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The Affordable Care Act and Medicare

President Barack Obama signed the Affordable Care Act into law in March of 2010 to provide health care reform measures, including new additions to Medicare. Understanding the relationship between the Affordable Care Act and Medicare, and the changes scheduled to take effect between 2010 and 2020, is important for eligible seniors.

Investment in Medicare

Under the Affordable Care Act, the government plans to invest $350 million over a ten-year period into Medicare to go towards the reduction of waste, fraud, abuse and payment errors.

The Act extends the life of the Medicare Trust Fund's life by 12 years to 2029, which is intended to save seniors premium and coinsurance costs. In addition to providing financial support to Medicare, the Affordable Care Act aims to improve patient care through initiatives that coordinate care between hospitals, patients and doctors.

Benefits for Original Medicare Members

Under the Act, Original Medicare enrollees can qualify for preventive services and a yearly wellness exam. Preventive services include:

  • Cessation counseling for tobacco use
  • Yearly wellness exam: You can get this overall review of your health during the first 12 months of your Part B coverage. After this period, your exam will be scheduled based on your assessed health and risk factors.

No Part B Deductibles or Co-Payments for Key Screenings

As a senior under Medicare Part B, you'll be able to complete the following screenings without a deductible or co-payment under certain coverage criteria. If your Medicare Part A and Part B fall under a Medicare Advantage Plan, these benefits may still be free for you, as well:

  • Bone mass measurement
  • Human Immunodeficiency Virus (HIV) screening
  • Mammograms
  • Screenings for cervical cancer, cardiovascular disease, colorectal cancer, diabetes and prostate cancer
  • Shots for flu, pneumonia, and hepatitis B.

Discounts for Generic Drugs that Fall in the Coverage Gap

If you have Medicare prescription drug coverage, you may have prescriptions that fall in the donut hole, or the Part D coverage gap, and you'll have to pay for them out-of-pocket. After 2011, you'll receive a 50 percent discount on high-cost prescription brand-name drugs that fall inside the donut hole.

Learn more about how the Affordable Care Act will work to close the Medicare Part D coverage gap in the coming years.

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