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Some Ways the Health Care Reform Law Affect You in 2011

Information provided by the Kaiser Family Foundation’s Kaiser Health News

This year a number of policies from the new health care reform law will be implemented. Below is a description of just some of health changes that will go into effect in 2011.

Insurance Rebates and Limitations on Premium Increases: Starting this year, health insurers must spend at least 80 percent of their premiums on medical care, or face the possibility of giving rebates to consumers. Rebates will not be sent to everyone as this new rule does not apply to all plans. The goal is to pressure insurers to restrain profits and administrative costs, such as overhead, marketing and executive salaries.
Another check on insurance companies is that regulators have proposed that beginning July 1 premium increases of 10 percent or more be subject to additional review by states and the federal government. The review would determine if the increase is considered unreasonable. The proposed rule would affect policies sold to individuals and small businesses.

Lower Prescription Costs for Seniors: Prescription drug costs could shrink $700 for a typical Medicare beneficiary in 2011, as the law begins to close the notorious doughnut hole – the gap in prescription coverage when millions of seniors must pay full price at the pharmacy. Starting in January, drug companies will give seniors 50 percent off brand drugs while in the gap, excluding those low-income people who already get subsidies. Generics will also be cheaper.

Healthy Eating: Beginning soon after the Food and Drug Administration finalizes rules in 2011, chain restaurants with 20 or more locations, and owners of 20 or more vending machines, will have to display calorie information on menus, menu boards and drive-thru signs. Restaurants must also provide diners with a brochure that includes detailed nutritional information, like the fat content of their dishes.

Staying Healthy: Several provisions of the law promote prevention of disease, especially for seniors. Medicare enrollees will be able to get many preventive health services – such as vaccinations and cancer screenings – for free starting in January. Specifically, the law eliminates any cost-sharing such as copayments or deductibles for Medicare-covered preventive services that are recommended (rated A or B by the U.S. Preventive Services Task Force). Also starting in January, Medicare beneficiaries can get a free annual "wellness exam" from their doctors who will set up a "personalized prevention plan" for them. And people working for small employers will get some help. The law authorizes the federal government to issue grants totaling $200 million for companies with fewer than 100 workers that start wellness programs focused on nutrition, smoking cessation, physical fitness and stress management.

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