Grijalva Highlights Increased Availability of Medicare Preventive Services – Affordable Care Act Cuts Health Screening, Checkup Costs
Washington, D.C. – The Patient Protection and Affordable Care Act (PPACA), last year’s landmark health reform law, eliminated insurance copayments for many important screenings and preventive checkups for Medicare patients. The Centers for Medicare and Medicaid Services (CMS) has released a new report showing that more than 5 million Medicare recipients – nearly one in six beneficiaries – have taken advantage of at least one of those benefits since the beginning of the year.
As the report notes, “Beginning January 1, 2011, the Affordable Care Act eliminated Part B coinsurance and deductibles for recommended preventive services, including many cancer screenings and key immunizations. The law also added an important new service — an Annual Wellness Visit with the doctor of their choice— at no cost to beneficiaries. As of June 10, 2011, approximately 5.5 million people with traditional Medicare used one or more of the preventive benefits including, most prominently, mammograms, bone density screenings, and screenings for prostate cancer.”
Annual Wellness Visits include a review of the patient’s health and the development of a personalized wellness plan. Over 780,000 beneficiaries received an Annual Wellness Visit between January 1 and June 10, according to the CMS report.
“This is how good laws work,” said Rep. Raúl M. Grijalva, who voted for the reform bill. “We’ve made important health care services more available to millions of people and saved taxpayer money at the same time. Every disease or chronic condition we avoid because of an early screening means a healthier American and less cost to the public in the long run. I hope seniors in Southern Arizona and around the country take advantage of these services as often as possible.”
CMS also released an open letter to doctors explaining how the PPACA makes more health services affordable and available to all patients regardless of their Medicare status. Protections already in effect include:
· Ban on Lifetime Limits and Rescissions: Health plans are now prohibited from imposing a lifetime dollar limit on covered benefits. Health plans cannot revoke coverage based solely on a mistake on an application, a method some insurers have used to disenroll sick, high-cost enrollees.
· Choice Of Your Own Doctor: Patients in many health plans can choose the primary care doctor they want from their plan’s provider network. They may also see an OB-GYN doctor without a referral. In addition, most health plans may not require prior approval for emergency services or charge more for emergency services obtained out of network.
· Free Preventive Services: All new health plans must cover all recommended preventive services without cost sharing. Patients in these plans have access, at no cost, to preventive services such as blood pressure, diabetes and cholesterol tests, cancer screenings, and vaccinations.
· Access to Coverage For Children: Millions of young adults under 26 are now eligible to stay on their parents’ plan, and children under 19 can no longer be denied coverage due to a pre-existing condition (the same will apply to adults beginning in 2014).
· Pre-Existing Condition Insurance Plan (PCIP): For individuals who have been without health insurance coverage for six months due to a pre-existing condition, each state has a PCIP that allows these uninsured individuals to purchase affordable health coverage. For more information about enrollment in a PCIP, visit http://www.healthcare.gov/law/provisionslpreexisting/index.html.
The agency also launched a Spanish version of the Medicare website at http://es.medicare.gov. Medicare’s dedicated caregivers’ website “Ask Medicare” (http://www.medicare.gov/caregivers) now has a prevention section especially for caregivers.
The CMS report is available at Grijalva’s Web site at http://grijalva.house.gov/uploads/PreventionReport.pdf. The “Dear Doctor” letter is available at http://grijalva.house.gov/uploads/DearDocLetter.06%2020%202011.pdf.
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