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Federal Health Care Reform

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Information for North Carolina Medicare Beneficiaries

This website provides very general information about the Affordable Care Act. For the most complete and up-to-date information about the health care reform law, visit the federal website www.hhs.gov/healthcare.

While the Affordable Care Act primarily addresses coverage and access issues for people not on Medicare, the ACA also addresses several over-arching Medicare issues.

Your Medicare coverage is protected

Medicare isn’t part of the Health Insurance Marketplace established by ACA, so you don't have to replace your Medicare coverage with Marketplace coverage.

More Preventive Services for Less

Because of provisions in the ACA, Medicare now covers certain preventive services – such as mammograms or colonoscopies – without charging Part B coinsurance or deductibles. You can also get a free annual wellness visit to develop or update a prevention plan just for you, based on your current health and risk factors. You'll pay nothing for this benefit if the doctor participates in the Medicare program, and it is covered once every 12 months.

Medicare Prescription Drug Coverage (Part D) More Affordable

Over the next several years, you will pay less in the prescription drug coverage gap – also called a "donut hole" – until that gap is closed by 2020. The coverage gap closes by maintaining the manufacturers' discounts and increasing what Medicare drug plans cover. By 2020, you'll pay only 25 percent for covered brand-name and generic drugs during the gap— the same percentage you pay from the time you meet the deductible (if your plan has one) until you reach the out-of-pocket spending limit (up to $4,750 in 2013).

If you have questions about Medicare, please contact SHIIP, the North Carolina Seniors' Health Insurance Information Program, at 855-408-1212 (toll free) or visit www.ncshiip.com.