Kathleen Sebelius, Secretary of Health and Human Services, has provided a detailed update about the new benefits that consumers can expect to see in 2011. These benefits are a result of the reforms and regulations to health care that are a part of the Affordable Care Act. Consumers saw several beneficial changes to health care in 2010, and will continue to see changes until 2014.
Beginning in 2011, insurance companies will be required to spend at least 80% of the money they get from the premiums that they charge their customers on health care, and other quality improvements, that will actually improve the health of their customers. Theoretically, this could mean that consumers will be getting more value for the money they spend on health insurance, because less of their premium dollars will be going towards things like administrative costs and marketing. Insurance companies who fail to hit the 80% target will be required to send a rebate to all of the people who have purchased health insurance from them. So, if your insurance company slacks off on this new responsibility, you should expect to receive a nice rebate check in the mail from them, sometime in 2012.
New enrollees to the Medicare program will no longer have to pay out of their own pockets for what has been referred to as the “Welcome to Medicare” physical exam, which is a requirement for everyone who newly enrolls in Medicare. In 2011, everyone who uses Medicare, no matter how long or short a time they have been using it, will no longer have to pay out of pocket costs for annual physical exams. 2011 also brings us one step closer to closing the dreaded “donut- hole”. Those who fall into that coverage gap can expect to get a 50% discount on the brand name prescription drugs that they need, (assuming those drugs are covered by Medicare in the first place).
Medicare recipients who are hospitalized in 2011 can expect to see changes designed to prevent them from needing to be readmitted to the hospital. The idea is to coordinate care and to better connect patients to the health care services that can be found in their communities. By October of 2011, disabled people who use Medicare should see changes that will help them to stay in their homes, rather than in a nursing home. Doctors who see patients who use Medicare can expect to receive a 10% Medicare bonus payment, to help ensure that these doctors will continue to act as primary care physicians for people who use Medicare.
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