Carper addresses seniors at Coastal Leisure CHEER Center on Medicare

U.S. Sen. Tom Carper met with local seniors at the Coastal Leisure Cheer Center in Ocean View this week to discuss upcoming changes to Medicare.

Carper highlighted three changes that will happen due to the recently enacted health care legislation.

• In January 2011, Medicare recipients will be eligible for an annual physical, to include cognitive screening.

• There will be no more co-pays for preventive screenings, such as those for colonoscopy, breast cancer and diabetes.

• And, for people enrolled in Medicare Part D (the prescription drug program) who are in the “doughnut hole” – spending between $3,000 and $6,000 on prescription drugs per year – a fund set up by the pharmaceutical companies will pay half.

“It used to be you got one ‘welcome to Medicare’ physical and you didn’t get another one as long as you lived,” explained Carper. The annual wellness exams will allow seniors to stay on top of their health and concentrate on prevention and finding problems when they are small, said Carper.

He said the benefit of removing a co-pay from diabetes, breast cancer and colonoscopy screening is as simple as not giving people another reason not to get the exams.

“How many people in here love getting colonoscopies?” he joked, saying, in all seriousness, that sometimes just the co-pay of an already inconvenient and uncomfortable exam is all the reason for people need not to get checked – sometimes a life-altering choice.

“In January, the co-pays go away,” he said. “We want people to get the screenings.”

Carper explained the prescription drug benefit, at 50 percent this year, is paid for by a fund set up by the pharmaceutical companies, and it will grow.

“Between now and 2020, that will go up to 75 percent. There’s still a co-pay, but by 2020 it will go down to 25 percent. It’s a good change.”

“There is a common theme here of prevention and wellness. Deal with things when they are small and less expensive,” he said.

Carper also noted the work the federal government has done to combat Medicare fraud. He explained that, four years ago, Medicare had hired private contractors to work on Medicare fraud in California, Florida and New York, and they have recovered approximately a billion dollars in those years and have extended the Medicare trust fund’s life expectancy by about 12 years or so.

“Next year it will be in all 50 states,” he explained of the fraud investigations, which will include all parts of Medicare – A, B, C and D – instead of just A and B. “We want to keep pushing and make improvements.”