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10 Healthcare Reform Changes that Roll Out in 2013

There’s a common misconception that “ObamaCare” goes into effect on a certain date, and BAM! after that date, everything changes. Sorry, not true. Some changes have already taken place, and many more are coming soon.

While many of the big changes go into effect next year, here are 10 to look out for in 2013.


Changes for Medicare

1. Donut Hole Continues to Decrease by 10% Yearly Each year since 2010, the donut hole amount has been reduced by 10%. It will continue to go down 10% each year until it disappears in 2020. Then you’ll pay your normal 25% coinsurance.

2. Discounts on Some Brand-Name Prescription Drugs for Medicare The government has negotiated with brand-name drug manufacturers to offer 50% off some prescriptions. Check with your local pharmacy to see if the discount applies to your medications.

3. Bundled Medicare Payment Pilot Program The healthcare law allows providers who are receiving Medicare payments to choose to receive bundled payments for an episode of care, such as a heart attack. The program seeks to increase the coordination of care for the patient, which will hopefully improve both cost and quality outcomes.

4. Tax Increase for Medicare Part A Starting this year, there will be a 0.9% (from 1.45% to 2.35%) increased tax on earnings over $200,000 for individual taxpayers and $250,000 for married couples filing jointly. In addition, there’s a 3.8% assessment on unearned income for higher-income taxpayers.

5. Medicare Disproportionate Share Hospital Payments Starting Oct. 1, 2013, the healthcare law will reduce Medicare Disproportionate Share Hospital (DSH) payments initially by 75% and increases payments based on the percent of the population uninsured and the amount of uncompensated care provided.

These payments were developed by the federal government to help hospitals that provide a disproportionate share of free or uncompensated care. With Medicaid expansion there may be less need for the program’s benefits.

Changes for Medicaid

6. Medicaid Pay Raise for Family Doctors Patients with Medicaid will have greater access to high quality doctors because, starting this year, doctors who see Medicaid patients will get more money per patient from the government. Get more info.

7. Improving Medicaid Preventive Care A lot of times lower-income families don’t get the preventive care they need. When they finally see a doctor, they find out they have a chronic condition that requires a lot of care – like diabetes. By improving preventive care benefits for Medicaid patients, the government hopes to catch these chronic cases early and reduce the overall cost of care. Learn more about preventive care.

8. CHIP: Children Covered through 2015 If you make a little too much money to qualify for Medicaid, but still not enough to pay for coverage, the government program called CHIP will cover your kids through 2015. If your child gets sick, they can go to a doctor instead of the hospital. Theoretically this will reduce overall healthcare costs and increase wellness. More info about CHIP.

Changes for Employer-Based Insurance

9. Insurance Exchanges Roll Out This Fall It’ll be a totally different Open Enrollment than many are used to come this fall when the insurance exchanges open up. That means, you’ll be able to go to this “marketplace” and purchase your own insurance for you and your family. Read more about how the exchanges will impact you.

10. FSA Amount Capped at $2,500 You used to be able to put in as much money into your FSA as your employer would allow. Unfortunately, this year, the government says you can only put $2,500 of tax-free money into your account.

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