Health Care Reform and Elders:

I have been so busy representing my clients that I fell behind with my blog posts. The White House has been busy as well with big news items like financial reform and the recent oil spill, which quickly eclipsed health care reform in the public eye.

However, health care reform is here to stay and it is important to understand how it will change the lives of elders. Health care reform will impact elders in many different ways, from closing the Medicare Part D doughnut hole to creating a national long-term care insurance option. Below are some important provisions of the new law as it relates to elders. Follow the links at the end of this post to learn more.

Medicare:

• Creates a $250 rebate to Medicare Part D beneficiaries who hit the doughnut hole* (or as we Massachusetts folks like to say, the donut hole) in 2010.
• Closes the Medicare Part D doughnut hole by 2020, including phased-in mandatory drug discounts for prescriptions filled in the doughnut hole.
• Provides a free annual wellness visit and prevention assessment for Medicare beneficiaries.
• Extends the life of the Medicare Trust Fund by about nine years, now projected to be depleted in 2026 (as opposed to 2017, which was the projected depletion date before health care reform). 
• Ties Medicare Part D Premiums to income, resulting in higher premiums for many beneficiaries.

Medicaid:

• Creates a new community based care option and creates incentives for states to offer the option. Massachusetts already has a community based care option, and it is not yet clear whether the new option will be any better.
• Mandates that states include spousal impoverishment protections (Massachusetts already has these protections in place).

Other:

• Creates a national long-term care insurance program which will be funded through voluntary payroll deductions. Community Living Assistance Services and Supports (CLASS) program.
• Creates a number of care coordination programs and options.
• New nursing home regulations, including mandating training for workers who care for residents with dementia.
• Creates a number of new protections against elder abuse, including creating the Elder Justice Coordinating Council, and provides dedicated funding to Adult Protective Services.

Find Out More:

CBS: http://bit.ly/cCJKxi

Wallet Pop: http://bit.ly/cfw3y0

The Christian Science Monitor: http://bit.ly/aAyYba

The White House: http://bit.ly/9A1Fxi

AARP: http://bit.ly/9TCFqK

The Boston Globe: http://bit.ly/9E5xam

* for those of you unfamiliar with the term “doughnut hole”, it is the unofficial name for the Medicare Part D coverage gap. The coverage gap is a period of time during which the Medicare recipient has exceeded his or her drug coverage limit, but has not yet incurred enough drug expenses to reach the catastrophic coverage threshold. The elder is responsible for paying his or her own prescription drug costs out of pocket during this period, and such costs can run to thousands of dollars each year.