Today, there is a great deal of talk about the Affordable Care Act, or ObamaCare. Certainly, this new health care reform will change the way that people receive and pay for their medical services – and this change is likely to affect both young and old alike. Therefore, it is important to understand if – and how – such changes will affect Medicare.
Medicare and the Affordable Care Act
First, it is important for those who are enrolled in Original Medicare (Medicare Parts A and B) to understand that Medicare itself is not part of the Health Insurance Marketplace that was established by the Affordable Care Act.
Therefore, those who are enrolled in Medicare will not be required to change or cancel their coverage. This means that regardless of whether you have Original Medicare or a Medicare Advantage Plan, the benefits that you have can remain the same.
There are, however, some additions in that Medicare will now cover some additional preventive health care services such as colonoscopies and mammograms that will not require the enrollee to pay a deductible or coinsurance payment. A free annual wellness visit has also been added.
ObamaCare and Prescription Drugs
The Affordable Care Act also had some effect on Medicare Part D, the prescription drug plan of Medicare. Here, for those who are in the “donut hole,” a 50 percent discount will now be applied when purchasing Medicare Part D covered brand name prescription drugs.
The Medicare Part D donut hole is the coverage gap that exists in some of the Part D prescription drug plans, meaning that once the enrollee and their plan has spent a certain amount on covered drugs, they will again need to pay the full amount for their prescriptions – up to a certain dollar limit. Then, once this limit has been reached, the discount will again apply. The Medicare donut hole will be completely closed by the year 2020.
ObamaCare also helped to better coordinate care for those who are enrolled in Medicare. Now, Medicare has coordinated care programs that consist of the following:
Comprehensive Primary Care Initiative – The Comprehensive Primary Care Initiative is a partnership that was established between Medicare with other insurance entities and organizations with the goal of helping certain primary care providers and their practices to provide additional resources for improving the quality of the care they provide. Improvements include the updating of technology, hiring of new staff, and better coordinating of patients’ care.
Accountable Care Organizations (ACOs) – Through ACOs, doctors can use data from Medicare to help improve the way they provide care by communicating with each other and sharing health care information about patients. This means that you will have fewer repeated medical tests and will essentially spend much less time filling out repeat paperwork and forms.
What About Medicare Advantage Plans?
With regard to Medicare Advantage, while ObamaCare has reduced the payments to some providers, it plans to continue to reward those what will increase the quality of their coverage. Overall, the program has not cut any benefits from Medicare Advantage. And, while one of the goals of ObamaCare is to phase out excess payments to some Medicare Advantage providers, it does not plan to eliminate the program.
Medicare – Now and in the Future
The Affordable Care Act – or ObamaCare – has a goal of helping to protect Medicare’s benefits both now and in the future. One of the biggest goals of the Act was to extend Medicare’s trust fund.
Currently, the fund has been extended through at least the year 2029. This extension is due in large part to a reduction in financial abuse, waste, fraud, and overall Medicare costs. Doing so will help to provide Medicare enrollees with better overall care.