Five Things People with Medicare Should Know

By Don Berwick, Administrator, Centers for Medicare & Medicaid Services. Cross-post from

Do you have Medicare? Have questions about what the Affordable Care Act does for you?

Here are the five things people with Medicare should know about the law:

1. It makes prescription drugs more affordable.

If you enter the coverage gap known as the “donut hole,” you will receive a 50% discount when buying Part D-covered brand-name prescription drugs. This discount will be automatically applied at the counter of your pharmacy; you don’t have to do anything to get it. And over the next ten years, you will get additional savings until the coverage gap is completely closed in 2020.

2It gives you preventive care services for free.

If you have Medicare, you can get free preventive screenings and services like colorectal cancer screening and mammograms. You can also get a free yearly wellness visit to develop and update your personal prevention plan based on current health needs. Again, these services are free: no co-pays or cost-sharing for you.

3. It provides incentives for your doctors to work together for you.

The law makes it easier for your doctors to work together by offering them support and resources for patient-centered care.  If you’re hospitalized, the new law also helps you return home successfully—and avoid going back—by helping to coordinate your care and connecting you to services and support in your community.

4. It strengthens Medicare Advantage.

If you have Medicare Advantage, you will be protected from large increases to your premiums or decreases in your benefits.  Medicare reviews changes to your plan before they happen to stop the ones that are unreasonable. Beginning in 2012, Medicare Advantage plans will have even more reason to improve the quality of care you receive.  Plans that have a rating of three stars or more on the quality rating system will receive a bonus, part of the national effort to improve quality.

5. It helps ensure your access to care.

You can still choose your doctor. The law increases the number of primary care doctors, nurses, and physician assistants to provide better access to care through expanded training opportunities, student loan forgiveness, and bonus payments. Support for community health centers will increase, allowing them to serve some 20 million new patients.

For more information, please check out the online brochure, Medicare and the New Health Care Law – What it Means for You. (PDF – 314KB)

1-Stop Shopping – Quality Care Finder

Medicare’s Quality Care Finder helps you find health care options that meet your needs –it’s just one of many ways Medicare is providing you with better information so you can get better care. The Quality Care Finder makes it easy for you to find health care professionals, services, and facilities. Use the information on the Quality Care Finder to get involved and take control of your health care choices.

With the Quality Care Finder, you can:

  • Get contact information for facilities and professionals
  • Compare the quality of care and services
  • Get helpful tips about what to consider when comparing care and services
  • Search for Medicare-certified providers, or all providers
  • Search your area specifically, or any other location
  • Search for facilities and doctors for your friends and relatives

The Quality Care Finder pages cover:

  • Hospitals
  • Nursing Homes
  • Home Health agencies
  • Dialysis Facilities
  • Physicians
  • Drug and Health plans

The information on Quality Care Finder is updated regularly and easy to search. Try out the Quality Care Finder, and find health care options for you.

Freeing Doctors to Focus on Patients, Not Paperwork

By Kathleen Sebelius, Secretary of Health and Human Services. Cross-post from

Did you know your doctor has to spend 12 cents of every dollar she makes to hire staff just to fill out insurance forms and other paperwork?  Wouldn’t you rather she spend that time with you?

Today, the Department of Health and Human Services issued rules to simplify the mounds of paperwork that doctors, nurses, and other caregivers have to complete in order to get paid for treating you. We estimate that these changes will save our health care system $12 billion over the next 10 years.  More important, it will free caregivers to spend more time with you. We estimate these changes will give doctors back four hours a week and another five hours to their staff.

This common-sense streamlining means fewer phone calls between physicians and health plans, lower postage and paperwork cots, and fewer denied claims.  All in all, this means physicians can cut through the red tape and spend more time and money administering quality care to their patients.

Under these rules, called for by the Affordable Care Act, doctors and other health care professionals will be able to use a simple, streamlined form to ask your insurance company if you are eligible for benefits.  And a second form will be used for doctors’ offices to check to the status of insurance claims they have filed. And insurers have agreed to accept these forms rather than use multiple systems.

This is only the beginning of our efforts to cut out waste and inefficiency in our health care system and free dedicated doctors, nurses, and caregivers to focus their time and efforts on keeping patients healthy, treating illness, and restoring health.  Stay tuned.

Get Free Screenings to Help Fight Cancer

You can take control of your health with Medicare’s preventive benefits. Get free screenings to detect cancer early, when treatment works best. Preventing and stopping the progress of chronic diseases improves your health and quality of life. It also helps Medicare spend less on long-term illnesses that could have been prevented.

If you have Medicare, you can get the following screenings:

          Colorectal cancer screenings – four different screenings to detect colon and rectal cancers, each is covered as needed for all people age 50 and older

          Prostate cancer screenings – covered for all men age 50 or older

          Mammograms – screenings to detect breast cancer, covered for all women age 40 or older

          Pap test and pelvic exams – screenings to detect cervical and vaginal cancers, covered for all women

          Smoking cessation counseling – help quitting smoking, to help prevent lung, throat, and other cancers; covered for all people who use tobacco

Call your doctor’s office to set up your yearly preventive visit, where you can ask about any risk factors that may affect you, and schedule your preventive screenings. Your doctor can also help you keep track of when you should get screenings and which kinds are right for you.