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The Affordable Care Act, Medicare, and You

By Edited Dec 12, 2014 3 6

If you one of the 40+ million Americans who are currently on Medicare or, like me, will be applying in the next few years, you have probably been listening to all the news, and reading everything you possibly can about how the Affordable Care Act (Obamacare) affects Medicare.  I, too, have been concerned about the affect the new law will have on me, and recently researched all the articles I could find, including those that appeared in Time Magazine, the AARP Bulletin, and online, and have tried to summarize what I have found in the list of the pros and cons listed below:


We should all be aware of the recent changes to Medicare!


Benefits of the new Healthcare Law for Senior Citizens


!. In 2011, Medicare recipients began to get annual physicals and several other preventive services free. However, if you are in an Advantage program, instead of traditional Medicare, your plan's provisions may also have additional free or low-cost benefits. You'll have to check with your individual provider to see what changes may affect you.


2. Beginning back in 2010, the government began to "shrink" the doughnut hole that could cost many people thousands of dollars for their prescription coverage.  In coming years, the doughnut hole will shrink until it is completely gone in 2020.  Gradually, there will be more discounts, including some on generic drugs, until 2020 when the doughnut hole is expected to close and recipients will be paying only a 25% copay for brand-name prescriptions.  Many retirees are already seeing a reduction in their drug costs.


3. There is little or no change to the Medigap supplemental insurance program. You are not required to buy it. However, if you do choose to buy it after the initial time limit expires following the date you first sign up for Medicare, insurers can deny you coverage or charge higher premiums.


4.  Instead of a Medigap policy, you may decide to get one of the Medicare Advantage plans.  The Advantage plans how have to spend at least 85% of the money they receive in premiums on patient medical care. Also, their copayments have to match the copayments of traditional Medicare for many of the same services.


5. With all of the planned improvements, more preventive care, and higher premiums for high income retirees, Medicare is expected to stay solvent much longer than it would have without the new law.  It also is doing a better job at providing affordable medical treatment for the vast majority of senior citizens.


Disadvantages of the new Healthcare Law for Senior Citizens:


1. Until 2019, if you are on Medicare, single and earn over $85,000 a year, or you are married and earn more than $170,000, you will be required to pay higher Part B premiums. Congress may raise these income levels, if they choose, beginning in 2020 ... and most likely they will.


2. If you are at the same income levels mentioned above, you will pay higher premiums for drug coverage, as well.


3. If you are under 65, but wish to apply for Medicare because of a disability, you will still have a two-year waiting period.


4. If you are enrolled in a Medicare Advantage health plan, the government will phase out the excess money that they pay in premiums to those companies. (Currently, Medicare loses 14% on every Advantage policy.) Because of this and the other rules about the Advantage services, some of these companies may begin to charge higher premiums to the clients, or eliminate special services such as vision care, hearing aids and free health club memberships.


The bottom line is that there are now new services available to traditional Medicare patients. Traditional members will continue to be able to purchase Medigap policies. In addition, patients will still be able to choose to participate in a Medicare Advantage program, instead of traditional Medicare. However, Advantage premiums may gradually rise higher if you wish to get extra benefits, such as vision care, and hearing aids. Whether you decide to simply use traditional Medicare, the Medicare plus a Medigap policy, or select an Advantage program, you will still have the opportunity to make the choice that seems best suited to your needs and budget.  In my opinion, the new Affordable Care Act benefits most senior citizens, but not everyone, while continuing to provide choices to those who want to use the private Advantage insurance.



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photo courtesy of photoxpress.com

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May 16, 2010 11:12pm
Such a helpful article on medicare. Great job!
May 18, 2010 5:59pm
Thank you for all the education on this helpful info.
May 20, 2010 6:03am
Very informative article on healthcare and medicare. Thanks for sharing this great info! :-)
Sep 15, 2010 10:54pm
There are some positive changes ahead for people on Medicare. Hopefully the new Healthcare bill will make life a bit more affordable for senior citizens.
Dec 4, 2010 12:06am
Interesting article on Medicare and the upcoming changes. Thanks for sharing.
Dec 12, 2014 7:16pm
It appears that Obamacare actually strengthened Medicare and made it more affordable for the majority of senior citizens.
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