The New Year Brings New Health-Care Benefits under Health Reform Law

On Saturday, January 1, 2011 important new changes to U.S. health insurance rules will take effect under the new Health Reform Law – the Affordable Care Act.

Among the new provisions taking effect today are:

  • New rules designed to help those caught in Medicare’s prescription drug “doughnut hole” by providing them a 50% discount on drug costs they incur within the “doughnut hole” left uncovered by the 2006 Medicare Prescription Drug Benefit law.
  • Medicare beneficiaries get more free preventive care benefits — including free “preventive services”, including all screenings given an A or B rating by the U.S. Preventive Services Task Force. This could include mammograms, colorectal cancer screening, bone mass measurement and nutritional counseling. Medicare will also provide one free “wellness visit” per year for patients who want a checkup.
  • Limits on how much of customers’ money health-insurance companies can keep for overhead and profit.  The new rule requires that insurers must spend at least 80 percent of the money they collect in insurance premiums from customers on actual payment insurance claims for the customers’ benefit or for activities that improve customers’ health.  For policies sold to large groups instead of small companies and individuals, the number is even higher: 85 percent.  Only the remaining 15 or 20 percent of the money can be used for company salaries, marketing and overhead – or kept as profit.   Previously, there was no federal restriction on insurance companies’ spending.  According to the federal government, some previously insurers kept 30 or even 50 percent.
  • The creation of the Center for Medicare and Medicaid Innovation. This new agency is aimed at slowing down the rapid rise of health-care costs. It is supposed to foster innovation in both caring for patients and processing their payments and claims.

All of these changes under the new Health Reform Law go into effect Saturday, January 1.

Read More » The new year brings health-care changes – The Washington Post.


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