Extra Help with Medicare Prescription Drug Plan Costs
Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. The Extra Help is estimated to be worth about $4,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia.
The Medicare Part D Prescription Drug Benefit
The Medicare Modernization Act of 2003 (MMA) established a voluntary outpatient prescription drug benefit for people on Medicare known as Part D, which went into effect in 2006. All 55 million people on Medicare, including those ages 65 and older and those under age 65 with permanent disabilities, have access to the Medicare drug benefit through private plans approved by the federal government. During the Medicare Part D open enrollment period, which runs from October 15 to December 7 each year, beneficiaries can choose to enroll in either stand-alone prescription drug plans (PDPs) to supplement traditional Medicare or Medicare Advantage prescription drug (MA-PD) plans (mainly HMOs and PPOs) that cover all Medicare benefits including drugs. Beneficiaries with low incomes and modest assets are eligible for assistance with Part D plan premiums and cost sharing. This fact sheet provides an overview of the Medicare Part D program and information about 2016 plan offerings, based on data from the Centers for Medicare & Medicaid Services (CMS) and other sources.
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Health Reform Implementation Timeline
Implementation update: On July 19, 2010, the Office of Consumer Information and Insurance Oversight (OCIIO) issued regulations on the new preventive benefits coverage requirements. These rules apply to new plans established on or after September 23, 2010. On August 1, 2010, the U.S. Preventative Services Task Force released its recommendations. On July 19, 2011, the Institute of Medicine released a report that recommended several women’s preventive services that should be included in health plans with no cost-sharing. On August 1, 2011, HHS issued interim final regulations on preventive services, including requirements that insurers cover birth control with no cost-sharing. On August 3, 2011, HHS issued an amendment to the final regulations. On February 15, 2012, HHS issued final rules “authorizing the exemption of group health plans and group health insurance coverage sponsored by certain religious employers from having to cover certain preventive health services.” Also on February 15, 2012, HHS issued an issue brief estimating that 54 million Americans had received preventive benefits without cost-sharing. On August 1, 2012, HHS began requiring most new and renewing health plans to provide women’s preventive health services, including contraception, with no cost-sharing. HHS issued a brief estimating that 47 million women will receive coverage for these services without cost sharing.”
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A list of all 50 states and the District of Columbia ranked by percentage of population not covered by health insurance during 2015. Also included, the total ACA Exchange enrollment for each state. Source: U.S. Census Bureau, Health Insurance Coverage in the United States: 2015, issued in…