2011 Health Care Changes
With health care costs becoming a larger part of peoples’ budgets every year, it is important to stay on top of changes as you would with any other personal finance topics. 2011 introduces several health care consumer changes, both in terms of the industry direction as well as the effects of the 2010 Health Reform passage. In our continuous quest to help you save time by simplifying the confusing world of health care, here is our concise snapshot of what changes you should expect for 2011.
Deductibles and copay levels will increase. One of the ways employers and insurance carriers have responded to the increased cost of coverage is by putting more of the financial burden on the consumer. The average deductible is now over $400, the highest ever, due to both the proliferation of high-deductible health plans and increasing deductibles on traditional health plans. Most indsutry studies predict that 50 to 75% of employers will raise deductibles this year. What can you do? Be sure you cover your deductible amount through a Flex Spending Account, and evaluate your options based on your own usage patterns. What might be the right plan for you one year may not necessarily be the right plan going forward.
Your Flexible Spending Account (FSA) or Health Savings Account (HSA) no longer covers over-the-counter drugs. Unless prescribed by your doctor, these medications are no longer reimbursed as a provision of the Health Reform bill. This includes things like Tylenol, Claritin, cough syrup, and other over-the-counter items that used to be reimburseable without a prescription.
Expect your health care provider to ask for payments up-front. A growing trend among physicians, clinics, and hospitals is to ask for your portion of the payment at the time of service – something they have every right to do. Healthcare providers are getting squeezed along with everyone else, and this is one way they keep their own financial house a little cleaner. As long as they get the amount right, this can actually save you time by reducing the bills you need to attend to after the fact. It is not only your insurance card you need to remember for the doctor’s appointment, but you probably need to bring your credit card as well.
Medicare patients get a little extra help, in return for higher premiums. In 2011, the Medicare drug coverage gap will begin to phase out, beginning with mandated discounts for drugs purchased while beneficiaries are in the gap level. At the same time, premium subsidies will begin to decrease for those Medicare enrollees with higher incomes. As usual, Medicare premiums and deductibles will both show a nominal increase for the new year.
Food nutritional information will become more widespread. Starting in March, food sold from chain restaurants and vending machines will need to have nutritional information available.
If you work for a smaller employer, you may start to see positive health benefit changes. Health Reform provides funding for small employers to invest more in wellness programs beginning in 2011, something we hope most of them will take full advantage of. Building on the 2010 changes allowing for small companies to receive tax credits for providing insurance, employees of smaller companies should be seeing some of the more noticeable positive changes of Reform by now.
Medical Students may find more opportunities in family practice. In an effort to stem the tide of future physicians going into the high-cost specialties, creating a shortage of general physicians, more funding will go to family practice residencies. Community-based clinics will be targeted for most of these opportunities. More training in outpatient settings will also be encouraged.
Your doctor may no longer be in private practice. Many physicians are choosing to be employed by hospitals rather than running their own smaller practice – a trend that increased in 2010 and is expected to continue in 2011. The result to most consumers should be minimal, although you might find yourself going to hospitals for some tests that use to be done in a smaller setting, or receiving your medical bills from a health system instead of from your doctor’s office.
Depending on what state you live in, other changes may also affect you. Colorado residents, for example, now have "gender neutral" insurance rates which can't build in gender-specific acturial nuances. California is implementing a statewide Health Insurance Exchange, and several states will require doctors and hospitals to provide good-faith price estimates for any patient who asks.