As the one-year anniversary of the Affordable Care Act (ACA) approaches on March 23rd, it brings with it many new advantages for older Americans. The ACA directly impacts seniors by closing Medicare’s prescription drug benefits gap, promising comprehensive preventive care coverage and removing loopholes used by insurance companies to deny coverage. In these aspects, the ACA expands coverage for seniors while reducing the opportunity for exploitation.
Elimination of the “donut hole” is a key example of one of the improvements brought by the ACA. The “donut hole” is a drug coverage gap that forces participants to pay costs in full after their annual expenses reach $2,830. Until intervention from the ACA, Medicare beneficiaries paid the total cost of drugs until their annual expenses surpassed $6,440. The new law diminishes this gap in coverage by offering Medicare participants a 50% discount on brand name drugs. WOW’s Elder Index has found that out-of-pocket health care costs account for the second highest expense for elders, after housing.
Furthermore, the Affordable Care Act expands preventive care coverage to seniors by offering free annual wellness visits and personalized prevention for individuals enrolled in Medicare. By 2018, all private health insurance plans must cover preventive services without co-payments.
Finally, the Act will prevent insurance companies from rescinding coverage based on unintentional mistakes on applications. Currently, insurance companies have the right to revoke policies when a beneficiary becomes sick if there are unintentional mistakes on paper work. The new regulations eliminate this policy by prohibiting insurers from withdrawing coverage unless fraud or intentional misrepresentation of facts has occurred.
The anniversary of the Affordable Care Act and the introduction of its new reforms will help secure more fair healthcare policies to seniors. In the long run the ACA saves taxpayer dollars by eradicating fraud and abuse within the Medicare system and simultaneously guaranteeing elders more reliable coverage.
Sahdia Khan
Elder Economic Security Initiative Intern
Thursday, January 26, 2012
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