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Maine Voices:
What Medicare beneficiaries need to know about health care reform

Changes to benefits and types of coverage options are coming as 'Obamacare' is implemented.

By STEVEN KING

PORTLAND - July 30 marks the 45th anniversary of the Medicare program. On that date in 1965, President Lyndon Johnson signed the Medicare and Medicaid Bill into law in the presence of former President Harry Truman, who received the first Medicare card at the ceremony.

ABOUT THE AUTHOR

Steven King is the executive director of UnitedHealthcare in Portland. The firm serves nearly 9 million – or one in five – Medicare beneficiaries nationwide.

Nearly 19 million beneficiaries followed President Truman and enrolled in Medicare in the first year of the program.

Today more than 45 million Americans are enrolled, including 48,069 in Cumberland County, making Medicare the nation's largest health-insurance program.

While Medicare has evolved in many ways over the years, it is during the next decade that some of the program's most transformative changes will occur. According to the U.S. Census Bureau, more than 34 million baby boomers will become eligible for Medicare in the next decade alone, at a rate of more than 10,000 every day.

As anticipated enrollment undergoes tremendous growth, Medicare will also be affected by the health care reform legislation passed by Congress earlier this year. The new law will bring changes to some benefits and types of available coverage options.

Whether you are aging into the Medicare population or provide care for someone who is eligible for Medicare, it is important to understand health care reform and what it means -- and doesn't mean -- for the program.

Medicare beneficiaries will continue to have a choice about how they receive Medicare coverage. Medicare Advantage plans will be available for most seniors and other beneficiaries as an alternative to traditional Medicare in 2011.

Medicare Advantage plans have a track record of providing cost-effective, comprehensive health coverage, helping more than 11 million beneficiaries save money and access services not covered by traditional Medicare.

As they're reviewing their 2011 plan options, beneficiaries should ensure they're making the Medicare choices that meet their needs, whether it's a Medicare Advantage plan or traditional Medicare with or without supplemental coverage. The most important thing is to make an informed choice.

Beneficiaries enrolled in a Medicare Part D (prescription drug) plan who hit the "doughnut hole" can expect financial assistance. As beneficiaries enter the Part D gap, they will receive a one-time $250 rebate check.

It's estimated that 3.4 million beneficiaries will receive a rebate check this year. Starting in 2011, the doughnut hole will be reduced in stages until it's closed entirely in 2020. Also in 2011, beneficiaries in the doughnut hole will pay about 50 percent of the cost of most brand-name drugs.

Beneficiaries should anticipate some changes to the enrollment periods. The health-reform law eliminates the Open Enrollment Period -- the period during the first three months of the year when Medicare Advantage enrollees could switch to a different Medicare Advantage plan.

Because of this change, beneficiaries must be diligent when selecting their Medicare Advantage plan during the upcoming Annual Election Period, which starts Nov. 15 and ends Dec. 31. The Annual Election Period, also known as AEP, will change again next year, so look for more updates in 2011.

To help understand the full scope of changes to Medicare that will gradually phase in over the next several years, Medicare beneficiaries may access resources at www.MedicareMadeClear.com, where they can download an easy-to-use reference guide for understanding Medicare called Medicare Made Clear. They may also call (800) MEDICARE.

- Special to the Press Herald