If I’m nearing 65, what does health care reform mean for me?

Who is this for?

Michigan Health Insurance – Customer Service – Medicare

If you’re getting ready to enroll in Medicare, this information will help you learn how health care reform changed Medicare plans.

You get a lot of information about Medicare before you turn 65. And you may have heard a lot about health care reform. But it may not be easy to figure how or if the two work together. We'll help you understand the basics.

Signing up for Medicare

People who buy their own insurance experienced a lot of change during health care reform. In most cases, they had to get a new plan that meets Affordable Care Act requirements. Some employers did too. And many people used the Health Insurance Marketplace at healthcare.gov in the process.

Health care reform didn't change how you choose and sign up for a Medicare plan. You don't need to go to healthcare.gov to shop for or buy a plan. That's because Medicare plans have to meet standards set by the Centers for Medicare and Medicaid Services, not the Affordable Care Act. Learn more about Medicare plans and signing up for Medicare.

Medicare benefits and health care reform

Because of health care reform, some preventive services became more affordable. You don't have to pay Part B deductibles or coinsurance for things like mammograms or prostate cancer screening. Medicare plans now also include a free annual wellness visit. 

More affordable Medicare prescription drug coverage

You may have heard about the donut hole. That's the coverage gap associated with Medicare Part D drug coverage.

Health care reform has helped Medicare members who reach the donut hole. The discount on brand-name drugs increased to 55 percent. What members pay for generic drugs in the donut hole decreased. 

By 2020, the donut hole will close, meaning you’ll pay even less for prescription drugs when you have Medicare.