Will Your Nc Health Plan Change?

Regardless of the choices made by legislators, it will be very important for people to educate themselves on the new healthcare plan so that they understand what the current face of health care, Medicare, Medicaid, and insurance looks like.

There are many sectors that will be affected by the (potential) changes that will result from health care reform. When it comes to NC health plans, every citizen has a vested interest in making sure that they are able to afford adequate insurance to cover them, both in case of an emergency as well as for the costs of day to day life. Many who have sought out an NC health insurance quote or have researched Asheville health plans have questioned how the new health care proposals will affect the health care industry.

Let’s take a look at how the proposals have handled the Medicare prescription drug “donut hole.” One example in how the health care reform may change the face of health insurance is in the way that Medicare works. The donut hole is this: Medicare pays for prescriptions up to $2,830, after which their coverage stops. There is a gap between then and when prescription coverages picks up again, so that only after out of pocket spending reaches $4,550 will prescription coverage resume. The issue here is clear: prescription coverage lapses often at a time when people need it most, and many people resort to skipping doses or not filling some or all of their prescriptions, endangering and possibly damaging their health. They may also incur higher health care costs as a result of not having the medication they need.

The President’s Proposal: This is the most complete of all the solutions currently on the table. To begin with, instead of upping the amount before the donut hole as the House and Senate bills do, it will provide a $250 rebate to Medicare beneficiaries who hit the donut whole in the year 2010. It then begins the process of eliminating the donut hole completely by phasing the coinsurance down so that by 2020 it meets the standard 25% coverage throughout the gap in coverage.

The Senate Bill: The Senate bill looks to ease the gap by providing a 50% discount for certain drugs during the donut hole period. It also raises, by $500, the amount paid before the donut hole begins.

The House Bill: The house bill also raises the amount before the donut hole by $500. It also provides for a plan that will phase the donut hole out entirely over a period of ten years.

Each of these options provides better care and coverage to seniors (or others who qualify for Medicare) whose prescription medication needs exceed the amount that is currently covered. Obviously, this is only one example of the many changes that are currently being addressed in the reform debates. Extending coverage to an older, more expensive to care for age group returns the debate to finance instead of health, but as the legislators seek to find a way to better the system, this is a very obvious consideration that cannot be excluded. Some of the others that are currently being debated include whether or not to lower the age of Medicare availability to 55. Opponents point out that the people most likely to be uninsured are young- from 19 to 29- and are usually cheaper to ensure than those in older age groups.