that’s a law worth protecting.
 
If you need more personalized advice on how the Affordable Care Act will help you, contact the Mystic Valley Elder Services’ SHINE (Serving the Health Information Needs of Elders) counselors for assistance understanding your Medicare benefits and other health insurance options.  You can take advantage of this free service by calling 781-324-7705.

Do you have a question? Write to Dan O'Leary, Attn: Q&A, Mystic Valley Elder Services, 300 Commercial St., #19, Malden, MA 02148 or send an e-mail to questions@mves.org.

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