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What You Need to Know About Health Care Reform

There has been a lot of misinformation put out about the new health care reform legislation passed by Congress and signed into law by President Obama. Here are some of the things you need to know about the new law:

If you are a senior who is paying thousands of dollars out of your own pocket for your medications, your benefits under Medicare Part D will improve. This year, Kansans in the coverage gap will get a $250 rebate. Next year, they will get a 50% discount on brand name drugs and within 10 years, the coverage gap will be eliminated.

If you are planning for future long-term care needs, you will have the choice of participating in a voluntary insurance program designed to help people remain independent if they need daily assistance. This program, known as CLASS -- for Community Living Assistance Services and Supports -- will collect premiums through payroll deductions of those who participate.

If you have any adult children who need coverage, you may keep them on your employer plan until they reach age 26.

If you are a boomer (born between 1946 and 1964) some of the new provisions should be of great interest to you. In Kansas, 52,000 residents age 50 to 64 lack health insurance, often because they find premiums to be unaffordable. Starting this year, consumers who have been unable to buy insurance because of pre-existing conditions and are not already part of the state’s high-risk insurance pool may be eligible for a temporary program of affordable coverage. In 2014, insurance companies will no longer deny you coverage because of a pre-existing condition. Instead, individuals—just like members of Congress—will have access to a choice of insurance options through a marketplace of new, more affordable plans.

Consumers also should be aware that insurers will be prohibited from imposing lifetime benefit caps or unreasonable annual limits, starting this year. Similarly, they will be prohibited from cutting off coverage when you get sick.

Out-of-pocket costs for prevention are going to go down. Starting next year, patients in Medicare can get annual wellness check-ups free of charge, along with important preventive services, such as screenings for cancer and diabetes. Consumers of private health insurance also will qualify for free health screenings, a change from the past practice of charging co-payments.

The new law also takes steps to keep doctors' doors open for Medicare patients. Physicians will get bonus payments for primary care, a little-noticed strategy to promote access for seniors.

Finally, it is important to note what is not changing under health insurance reform. The law explicitly prohibits any cuts to seniors’ guaranteed Medicare benefits.

You should do what you can to learn what the new provisions mean for you. Many websites offer useful information about the law, including Knowledge about these different benefits may prove extremely valuable for you and your family.

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