YOUR HEALTH: TAKE CHARGE!
THE NEW HEALTH CARE LAW AND YOU
By: Winston Wong, M.D., M.S., NCAPIP Vice Chair on Policy
In March 2010, President Obama signed a historic new health care law promising sweeping reforms to repair America's broken health care system. The Patient Protection and Affordable Care Act, commonly known as the ACA, is designed to provide accessible and affordable health care to Americans through accountability, cost efficiency, and the promotion of wellness and healthy lifestyles.
As the health care system is complex, reforming it requires a multitude of innovative and integrated approaches. Because the ACA contains over 1,000 pages of far ranging provisions and programs and will take 10 years to fully implement them, the public is understandably anxious over its real benefits and impact on their health. Since a critical component of the ACA is enabling the health consumers to be more proactive in taking charge of their health, NCAPIP intends to keep poor community members informed and engaged on the ACA's continued implementation. Below is a summary of provisions to take effect in 2010 and 2011 that have direct impact on the Asian American, Native Hawaiian, and Pacific Islander communities.
Improving Care and Affordability for Seniors
The Medicare - Part D prescription drug program was enacted in 2006 to provide prescription drug coverage for Medicare beneficiaries. However, it created a coverage gap when a beneficiary's total drug spending falls between $2,840 to $4,550. This is popularly known as the donut hole where the enrollee will have to pay for these drug costs. Under the ACA, this coverage gap is scheduled to be closed within ten years. For those who fall into the donut hole, they have already received a $250 rebate in 2010. In 2011, they will get a 50% discount on brand-name prescription drugs and by 2014, seniors enrolled in Part D will not have to pay out of pocket costs for almost all of their medications.
Beginning in 2011, Medicare beneficiaries will also be entitled to free annual medical exams and preventive screenings.
Asian American, Native Hawaiian, and Pacific Islanders have one of the lowest rates for preventive health screening services.
Starting in September 2010, health plans must cover certain preventive screening and services without charging their new and renewed enrollees co-pay, deductibles, or other out of pocket pays. Some eligible services include immunizations and vaccinations, mammograms, colonoscopy, diabetes, and cholesterol testing.
A prevention and public health fund is established to support health wellness programs throughout the country. In 2011, Medicaid will begin to cover smoking cessation services.
Providing Health Care Insurance to Millions Who Cannot Afford It
One out of five Asian American, Native Hawaiian, and Pacific Islanders do not have health insurance coverage because it is too expensive; the ACA makes coverage more affordable, and helps low income people purchase and receive government help.
- ACA will enable over 32 million Americans to have access to health coverage.
- As of September 2010, adult children will be able to stay on their parents' health plan until they are 26 years old.
- Starting in 2014, the government will establish state based "marketplaces" where consumers who do not have health insurance can compare plans for quality and access, and receive government assistance in purchasing insurance if they meet certain income requirements.
- A substantial number of uninsured AANHPIs are small business operators and workers. ACA offers small businesses with less than 25 employees who provide health coverage for their employees tax credits up to 35% of their contribution. To promote a healthier work force for the small businesses, grants will be available to help employers provide wellness programs such as nutrition, exercise and health education to keep their workers healthy.
- $11 billion will be available beginning in 2011 to support the construction or expansion of community health centers, many of which specialize in providing care to limited English speakers and recent immigrants. Over 20 million new patients are expected to be served by these centers. New funding will also be available to support school based health centers.
- Beginning in the fall of 2011, states will offer Medicaid covered disabled individuals the choice of receiving home or community-centered services rather than institutionalized or nursing home care.
- Making Insurance Plans More Consumer Friendly
- Insurance companies can no longer set a lifetime limit on certain essential services such as hospitalization. They will also be prohibited from denying coverage for children with pre-existing conditions.
- ACA makes it illegal for insurance plans to drop coverage after the beneficiary becomes ill.
- Starting in 2011, health plans for large employers will be required to spend at least 85% of its revenue on providing health services. For small business health plans, at least 80% of their expenses need to be attributed to the actual cost of providing care to patients.
- The public will have access to reports on long term care facilities and nursing homes.
SPECIAL EDITION - IMPORTANT INFORMATION ON MEDICARE
CENTERS FOR MEDICARE & MEDICAID SERVICES
National Medicare Multi-Media & Education Campaign
Welcome to Medicare
Your start to a healthy future
Have you recently enrolled in Medicare and aren't sure what to do next?
Here are a few tips to give you a jump start on a healthy future:
Step 1: Sign up for the "Welcome to Medicare" physical exam.
Call your doctor and schedule your "Welcome to Medicare" physical exam today. It's an easy way for you and your doctor to get an accurate benchmark for your health now and in the future.
During the exam, you and your physician will review your medical and family history, assess current health conditions and prescriptions, and conduct screenings to establish a baseline for future, personalized care.
You will also have an opportunity to talk about short- and long-term steps to improve your health and stay well under the care of doctors participating in the Medicare program. For example, your physician will provide you with a plan of action that may include referral for other services, including whether you should take advantage of preventive services - such as cancer screenings, flu shots, routine vaccines and diabetes tests - some of which are available for free to most Medicare beneficiaries as a result of the Affordable Care Act.
At the end of your appointment, be sure to schedule an annual "Wellness Exam" for the following year. Thanks to the Affordable Care Act, Medicare now covers a yearly check-up. It's a great way to assess changes in your health since the "Welcome to Medicare" and annual "Wellness Exam" can catch any health issues early.
Step 2: Register at MyMedicare.gov
Register at www.MyMedicare.gov for easy access to your health information. This free, secure online service provides access to personalized information regarding your Medicare benefits and services.
If you don't have a computer, ask someone you trust, like a family member or the administrator at your local senior center, to help you sign-up and regularly review your information.
Step 3: Take advantage of all your Medicare resources
Medicare offers a number of resources to help you get the most out of your benefits. Check out the "New to Medicare?" section of www.medicare.gov for information customized for new enrollees, review your "Medicare & You 2011" handbook; or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. If you need help in a language other than English or Spanish, say "Agent" at any time to talk to a customer service representative.
More information is available at www.healthcare.gov, a new web portal from the U.S. Department of Health and Human Services.
This information prepared by the U.S. Department of Health and Human Services.