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Fall 2016

Improved Benefits for Medicare Beneficiaries

Senior Population Growth 60plus 2050According to the Centers for Medicare & Medicaid Services (CMS), nearly 39.2 million Medicare beneficiaries took advantage of at least one preventive service with no copays or deductibles in 2015.

Before the Affordable Care Act (ACA) was enacted in 2010, health care premiums were too expensive for many families to afford. This legislation has made health care more affordable and universally available. Providing preventative services at no cost to the beneficiary, the ACA improves the quality of care for seniors aged 65 and older, people under the age of 65 with disabilities, and people with end stage renal disease, who are on Medicare.

According to CMS, millions of Medicare beneficiaries are already benefiting from the health care law’s improvements. Marcelo Espiritu, Product Analyst of Sourcewise Health Insurance Counseling & Advocacy Program states, “The ACA tries to encourage preventative medicine. It implemented $0 copays and deductibles for Medicare-covered preventative services, like appropriate screening and testing.”

The ACA provides improvements to Medicare prescription drug plan coverage (Part D) including reducing out-of-pocket expenses for seniors in the “donut hole” (also known as the coverage gap.)

According to CMS, nearly 10.7 million Medicare beneficiaries have received discounts on over $20.8 billion on prescription drugs – an average of $1,945 per beneficiary. People on Medicare in the coverage gap once paid 100% of the drug price. With the ACA, discounts for generic and brand name drugs have been increasing at different rates, but both will reach 75% by 2020.

The ACA provides accessible and affordable medical health insurance coverage to over 52 million Medicare beneficiaries—offering a range of preventative services at no cost, and providing discounts on drugs when in the coverage gap.