what does healthcare reform mean to me?

Healthcare reform affects everyone differently. The good news for Medicare beneficiaries is that the Affordable Care Act provides our members enhanced benefits on things like preventive services that require no copay or coinsurance, and more affordable prescription drugs. Below is a list of frequently asked questions that may help you better understand what impact healthcare reform has on Medicare Advantage plans.

Will healthcare reform have an impact on my Medicare Advantage coverage?

The new healthcare reform law supports Medicare Advantage plans and we will continue to offer quality coverage for Idaho’s seniors. Your Medicare Advantage plan continues to cover all that Original Medicare covers, eliminates the Original Medicare deductible and replaces your coinsurance responsibility with low copayments. The legislation will not eliminate your health insurance, or force you to make a change. During Medicare’s Annual Enrollment period at the end of each calendar year, you can compare plans and make a change if you prefer. However, no change is required and you can keep your current coverage.

How will the new law change my plan?

You get more preventive services, for less.

Medicare Advantage plans now cover certain preventive services, like mammograms or colonoscopies, without charging you a copay or coinsurance. You also get a free yearly "Wellness" visit. A complete list of preventive and screening services included at no extra charge with your plan is available at Medicare.gov.

You can save money on prescription drugs.

If you’re in the donut hole (also known as the Part D Coverage Gap), you'll get a 55% discount in 2015 or 2016 when buying Part D-covered brand-name prescription drugs. The discount is applied automatically at the counter of your pharmacy—you don’t have to do anything to get it. The discount for brand-name drugs will be 60% in 2017, 65% in 2018, 70% in 2019 and 75% in 2020.

Will my premium increase?

Government funding for Medicare Advantage plans has the potential to change, but our Medicare Advantage premiums are set for a full year. We notify members each year in October about any premium changes for the following year. We strive to provide stable, dependable coverage that strikes just the right balance between benefits and premiums.