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The Health Care Law & You

Fact Sheet: What the Health Care Law Means to People 65+

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If you are 65 or older the health care law benefits you in several ways. The law lowers prescription drug costs, strengthens Medicare and improves long-term care services. These benefits are in effect now.

Lowers out-of-pocket prescription drug costs

• If you reach the doughnut hole in 2013, you will receive a 52.5 percent discount on brand-name drugs and a 21 percent discount on generic drugs while you are in the coverage gap. How much you'll pay out of pocket for each drug may vary depending on your Part D plan, the prices your plan negotiated and how it has structured its gap coverage. These discounts will gradually increase until the Part D coverage gap disappears in 2020.

Strengthens Medicare

• If you have Medicare, you qualify for an annual wellness visit, mammograms and other screenings for cancer and diabetes — important preventive care at no charge.

• Medicare Advantage plans that give better quality care receive additional bonus payments.

• Plans must use some of this bonus money to offer you added health benefits.

• Medicare Advantage plans cannot charge people more than Original Medicare pays for certain services. These services include chemotherapy administration, renal dialysis and skilled nursing care.

• The law cracks down on waste, fraud and abuse in Medicare and the health care system as a whole.

• To guard against medical identity theft, the law also protects the privacy of your personal information.

Improves long-term care services and information

• You have more information about nursing home inspections, complaints against facilities and consumer rights. This information will help you make decisions when selecting a nursing home.

• Your state may receive more funds to expand home- and community-based services. For example, under the Community First Choice Option, participating states get more federal dollars to provide home- and community-based services to people with disabilities who live at home but need a higher level of care.

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