Medicare FAQs

No. The law does not cut your guaranteed Medicare Part A and Part B benefits. Beginning in 2011, you will have some additional benefits, including Medicare-covered preventive services at no cost.

However, government payments to Medicare Advantage – health plans that are run by private insurers – will be reduced over the next decade. Some Medicare Advantage plans offer added benefits that traditional Medicare does not offer. But some of those benefits may change due to the reduction in government payments.

In 2010, about 4 million beneficiaries will reach the doughnut hole, or coverage gap, in Medicare prescription drug coverage once they spend $2,830 in prescription drugs by the end of the year. Beneficiaries who reach the doughnut hole in 2010 will be given a $250 check by the government. Checks began going out to beneficiaries in June 2010.

Beginning in 2011, the coinsurance for generic drugs for Medicare beneficiaries who reach the doughnut hole will be 93 percent, compared to 100 percent this year. They will also receive a 50-percent discount on brand-name drugs and biologics. These discounts and out-of-pocket costs will count toward the catastrophic threshold calculation.

Over time, the health care reform law will shrink and eventually eliminate the doughnut hole, and continue to phase out cost-sharing for brand-name and generic drugs.

Beginning in Jan. 2011, Medicare-covered preventive services will be offered with no cost-sharing. Detailed information will be available on the Medicare website. [www.medicare.gov].

No. The provision that covers dependents up to age 26 does not apply to Medicare.

Medicare Advantage plans are required to offer Medicare Part A and Part B benefits. Most Medicare Advantage plans also include Medicare prescription drug benefits. These are not the same as the "essential benefits" required for individual and small group health plans.

The new law creates a voluntary program called the Community Living Assistance Services and Support (CLASS) Act to help pay for long-term care.

The early retiree reinsurance program is a new federal program for qualified employers and unions. The program reimburses 80 percent of claims between $15,000 and $90,000 submitted by employers who provide health care coverage to retirees ages 55 through 64 who meet other specified conditions. The early retiree reinsurance program is not applicable to Medicare-eligible recipients.