More People Using Free Preventive Benefits Provided by Affordable Care Act

Press Release

By:  Kathleen Sebelius
Date: Oct. 6, 2011
Location: Washington, DC

The Centers for Medicare & Medicaid Services (CMS) reported today that nearly 20.5 million people with Medicare reviewed their health status at a free Annual Wellness Visit or received other preventive services with no deductible or cost sharing this year. In addition, nearly 1.8 million people with Medicare have received discounts on brand-name drugs in the Medicare Part D coverage gap, also known as the "donut hole," between January and August of this year. The total value of discounts to people with Medicare in the donut hole is nearly $1 billion through August of this year, with an average savings of $530 per beneficiary.

"Thanks to the Affordable Care Act, more people with Medicare are getting preventive services like mammograms for free," said HHS Secretary Kathleen Sebelius. "The new health care law is also making prescription drugs more affordable for millions of seniors and people with disabilities."

Some of the free preventive services available to people with Medicare include:

* Mammograms and cervical cancer screenings
* Annual Wellness Visit
* Cholesterol and other cardiovascular screenings
* Colorectal and prostate cancer screenings

"October is National Breast Cancer Awareness month -- a great time for women with Medicare to schedule a free Annual Wellness Visit with their doctors. At that visit they can talk about their personal risk for breast cancer, if they should have a mammogram or how often to have one," said CMS Administrator Donald Berwick, MD. "If you and your doctor decide that a mammogram is in order, Medicare will cover that preventive screening annually, free of charge. Already, more than 4 million women have taken advantage of that benefit this year."

The rising number of people who are taking advantage of preventive benefits and prescription drug discounts comes as people with Medicare are beginning to review their plan options for next year. The popular web-based Medicare Plan Finder is now available to help beneficiaries, their families, other caregivers, and senior program advocates look at all local drug and health plan options that are available for the 2012 benefit year.

The annual enrollment period begins earlier this year than last year, on October 15, and runs through December 7. People with Medicare will have seven weeks to review Medicare Advantage and Part D prescription drug coverage benefits and plan options, and choose the option that best meets their unique needs or keep the plan they have today. The earlier open enrollment period also ensures that Medicare has enough time to process plan choices so that coverage can begin without interruption on January 1, 2012.

Every person with a Medicare Advantage or a Part D drug plan will also see better value in those plans for the second year. Average Part D drug plan premiums will remain virtually unchanged in 2012. Those in the Part D coverage gap, or do nut hole, will continue to be able to get discounts on covered brand name drugs. People with Medicare will get deeper discounts in the years ahead until the gap is closed in 2020. On average, Medicare Advantage premiums will be 4 percent lower in 2012 than in 2011, and plans project enrollment to increase by 10 percent. All beneficiaries will have access to Medicare-covered preventive services with zero cost-sharing, including the Annual Wellness Visit, bone-mass measurement, colon cancer screenings, and diabetes screenings, as well as influenza and pneumococcal vaccines, to name a few.

To access the Medicare Plan Finder, go to: https://www.medicare.gov/find-a-plan/.

For more information about how the Affordable Care Act closes the donut hole over time, go to: http://www.medicare.gov/Publications/Pubs/pdf/11493.pdf

For state-by-state information on the number of people who are benefiting from discounts in the donut hole in 2011, go to: https://www.cms.gov/Plan-Payment/

For state-by-state information on utilization of free preventive services and the Annual Wellness Visit, go to: http://www.cms.gov/NewMedia/02_preventive.asp

For more information on Medicare's prevention benefits, go to the Share the News. Share the Health! website: http://www.medicare.gov/share-the-health/or call 1-800-MEDICARE.