Health Care Expense

Health Care Expenses on the Rise
Retire Fast.

Pick up any newspaper and the headlines scream about the rising cost of health care.  There is good reason for this.  The largest percentage of the U.S. population, in its history, will soon become eligible for Social Security and Medicare benefits.  The baby boomer generation will put a tremendous strain on these government programs.  The U.S. government, in an attempt to ease this strain, passed the Medicare Modernization Act of 2003 (MMA).

The Medicare Modernization Act of 2003 (MMA) provides Medicare recipients more choices in health care coverage and better health care benefits.  Some of the new benefits under the MMA are:

Medicare-Approved Drug Discount Cards

The Medicare-approved drug discount cards program is temporary until the Medicare prescription drug plans start in 2006.   Through this plan, you can receive a discount on covered brand name and generic drugs.  Enrollment is not automatic; you must choose a discount card and then enroll.  You can learn more by reading the booklet Guide to Choosing a Medicare-Approved Drug Discount Card (CMS Publication 11062).

Preventive Benefits

Medicare pays for many preventive services. The preventive services include:

One-time "Welcome to Medicare" Physical Exam

Cardiovascular Screening

Cancer Tests

Breast Cancer Screening (Mammograms)

Cervical and Vaginal Cancer Screening (Pap Test and Pelvic Exam)

Colon Cancer Screening (Colorectal)

Prostate Cancer Screening (PSA)


Bone Mass Measurements

Diabetes Screening, Supplies, and Self Management Training 

Glaucoma Tests

Other Health Information

Chronic Obstructive Pulmonary Disease (COPD)


Medicare Advantage Health Plans

Medicare Advantage is the new name for Medicare + Choice. Medicare Advantage Plans are available in most areas of the country. To join one of these plans, you must have both Medicare Part A and Part B.  Medicare Advantage Plans include:

Medicare Managed Care Plans? You see doctors in the plan's network. A primary doctor coordinates your health care. Referrals are required for most services and to see doctors out of the plan's network.

Medicare Preferred Provider Organization Plans (PPOs)  You can see any doctor, but it costs less to see doctors in the plan's network. No referrals are necessary.

Medicare Private Fee-for-Service Plans  You can see any doctor that accepts the plan's payment. No referrals are necessary.

Medicare Specialty Plans  A special type of plan that provides more focused health care for specific people.

Medicare Prescription Drug Plans (will start in 2006 - enrollment starts in 2005)

Enrollment to get a Medicare prescription drug plan is notautomatic. If you want to participate, you must choose a plan offering the coverage that best meets your needs and then enroll.  You can get your prescriptions through a Medicare Advantage Managed Care Plan, the Original Medicare Plan or another type of Medicare Advantage health plan or a Medicare Managed Care Plan that is not a Medicare Advantage Plan.  You pay a premium for these benefits and you also pay a deductible.  This is above and beyond any premiums paid for Medicare Part A and Part B.

Regional Preferred Provider Organization Plans (will start in 2006)

The Medicare Modernization Act allows regional Preferred Provider Organization Plans (PPOs) to give all people with Medicare choices for Medicare health care coverage. In a regional PPO, members will have an added protection. PPOs will limit the maximum amount that members pay for care outside the network.

These new benefits are geared toward preventative care.  Statistically, paying for preventative care is less expensive than treating acute medical emergencies and long-term care services.  Thus, the government should see a slight decrease in its benefits paid, even with the extended benefits now being offered to retirees.

If you want more information about Medicare:

Call 1-800-MEDICARE

Visit the official Medicare website at

Visit the Health and Human Services website at

Read Medicare & You -available through the Department of Health & Human Services

Call your State Health Insurance Assistance Program

View Medicare Covers America - a health information cable television series produced by the Centers for Medicare & Medicaid Services.

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