[Sign Up Now] to Receive Our FREE Daily SCVTV-SCVNews Digest by E-Mail

Inside
Weather
Santa Clarita CA
Clear
Clear
71°F
 
Calendar
Today in
S.C.V. History
April 18
1945 - Actors Harry & Olive Carey sell Saugus ranch after 29 years; now Tesoro del Valle [story]
Carey Ranch


Guest Commentary By David Sayen
| Saturday, Mar 17, 2012

We hear a lot of back and forth these days about the Affordable Care Act – aka the federal health reform law – but not much about how it affects people with Medicare.

When you sort through all the rhetoric, one thing is clear: the 2-year-old reform law contains some real benefits for those who get their coverage through Medicare.

Take the so-called “donut hole” in the Medicare prescription drug program, Part D.

The donut hole is a gap where you don’t have coverage even though you’re still paying premiums. After you’ve paid a certain amount out of pocket, your coverage resumes. Congress intended the hole to hold down costs in the drug program, the biggest expansion of Medicare benefits in many years.

Under the Affordable Care Act (ACA), the hole is being gradually closed until it completely disappears in 2020. This year, the law gives people with Medicare a 50-percent discount on covered brand-name drugs in the donut hole, and a 14-percent discount on covered generics.

In 2011, more than 319,000 Medicare beneficiaries in California saved a total of $171 million in the donut hole. That’s an average savings of $538 per person.

The ACA also helps people with Medicare by eliminating coinsurance and deductibles on vital preventive health services. Such services can help keep people healthy and detect disease in its earliest, most treatable stages.

As a result, Medicare now offers a long list of preventive health services with no out-of-pocket costs, including screenings for cancer, diabetes, cardiovascular disease, osteoporosis, and shots for flu and pneumonia.

The health reform law also adds new preventive screenings and counseling for obesity, alcohol abuse, and depression.

More than 2 million Californians with Medicare received at least one Medicare-covered preventive health benefit in 2011.

The health reform law also creates another important benefit for people with Medicare: annual wellness visits.

If you’ve had Medicare Part B for longer than 12 months, you can get a yearly wellness visit with your doctor to develop or update a personalized plan to prevent illness based on your current health and risk factors.

(The annual wellness visit is in addition to the one-time “Welcome to Medicare” preventive visit when you first enroll in Medicare.)

More than 165,000 Californians with Medicare took advantage of a wellness visit last year.

Because of financial incentives in the ACA, seniors also can expect to see better quality in their Medicare Advantage health plans. Such plans are operated by private insurers and generally require you to stay within a network of physicians and other providers or face higher out-of-pocket expenses.

Medicare Advantage plans that receive quality ratings of three stars or more under our Five-Star Rating System will get bonus payments. We believe the bonuses will motivate other plans to improve their quality as well.

Medicare Advantage plans that receive five stars – the highest rating – will be able to market to and enroll seniors year-round, not just during the open enrollment period in the fall. That means seniors can switch to the best plans at any time. (To check your plan’s rating, go to www.Medicare.gov.)

Lastly, the ACA provides a variety of new tools to crack down on Medicare fraud.

The law not only toughens federal sentencing guidelines for fraud (meaning crooks will spend more time in prison), it also allows us to suspend payments to providers suspected of trying to rip off Medicare.

In addition, we’re now using sophisticated predictive analytics software to identify patterns of fraud and target crooks. This is the same type of software credit card companies use to stop fraud.

 

David Sayen is Medicare’s regional administrator for California, Arizona, Nevada, Hawaii, and the Pacific Trust Territories. You can get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).

Comment On This Story
COMMENT POLICY: We welcome comments from individuals and businesses. All comments are moderated. Comments are subject to rejection if they are vulgar, combative, or in poor taste.
REAL NAMES ONLY: All posters must use their real individual or business name. This applies equally to Twitter account holders who use a nickname.

0 Comments

You can be the first one to leave a comment.

Leave a Comment


Opinion Section Policy
All opinions and ideas are welcome. Factually inaccurate, libelous, defamatory, profane or hateful statements are not. Your words must be your own. All commentary is subject to editing for legibility. There is no length limit, but the shorter, the better the odds of people reading it. "Local" SCV-related topics are preferred. Send commentary to: LETTERS (at) SCVNEWS.COM. Author's full name, community name, phone number and e-mail address are required. Phone numbers and e-mail addresses are not published except at author's request. Acknowledgment of submission does not guarantee publication.
Read More From...
RECENT COMMENTARY
Monday, Apr 15, 2019
Congress created the job of Medicare Beneficiary Ombudsman to assist people with Medicare with their inquiries, complaints, grievances, appeals, and requests for information.
Thursday, Apr 4, 2019
Welcome All to the Saugus Union School District State of the District Series.
Tuesday, Apr 2, 2019
Some of my favorite memories are of exploring our City’s trails and paseos on bike or foot with my children.
Monday, Apr 1, 2019
In her April 2019 column, Santa Clarita Mayor Marsha McLean invites the community to attend the city's 26th Cowboy Festival the weekend of April 13-14 at Hart Park and nearby venues in Old Town Newhall.
Friday, Mar 15, 2019
Medicare covers a wide variety of shots to help you stay healthy. It also covers numerous tests to help detect diseases early, when they’re in their most treatable stages.
Monday, Mar 4, 2019
This month marks the beginning of the next exciting phase of progress toward the completion of the new Canyon Country Community Center.

