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Medicare, ObamaCare and You

October 02, 2013


I can’t tell you I’m a huge fan of the new Affordable Care Act (ACA) but it seems as if it’s here to stay for now. So, with that in mind, I want to address the biggest question I’m getting from clients, friends and family: “How will ObamaCare affect Seniors (65+)?”

According to the Center for Medicare and Medicaid Services (CMS, the federal bureau that manages Medicare) if you are covered by Medicare or Medicaid, or are retired under the Federal Employee Health Benefits plan, then you do not need to be concerned about the Health Insurance Marketplace established by the ACA. Whether you are enrolled in Original Medicare or a Medicare Advantage Plan, you can stay with your current plan under the ACA. You do not need to buy private health insurance and this October 1 launch of the Health Insurance Marketplace has no effect on you. Below are some of the benefits of the new Affordable Care Act:

• New Medicare enrollees get a no-cost “Welcome to Medicare” wellness visit with their doctor. It is not a complete physical, but rather a conversation about your medical history and about steps which can be taken to maintain your health.

• Certain preventive services, like mammograms or colonoscopies, will be covered and you won’t have to pay any coinsurance or deductible under Medicare.

• Your prescription drug coverage may become less costly. If you spend enough on prescriptions to reach the donut hole you will begin to receive 50% discount on brand-name prescription drugs. CMS says that the discount will be applied automatically at your pharmacy without action on your part. Additionally, the ACA will eliminate the donut hole by year 2020.

• ObamaCare does not cut any benefits from your Medicare Advantage plan…officially! However, due to some decreases in what the Medicare Advantage plans are being reimbursed by CMS, some of those companies are choosing to pass that pinch down to the members. So, you might see a cut in benefits that your own Medicare Advantage plan has put into place. All Medicare Advantage plans are required to provide at least the same benefits as Medicare, though.

Bottom Line: Medicare isn’t part of the new Affordable Care Act Health Insurance Marketplace. You have nothing to do by October 1 or by year end that is related to the ACA.

Now….keep in mind that “Medicare Season” is fast approaching. If you are considering changing your Medicare Advantage Plan or Medicare Supplement, please don’t hesitate to call our office for an appointment. We are happy to assist you in choosing a plan that meets your needs at an affordable rate.
~ Larry