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New Medicare Benefits, Changes Begin

In 2011, the new health care law brings new discounts and more ways for you to stay healthy

En español | With the start of the new year, people who are insured by Medicare Parts B and D can take advantage of expanded preventive services and greater discounts on prescription drugs.

Portrait of a senior woman

Photo by: Image Source/Corbis

The new health care law includes new benefits for people with Medicare.

Wellness Exams and Preventive Care: If you are new to Medicare, you are entitled to a free “Welcome to Medicare” exam. This comprehensive physical, which must occur no later than 12 months after you enroll in Medicare, includes a review of your health history, counseling about preventive services and, if needed, referrals to specialists. And now, because of provisions in the new health care law, all Medicare Part B recipients who want a check-up can receive a free annual wellness exam.

People with Medicare are now also are entitled to free screenings for cancer and diabetes, among other diseases. These services include mammograms, bone density measurements, colonoscopies, glaucoma tests, prostate exams (including PSA tests) and nutrition therapy.

Smoking Cessation Counseling: Before 2011, Medicare-covered help to stop smoking required that patients pay for a portion of the services, which were limited to people who had been diagnosed with a tobacco-related disease. Now all who have Part B coverage are entitled to as many as eight smoking cessation visits.

Prescription Drug Coverage: Although the Medicare Part D "doughnut hole" remains, you will no longer need to shoulder 100 percent of your drug costs while you are in the coverage gap.

In 2011, you will enter the gap once you and your insurer have spent $2,840 on your prescriptions. During your time in the gap, you will receive a 50 percent discount on all brand-name prescriptions and biologic drugs, and a 7 percent discount on generic drugs (versus 2010, when you were solely responsible for paying your prescription costs).

Once your total drug costs reach $4,550 (see the Ms. Medicare column "Paying Less for Drugs in the Doughnut Hole" for details about how this is calculated), you are eligible for "catastrophic coverage" and your prescription costs drop to a lower copay for the remainder of the year. Last year, when there were no doughnut-hole discounts, $250 rebate checks were sent to all affected Part D subscribers. Because of the discounts now in place, there will be no rebate checks for 2011 expenses.

Another 2011 change for Part D subscribers is that if you have a high annual income (more than $85,000 for individuals and $170,000 for couples) and pay higher-income premiums for Part B, you'll also pay a higher premium for Part D drug coverage.

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