Medicare Donut (Doughnut) Hole-Health Insurance Coverage/Young Adult Kids

See links to other posts related to Medicare at the end of this posting.

Many of us caring for the health of aging parents are simultaneously worrying about our children—young adults trying to enter the job market who have no health insurance coverage. Even before the recession we worried because so many of our young adult children had minimal access to insurance coverage.

The legislation passed by the House of Representatives last night will allow us to breathe more easily at both ends of the caregiving age range. See the March 22, 2010 New York Times article, For Consumers, Clarity on Health Care Changes.

Go to What Goes into Effect Right Away — from House of Representatives Energy and Commerce Committee for the full list of changes that will take place immediately or within months after the bill is enacted. Of greatest significance to aging children with aging parents and young adult children are:

  1. The Medicare Part D donut (doughnut) hole will gradually disappear for our aging parents.
  2. Those of us who also have young adult children who have yet to have jobs with health coverage/benefits will be able to continue our children, through age 26, on family health insurance policies.

I hope our aging parents understand how important it is to have this counterbalance that supports the health of their grandchildren.

SOME KEY PROVISIONS THAT TAKE EFFECT (almost) IMMEDIATELY UNDER SENATE BILL AS AMENDED BY RECONCILIATION BILL (an extended list of such provisions appears here)

  • BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE—Provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. Effective for calendar year 2010. (Beginning in 2011, institutes a 50% discount on brand‐name drugs in the donut hole; also completely closes the donut hole by 2020.)
  • EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 26th BIRTHDAY THROUGH PARENTS’ INSURANCE–Requires health plans to allow young people up to their 26th birthday to remain on their parents’ insurance policy, at the parents’ choice. Effective 6 months after enactment.
  • FREE PREVENTIVE CARE UNDER MEDICARE—Eliminates co‐payments for preventive services and exempts preventive services from deductibles under the Medicare program. Effective beginning January 1, 2011.
  • HELP FOR EARLY RETIREES—Creates a temporary re‐insurance program (until the Exchanges are available) to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55‐64. Effective 90 days after enactment.
  • ENDS RESCISSIONS—Bans health plans from dropping people from coverage when they get sick. Effective 6 months after enactment.
  • NO DISCRIMINATION AGAINST CHILDREN WITH PRE‐EXISTING CONDITIONS—Prohibits health plans from denying coverage to children with pre‐existing conditions. Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to all persons.)
  • BANS LIFETIME LIMITS ON COVERAGE—Prohibits health plans from placing lifetime caps on coverage. Effective 6 months after enactment.

Links to other posts related to Medicare

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