Latest Additions to SCVNews.com
The College of the Canyons men's basketball program invites boys and girls in third to eighth grade to participate in the 2019 Howard Fisher's Cougar Basketball Camp, with two sessions running this summer.
Registration for Howard Fisher’s 2019 Cougar Basketball Camp Now Open
LOS ANGELES - The Los Angeles County Department of Public Health (Public Health) confirmed one case of measles in a person who flew in and out of Los Angeles International Airport (LAX) on April 3 while infectious.
County Confirms Another Case of Measles in Person Who Flew In & Out of LAX
In a world where children are exposed to many dangers, being informed is the best tool a parent can acquire.
May 8: ‘Growing Together’ Parent Resource Symposium
As part of its long-standing commitment to innovative efforts that support adoption of renewable energy and preserve air and water quality, the Board of Supervisors will present the 11th annual Green Leadership Awards on Tuesday, April 23 at their regularly scheduled meeting.
Supes to Recognize ‘Green Leaders’ at Next Meeting
NORTHRIDGE - The CSUN softball team returns to Matador Diamond this weekend to complete a six-game home stand against Cal Poly.
CSUN Readies for 3-Game Set Against Cal Poly
LOS ANGELES – With measles outbreaks occurring nationally and internationally and the increase in travel during the spring break season, the Los Angeles County Department of Public Health (Public Health) reminds everyone who has not been immunized against measles to get the measles-mumps-rubella (MMR) immunization
County Issues Public Health Warning as Measles Outbreaks Continue
Kerry Brougher, Director of the Academy Museum of Motion Pictures, announced Thursday the George Lucas Family Foundation has provided a transformative grant in support of the Academy Museum’s educational mission.
Academy Museum Admission Free to Kids Under 18 after Lucas Family Foundation Grant
Close to a dozen people were hurt including four who were taken to the hospital following a four-vehicle pileup in the northbound lanes of Highway 14 near Via Princessa shortly after midnight.
Four-Vehicle Pile Up on State Route 14 Causes Injuries
Former gang-member-turned-scholar, Robert J. Durán, will explore how the label “gang member” is used to criminalize Latino youth along the border between the United States and Mexico, during a lecture at California State University, Northridge on Monday, April 29.
April 29: CSUN Lecture Explores ‘The Gang Paradox’ Along US-Mexico Border
The Gentle Barn is honoring 2019's Year of the Pig with some of the world's most amazing pigs at a public event Sunday, April 21, from 10:00 a.m. - 2:00 p.m.
April 21: Gentle Barn Celebrates Year of the Pig with Piggy Party
LANCASTER – Lancaster jumped out to an early lead and hung on late to beat Inland Empire, 8-5, in the rubber match of a three-game series Wednesday night at The Hangar.
JetHawks Survive Rubber Match
NASA and its International Space Station partners have set a new schedule and new crew assignments that will include the first flight of NASA astronaut Jessica Meir, an extended stay for NASA astronaut Andrew Morgan, and a record-setting flight for NASA astronaut Christina Koch.
NASA Astronaut Projected to Set Record for Longest, Single, Female Spaceflight
CANYON COUNTRY — Miciah Edwards, a junior at Canyon High School will be a Delegate to the Congress of Future Medical Leaders in Lowell, MA, which will take place from June 23 - June 25.
Canyon Honor Student Nominated for Congress of Future Medical Leaders
The North Los Angeles County Transportation Coalition's Board of Directors will hold its regular meeting Monday, April 22, at 1:00 p.m.
April 22: North Los Angeles County Transportation Coalition Regular Meeting
Nearly 2,000 books left behind at the former Albert Einstein Academy, which closed its doors last year due to declining enrollment and financial constraints, found homes at two different schools on two different continents.
Abandoned Einstein Academy Books Donated to Porter Ranch, Ugandan Schools
1945 - Actors Harry & Olive Carey sell Saugus ranch after 29 years; now Tesoro del Valle [story]
Carey Ranch
Composer, sound artist and CalArts alum Ellen Reid (Music MFA 11) on Monday was awarded the Pulitzer Prize for music for "p r i s m," "a bold new operatic work that uses sophisticated vocal writing and striking instrumental timbres to confront difficult subject matter: the effects of sexual and emotional abuse."
CalArts Alum Ellen Reid Wins 2019 Pulitzer Prize for Music
The Santa Clarita Valley Senior Center is proud to announce the opening of the new SCV Senior Center in Canyon Country and its dedication in a public ribbon-cutting ceremony on Wednesday, April 24 at 10 a.m.
April 24: New SCV Senior Center Dedication Day
