header image

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

Inside
Weather


 
Calendar
Today in
S.C.V. History
March 29
1928 - Little dam victim, thought unidentified & buried in SCV, actually ID'd & buried in Chatsworth [story]
Newhall Cowboys


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
Wednesday, Mar 27, 2024
Remo, Inc. is is the world's leading manufacturer and developer of synthetic drumheads and shells. They’ve been in business for 60 years
Tuesday, Mar 26, 2024
Springtime in Santa Clarita brings not only vibrant blooms and opportunities to embrace the outdoors with warmer weather, but also an array of free, family-friendly events and this Saturday is no exception.
Thursday, Mar 21, 2024
Did you know that each year, Main Street in Old Town Newhall undergoes countless makeovers for different events, such as Light Up Main Street and the Fourth of July Parade?
Thursday, Mar 21, 2024
Los Angeles County Supervisor Kathryn Barger, whose Fifth District includes the Santa Clarita Valley, issued the following statement Thursday in response to an announcement by Federal Communications Commission Chairwoman Jessica Rosenworcel of a proposal to change how calls to the 9-8-8 Suicide and Crisis Lifeline are routed.
Monday, Mar 18, 2024
Unlike our children who enjoy a week-long spring break, we adults no longer have that luxury.
Friday, Mar 15, 2024

Latest Additions to SCVNews.com
1928 - Little dam victim, thought unidentified & buried in SCV, actually ID'd & buried in Chatsworth [story]
Newhall Cowboys
Los Angeles County Public Works is updating the Los Angeles County Bicycle Master Plan.
April 16:  County Bicycle Master Plan Virtual Community Meeting
College of the Canyons mens golf got back on track during its return to conference play on Monday, carding a five-man score of 370 to top the eight-team field at Brookside Golf Course and maintain its unblemished conference mark.
Cougars Win Again, Keep Conference Streak
Los Angeles County Treasurer and Tax Collector, reminds property owners that the second installment of the 2023-24 Annual Secured Property Taxes becomes  delinquent if not received by 5 p.m. Pacific Time or United States Postal Service postmarked on or before Wednesday, April 10, 2024.
County Treasurer Reminds Property Owners of April 10 Due Date
Local nonprofit Fostering Youth Independence is seeking “Allies” to support Santa Clarita youth who are aging out of the L.A. County foster care system.
April 16: FYI Seeks Volunteers To Pair With Local Foster Youth
The Los Angeles County Department of Public Health today unveiled the latest L.A. County Health Survey, which gathers vital data on health behaviors, conditions, neighborhood settings, and the needs of L.A .County residents, informing future public health policies and programs.
Public Health Unveils the 2023 L.A. County Health Survey Findings
Due to the projected rain forecast, Eggstravaganza will now be held indoors at the Canyon Country Community Center beginning promptly at 10 a.m. on March 30.
March 30: Eggstravaganza Now Being Held Indoors at Canyon Country Community Center
To support the mental health of California's young people, the California Department of Public Health awarded $25 million to 28 tribal and community-based organizations across the state.
California Announces $25 Million in Awards for Youth Mental Health
The College of the Canyons Athletic Department will host a dedication ceremony to unveil the Michele Jenkins Softball Team Room in honor of the longtime board member and ardent softball program supporter’s nearly 40 years of service to the district.
April 16: COC to Host Michele Jenkins Team Room Dedication Ceremony
PFLAG Santa Clarita has announced the establishment of the Peggy and Jeff Stabile PFLAG SCV Scholarship. The scholarship will provide financial assistance to LGBTQIA+ students pursuing higher education and committed to advocating for LGBTQIA+ rights and promoting diversity and inclusion.
PFLAG SCV Announces Stabile PFLAG Scholarship
1934 - Bouquet Canyon Reservoir, replacement for ill-fated St. Francis Dam & reservoir, begins to fill with water [story]
Bouquet Reservoir
The California Department of Public Health launched the “Never a Bother” campaign, a youth suicide prevention public awareness and outreach campaign for youth, young adults, and their parents, caregivers, and allies.
California Launches New Youth Suicide Prevention Campaign
The Santa Clarita Master Chorale invites the community to "Let the Sunshine In," a delightful evening of food, wine and song at the annual Cabaret & Cabernet fundraising benefit.
April 20: Santa Clarita Master Chorale’s Cabaret, Cabernet Fundraiser
The Los Angeles County Department of Public Health cautions residents who are planning to visit the below Los Angeles County beaches to avoid swimming, surfing, and playing in ocean waters:
March 27 Ocean Water Warning
As an integral ingredient necessary to help the Santa Clarita Valley to flourish, feedback from the business community is the secret sauce for achieving great things.
SCVEDC Asks For the Business Community’s Opinion on Santa Clarita
Raise your heart rate while raising funds for the Santa Clarita Sister Cities Dollars-for-Desks campaign to provide school desks for students in Sariaya, Santa Clarita's Sister City in the Philippines.
April 13: Sister Cities Zumba-thon Fundraiser
Remo, Inc. is is the world's leading manufacturer and developer of synthetic drumheads and shells. They’ve been in business for 60 years
SCVEDC Company Spotlight: Drumming Up Big Business with Remo, Inc.
California State Assemblywoman Pilar Schiavo (D-Chatsworth) and Assemblyman James Ramos (D-Highland) have introduced AB 3074 the "School or athletic team names: California Racial Mascots Act."
Schiavo Introduces Bill to Prohibit ‘Derogatory’ School Mascot Names
Los Angeles County’s Justice, Care and Opportunities Department  in collaboration with Local Initiatives Support Corporation Los Angeles is proud to announce the 2nd Annual Pitch Competition for the cohorts of JCOD's Incubation Academy.
March 28: JCOD Incubation Academy Helps Grassroots Non-Profits For the Second Year
Children’s Bureau is seeking foster families and now offers two virtual ways for individuals and/or couples to learn how to help children in foster care while reunifying with birth families or how to provide legal permanency by adoption.
April 18: Children’s Bureau Hosts Virtual Orientation
The Sunburst track was constructed in 1887 by the Southern Pacific Railroad and was a part of the main line running between San Francisco and Los Angeles.
Enjoy Spring With a Ride On The Sunburst Track
California State Superintendent of Public Instruction Tony Thurmond hosted a Personal Finance Summit today where he announced his support for Assembly Bill 2927 (McCarty), legislation that would require a personal finance education course for California high school graduation.
State Superintendent Announces Support for Personal Finance Graduation Requirement
1847 - Probable birth date of Pico Canyon oil driller Charles Alexander Mentry [story]
C.A. Mentry
SCVNews.com