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How Will Health Care Reform Impact Medicare?

Health Care Reform and MedicareAlthough there is a lot of confusion regarding the Affordable Care Act (or Obamacare) and how it is going to affect people, it seems like this confusion is a lot worse amongst our nation’s seniors. Let’s face it, Medicare alone is a difficult thing to understand, but when you add to it the changes that the ACA is bringing about, things get even more confusing.

If you’re like most senior citizens, you take great interest in your own health care as well as in the health care industry, and do the research to try to make sense of how potential changes might impact your health insurance.

Despite this, a recent study shows that over 80 percent of senior citizens aren’t sure how the Affordable Care Act is going to impact their health insurance. Much of this can be attributed to various misinformation that muddies the already murky waters of Medicare even more.

By writing this post, I hope to help clear up some of the questions many folks have regarding the ACA and what its impact on Medicare is going to be.

Will I Have to Wait Longer to Qualify for Medicare?

No. Contrary to popular belief, the Affordable Care Act is not going to increase the age at which you become eligible for Medicare. You are able to enroll in Medicare three months prior to your 65th birthday if you would like.

Some people choose to delay enrolling in Medicare because they are covered under a group health plan through their employer. Those individuals can enroll in Medicare as soon as they retire, or three months prior to their retirement date. These people can also opt out of their group health plan and choose Medicare instead, as long as they are 65.

Will My Medicare Premiums Raise Due to Health Care Reform?

No. The way Medicare Part B premiums are calculated (keeping in mind that Medicare Part A is available to anyone age 65 and older at no cost) is that the federal government pays roughly 75 percent of Medicare costs, while the recipient pays about 25 percent.

There is a point where Medicare-eligible people may pay a higher premium if they are in a considerably higher income bracket. By the same token, those who are considered low-income will pay smaller (or no) premiums. However, as a general rule most people will not pay over 25 percent of their health care costs.

Am I Eligible to Purchase Insurance Through the Health Exchange?

No. Once you have reached the age of 65, you are no longer eligible to purchase either a medical or prescription drug insurance policy on the health exchange in your state.

If you are Medicare-eligible, you will need to both enroll in Medicare and purchase any supplemental plans you need, or purchase a Medicare Advantage plan to take the place of Medicare. This has not changed at all due to health care reform.

Will I Pay a Penalty if I Cannot Afford My Premiums?

This is not a simple yes or no answer, because it truly depends on your individual circumstances. However (and, again, I am generalizing), most low-income senior citizens can pay little to nothing in premiums, or will qualify for Medicaid instead of Medicare.

If you are above that income level but still cannot afford your premiums, you may be able to file for an economic hardship exemption, which would negate any tax penalty you might otherwise have to pay.

Will I Have to Change My Primary Care Provider?

No. You will be allowed to continue to see your current physician as long as he or she is a Medicare provider. Chances are you are already enrolled in Medicare and have the same doctor you have had for years. The Affordable Care Act will not change that.

You are also not likely to have longer wait times before seeing your doctor, nor will you have someone tell you that you cannot visit a particular doctor.

Although health care reform is a law, this only means that you are required to have insurance. It does not mean the government gets to decide whether you are allowed to be treated.

Other Considerations

Although there are many other questions on people’s minds right now, the issues I have talked about here seem to be the most confusing for senior citizens. As a result, some seniors are making potentially life-altering mistakes when it comes to their health.

I have composed a short list of do’s and don’ts for those of you who might fit into this category.

•    Do talk to an insurance professional regarding your choices as you become eligible for Medicare. My team at MediGap Advisors is here to offer you advice and information without any obligation to make a purchase or pay a fee. If you do not talk with one of my Advisors, talk to someone who is equally well-versed in Medicare and health care reform.
•    Don’t make the decision to stop taking your prescription medications or avoid seeing a doctor in order to save money. If you have reached a point where you cannot afford to pay for your medications, please contact your physician and find out what programs might be available to help you.
•    Do shop around before making a decision about which Medicare supplement or Medicare Advantage plan to purchase.
•    Do consider ways to save money on medical services by using prescription discount services or reduced lab fee programs.

Your health as a senior citizen is just as important as the health of a 20-year-old—your needs are just different. If you have any questions or concerns about how your Medicare might be impacted by health care reform, please do not feel like you have to figure it out on your own.

You can contact a MediGap Personal Advisor at 866-323-1441 if you need more information or would like some guidance as to how you can save on health care without compromising the quality of care you receive.

Wiley Long

Wiley Long

Wiley Long is founder and president of Medigap Advisors, and is passionate about helping people navigate the confusing waters of Medicare. He is the author of The Medicare Playbook: Designing Your Successful Health Coverage Strategy, a clear and simple explanation so you can make the most of your Medicare coverage. For more information visit www.MediGapAdvisors.com.
Wiley Long

 

 
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