The Master's University men's golf team fired a collective 13-over in the second round of the Golden State Athletic Conference Championship on Tuesday, moving up two spots and trailing only Ottawa University of Arizona.
Mustang Golf Moves Into Enviable Position at GSAC Championship
College of the Canyons finished a stroke behind tourney winner Santa Barbara City College to see its conference tournament win streak halted at five during the Western State Conference event played at San Dimas Canyon Golf Course on Monday.
Cougars Men’s Golfers Finish Second at WSC No. 8 in San Dimas
College of the Canyons' doubles team of Una Stanisavljevic and Seleste Sakato finished runner-up at the Western State Conference Doubles Championships after a tough loss in Friday's championship match.
Lady Cougars Doubles Duo Finishes Runner-Up At WSC Championships
With a goal of lowering prescription drug costs, Los Angeles County officials said Wednesday they will join a new state program that allows the county to bargain directly with drug companies.
LA County Joins California Bulk Drug-Buying Program
The SCV Man & Woman of the Year winners will be announced at the 54th annual Recognition Dinner at the Hyatt Regency Valencia on Friday, May 3, starting at 6 p.m.
May 3: SCV Man & Woman of the Year Awards Dinner
A tentative agreement between Henry Mayo Newhall Hospital and its registered nurses has been made after an emergency meeting was held Tuesday night.
Henry Mayo Newhall Hospital, Nurses Reach Tentative Agreement
The city of Santa Clarita has been recognized by the California Internship & Work Experience Association as a 2019 Employer of the Year, an award bestowed upon employers that model exemplary internship and work experience programs.
Santa Clarita Wins Award for College Intern, Work Experience Programs
The Santa Clarita Valley Chamber of Commerce will host its first "Pop-Up Biz Expo," a new concept to help SCV businesses promote their products and services, on the California Institute of the Arts campus in Valencia on Wednesday, June 19, from 5 p.m. to 8 p.m.
June 19: SCV Chamber to Open First Pop-Up Expo for SCV Businesses
During a recent four-day trip to Seattle, 12 video production students from Castaic Middle School were part of a group that garnered four awards at the 2019 Student Television Network Awards.
Castaic Middle School Video Production Students Win National Awards
Los Angeles County Supervisors Janice Hahn and Sheila Kuehl on Tuesday recommended creating a permanent Youth Advisory Body to give young people a voice in the creation and implementation of county policy matters that impact them.
Supes Propose LA County Youth Advisory Body
The JetHawks were unable to extend their winning streak to seven Monday, losing to Inland Empire, 7-1, at The Hangar.
JetHawks’ Win Streak Comes to an End Tuesday
The California Air Resources Board Wednesday announced a settlement with Fiat Powertrain Technologies Industrial S.p.A for emissions-related violations affecting nearly 2,000 on-road and off-road diesel engines.
Fiat Pays California $6.4M Penalty for Diesel Emissions Violations
Just before a Whittier man was sentenced to more than 22 years in prison for three counts of vehicular manslaughter, the father of one of those victims had a chance to describe the three years of pain he has endured.
Grieving Father Forgives Man Who KIlled His Daughter
The Boys & Girls Club of Santa Clarita Valley will host its 48th annual auction and fundraiser on Saturday, June 1, at the Hyatt Regency Valencia, with doors opening at 5 p.m.
June 1: 48th Annual Auction to Benefit Boys & Girls Club SCV
Santa Clarita was ranked the ninth-safest city in California by an online firm that crunched the latest crime statistics compiled by the FBI.
Santa Clarita Named 9th Safest City in California
With a May 1 deadline to submit state budget revisions rapidly approaching, California Governor Gavin Newsom promised Southern California officials and health service providers Tuesday that the state could financially back their efforts to tackle homelessness.
Newsom Vows Relief for Homeless Californians
The California High-Speed Rail Authority indicated Tuesday it is likely to recommend approval of interim rail service connecting Central Valley cities before expanding the service to Los Angeles and San Francisco as funding becomes available.
California Bullet-Train Agency Eyes Central Valley-Only Service, for Now
The Los Angeles County Board of Supervisors on Tuesday unanimously approved a motion by Supervisor Kathryn Barger to offer a $20,000 reward for information leading to the apprehension and/or conviction of the suspect(s) responsible for the heinous murder of Chyong Jen Tsai, a 76-year-old Arcadia woman.
County Offers $20K Reward in Arcadia Homicide Investigation