Impact of the Affordable Care Act on Medicare

ACA Medicare doctorThis article is contributed by Emily Newhook.

News coverage of Affordable Care Act – or “Obamacare” – seems relentless, but many people still have difficulty figuring out exactly how the Patient Protection and Affordable Care Act (ACA) will affect them personally. This is especially true for Medicare beneficiaries. There is plenty of misinformation and confusion as to what parts of the ACA apply to Medicare beneficiaries and how this government program will change under the new law.

So what should you know as the administration begins to implement the ACA? We’ve answered a list of common questions to set the record straight.

How are beneficiaries affected?

ACA MedicareThe first thing to know is that no one will be losing his or her Medicare coverage under the ACA. In addition, there is no need to fill out any paperwork or apply for new insurance through the state run health exchanges.

Will there be changes in my coverage?

The implementation of the ACA does mean some changes to parts of Medicare. Let’s go through them part by part.

Medicare Part A:

Part A covers hospital care, skilled nursing facility care, nursing home care, hospice and home health services. There are no changes to Medicare Part A coverage under the ACA.

Medicare Part B:

Part B covers supplies and services needed to diagnose or treat a medical condition and provide preventive care. Under the ACA, there will be a number of improvements to Part B. Mammograms, colonoscopies, diabetes screenings, cancer screenings and a host of other preventive services including an annual wellness visit with your doctor are now completely free. In addition, premiums for beneficiaries making less than $85,000 per year for a single person and $170,00 for a couple will be lower this year. Premiums for those making more than the limits will still see their normal, scheduled increase in 2014, but not because of the ACA.

Medicare Part C:

Medicare Part C is the provision that allows for add-on services offered by private companies commonly known as Medicare Advantage Plans. Medicare Advantage Plans offer all the same benefits as Medicare, but also offer extra coverage for an additional fee. This extra coverage will sometimes include prescription plans. If you have a Medicare Advantage Plan, it is possible your plan may change. The Affordable Care Act incentivizes improvements to Medicare Advantage Plans. At the same time, the ACA puts limits on how much Medicare contributes to the costs of these plans, meaning some insurers may cover less or possibly drop benefits, such as dental care.

Medicare Part D:

Part D is your drug coverage if you don’t have drug coverage through a Part C Medical Advantage Plan. Under the ACA, beneficiaries that find themselves in the “doughnut hole” between Medicare’s initial coverage ($2,970) of drugs and the catastrophic drug coverage ($4,750) will receive a discount 51.5 percent on brand name and 21 percent on generic prescription drugs.

How will my care change? Can I still see my doctor?

This has been a point of contention for Medicaid recipients and those shopping in the new exchanges for private plans – some of who may need to change doctors to save money. Nothing in the ACA, however, changes what doctor Medicare beneficiaries can see. You doctor can independently decide not to see Medicare patients anymore, but that is not a provision of the new law.

In terms of care, the ACA incentivizes the use of several technologies that stand to dramatically enhanced the way your care is managed, such as electronic medical records. These are safe and secure digital medical records that will help the various doctors you see a) keep your records in one useful place and b) streamline care from appointment to appointment. It also bolsters the use of telehealth programs – such as remote monitoring and videoconferencing – which can improve care for Medicare patients who don’t have easy access to comprehensive provider or hospital systems.

How has the Affordable Care Act impacted your benefits and health care? Do you feel that your providers – from physicians to administrators to insurers – have explained it to you in a way that makes sense? Tell us in the comments.

Author Bio: Emily Newhook is an outreach coordinator for the MHA degree program from the George Washington University, MHA@GW. Outside of work, she enjoys writing, film studies and powerlifting. Follow Emily on Twitter: @EmilyNewhook

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