What Medicare Insurance Means for Seniors Under the Affordable Care Act (ObamaCare)

Changes to Medicare insurance 2013-2015: For Seniors with Medicare insurance or Medicare Advantage not much will change under the Affordable Care Act (ObamaCare). Most seniors will enjoy the benefits, rights and protections of the new health care law like expanded access to wellness visits, preventative care and drugs with little or no change to their insurance costs. Although most seniors will have nothing to worry about, some higher earning seniors may see their Medicare or Medicare Advantage premiums rise slightly or be affected by some taxes like the capital gains tax. Let’s find out what 2013-2015 means for Seniors and Medicare.

No one who qualifies for Medicare has to pay a fee for not obtaining insurance or shop on their State’s Health Insurance Marketplace. If you like your Medicare insurance, you can keep it.

Changes to Medicare InsuranceSeniors Medicare Insurance: What You Need to Know For 2015

During the presidential election The Affordable Care Act (ObamaCare) and Medicare became a blended argument. Now with the State exchanges (sometimes known as marketplaces) open for business, it is time to set the record straight for Medicare insured Americans.

Since you already have insurance through traditional Medicare or Medicare Advantage ObamaCare does not affect you. You need to do – NOTHING!

Several pieces of misinformation need clarification though.

Seniors will be able to get all of the benefits of the Affordable Care Act, but won’t be responsible for most of the costs.

Clearing Up the Medicare Myths

There are lots of myths out there about Seniors and their Medicare health insurance. Let’s debunk some of the common myths about Medicare based Health Insurance and the Affordable Care Act:

ObamaCare Means Medicare is Over

ObamaCare replacing Medicare is a myth. ObamaCare does not replace Medicare or Medicare Advantage, although it does reform some of the wasteful spending and other issues that were negatively affecting seniors. Everyone on Medicare or soon to be on Medicare, or to be on Medicare a decade from now will get Medicare.

In fact, certain features of the ACA protect Medicare benefits in new ways according to Nicole Duritz, AARP’s vice president for Health Education and Outreach.

To Comply With ACA Seniors Must Buy More Health Insurance

Seniors with Medicare do not have to purchase any other type of health insurance. Medicare is a recognized health insurance under the Affordable Care Act. If you have Medicare then you are in compliance. This groundless story came about from the Mandate. However, time the Exchanges open overlaps with Medicare open enrollment. Medicare policy owners may switch from traditional Medicare-to-Medicare Advantage and have the right to change their prescription coverage plans. However, the Exchanges do not deal with any Medicare changes. And there is no requirement for Medicare insured to make any changes.

Medicare Will Cost More

This is a half-truth.  Premiums are set to rise, as they did historically for individuals who earn more than $85,000 or couples with incomes in excess of $170,000. This is existing law and ObamaCare has nothing to do with it. Part B premiums for the more affluent will continue to be higher than for other income groups.

Medicare Part B Formula

The Medicare Part B Formula isn’t affected by the Affordable Care Act. Find out how the Medicare Part B formula works to help figure out if you will have to pay higher rates. Remember ObamaCare doesn’t affect premium rates for Seniors.

Here a Basic Overview Costs for Medicare in 2013 for seniors making less than $85,000 as an individual or $170,000 as a couple. Even though ObamaCare has been in place for three years not much is changing. The fact is the opening of the health insurance exchanges don’t have an impact on Medicare insurance costs.

2013 Costs at a Glance
Part B premium Most people pay $104.90 each month.
Part B deductible $147 per year
Part A premium Most people don’t pay a monthly premium for Part A. If you buy Part A, you’ll pay up to $441 each month.
Part A hospital inpatient deductible  You pay:

  • Days 1-60: $1,184 for each benefit period
  • Days 61-90: $296 coinsurance per day of each benefit period
  • Days 91 and beyond: $592 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)
  • Beyond lifetime reserve days: all costs

Premiums Lowered for Most

However, in 2012 most Part B Medicare policyholders saw a reduction in Part B premiums due to reforms under the ACA. In addition, the deductible went down for the first time in Medicare’s history.

Under the New Law Senior Must Pay the Penalty

More lies. People insured by Medicare are in complete compliance with the Affordable Care Act. They are not subject to the penalty for failure to buy insurance. In fact, folks enrolled in Medicare cannot purchase insurance through the exchanges. A company selling a policy to Medicare recipient is violation laws.

Medigap and Medicare Advantage Supplemental Plans

Beyond traditional Medicare parts A and B, seniors have other Medicare insurance options to help better meet their true medical costs. Supplement plans include “Medigap” which “covers the gap” between what Medicare pays and what your actual medical expenses may be and supplements traditional Medicare Parts A and B. Since you’ll have traditional Medicare, even with added in Medigap options, you’ll still be covered under ObamaCare.

Medicare Advantage, while not technically a type of supplemental health insurance, comprises a variety of plans that Medicare offers as a coverage alternatives to the traditional program. Medicare Advantage can be described as supplementing Medicare.

Please note you cannot have both Medigap insurance and Medicare Advantage. Both Medigap and Advantage options are sold by private companies.

If you have Medicare Part A (Hospital Insurance) or Medicare Part C (Medicare Advantage), you’re considered covered and won’t owe the fee for not having health insurance in 2014 and beyond.

Medicare Enrollees Get New Free Benefits Under ACA

Under the Affordable Care Act, folks on Medicare are entitled to free preventative care that includes flu shots, cancer and diabetic screening, and an annual wellness exam. Your primary care giver will give you the information.

The Affordable Care Act is not replacing Medicare. ObamaCare or the Affordable Care Act expands services to folks on Medicare, free and helps those who could not afford medical insurance before the law goes into effect. Medicare recipients do not have to buy anything from a state exchange – in fact, the ACA prohibits them from doing so. If you have Medicare, you have insurance and meet the mandate. For your group there are no fines for not meeting the mandate. You already do meet the mandate. Where Medicare and ACA come together, Medicare patients gain.

Under ObamaCare, Medicare provides more services and is financially better off. Seniors should welcome the changes and embrace them.

 

ObamaCare Changes to Medicare
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