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Health care reform timeline 2011 Posted: September 23rd, 2010

By Megg Mueller

Many of the Affordable Care Act's provisions are phased in over the course of several years. In 2011, several provisions that affect group health insurance and Medicare are implemented.

Jan. 1, 2011 changes for individuals health insurance and group health insurance plans

  • Individual health insurance plans and small-group insurance plans must spend 80 percent of premiums on medical services, while large group plans have to spend at least 85 percent. Before the Affordable Care Act, the average amount spent on medical services was 74 percent. If insurance companies don't meet the outlined levels, rebates must be sent to consumers.

Jan. 1, 2011 changes for Medicare beneficiaries

  • The Medicare "Donut Hole" continues to be addressed. Seniors who fall into the coverage gap, when their benefits are maxed out until a higher out-of-pocket limit has been reached, receive a 50 percent discount on Medicare Part D covered brand-name prescription drugs.
  • Medicare begins offering several free preventive care services to seniors, like annual wellness visits plus personalized preventive care plans without co-payments.
  • The Community Care Transitions Programs launches to help those high-risk Medicare beneficiaries who are hospitalized. The program is meant to prevent unnecessary hospital readmission by coordinating care and matching patients to community services.

October 2011

  • The Community First Choice Option gives states the opportunity to treat disabled persons using Medicaid at home and through community-based services, instead of just at nursing homes.

Other 2011 provisions

According to the Kaiser Family Foundation, 2011 sees an end to reimbursements from health savings plans, flexible spending accounts or other work-related reimbursement accounts for unprescribed, over-the-counter medications. Only prescribed medications will be eligible for reimbursements from these accounts.

Also set for 2011, all chain restaurants and food items sold out of vending machines will be required to disclose nutritional information.