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Older Americans Month: Living Healthy Lives with Medicare Preventative Coverage

Shannon Martin - May 10, 2011 10:59 AM

May is Older Americans Month and the theme for 2011 is “Connecting the Community”, a tribute to all that older Americans do to enrich our community.  This year also focuses on the technologies and supportive services that are allowing older Americans to live longer, healthier, more active lives. 

Many of us can likely share examples of some of the medical advances that are extending lives, as well as some of those that are helping individuals’ quality of life such as advances in hearing aides and surgeries for vision correction.  Most would agree that preventative care is a key to good health, and that screenings allow certain conditions to be identified early enough for more successful treatment. 

In that spirit, Medicare has updated its coverage for preventative care.  If you are not familiar with these changes, take a moment to visit www.medicare.gov or review your “Medicare and You” handbook.  Here is an overview of the changes:

Medicare preventive services are now covered by the Medicare program. This includes free:

Screening for colon cancer

Prostate cancer screening

Screening for breast cancer

Annual wellness visits*

 

*In the past, Medicare allowed for a one time "welcome to Medicare" wellness/physical only.

Additionally, many people are aware that in 2006, Medicare Part D was added to the Medicare program to provide prescription drug coverage through private insurers.  When this program was created, the coverage had a gap, known as the “doughnut hole”.  When costs reached a certain level, the consumer paid all the drug costs until they reached a further level, “catastrophic coverage”.  Recent healthcare reform legislation has provided that this gap be closed over the next few years, as follows:

“Doughnut hole” changes/Medicare Prescription Drug Benefit:

2010: Anyone who fell in to the "doughnut hole" received a $250 rebate check to assist with those costs.  This doesn’t apply to those receiving “special assistance” with costs through Social Security.  Be aware that there have been several scams related to this rebate, where clients are asked for their Medicare # or contacted via phone to sign up for a new plan.

2011: 50% discount on covered brand name drugs in doughnut hole period

2012-2020 and beyond: This discount incrementally increases until eventually the coverage gap is eliminated.

Additionally, this year the open enrollment period for health plans and prescription drug plans has been changed, in hopes of providing more time for people to consider their options.  The open enrollment period thus begins on 10/15 instead of the previous 11/15 and runs until 12/7, with changes effective on January 1st.  This also gives the administration and insurers more time to get cards to beneficiaries and avoid gaps and challenges that have been problematic in the past when the enrollment period ran right through the end of the year.

If you are a Medicare recipient or caring for a loved one who is, read more about your coverage at www.medicare.gov and check out resources such as the plan compare tool to find your best options.  Aging Wisely, LLC also offers updated fact sheets on coverage as well as blog posts on the latest news about Medicare and senior health issues.

Click here to get more information on handling the financing aspect of long term care needs.

Shannon Martin, M.S.W., CMC, is Director of Communications at Aging Wisely, LLC (http://www.agingwisely.com), a professional care management and patient advocacy organization and EasyLiving, Inc. (www.easylivingfl.com), a licensed home care agency, in Clearwater, FL.  Shannon serves as adjunct professor at Eckerd College in St. Petersburg, FL, where she created a course on “Eldercare”.  Prior in her career, Shannon served as social services director and admissions coordinator in an assisted living/skilled nursing facility and worked as a social worker and volunteer coordinator for a large hospice.   

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