Today’s Supreme Court ruling that Obamacare is unconstitutional has some important implications for those covered by Medicare.
If you have an Advantage plan, a Medigap plan, or a Prescription Drug plan, I expect all insurance companies to honor current contracts, including reform provisions. This means that if you plan coveres preventive care without co-pays or deductibles, it will continue to do so.
Prescription Drug Discounts
With prescription costs taking a big bite out of most beneficiaries’ budgets, there’s a lot of anxiety about what will happen to prescription drug benefits. Pharmaceutical manufacturers currently give discounts to Medicare beneficiaries who have reached the coverage gap known as the “donut” hole. Discounts, 50 percent on brand-name drugs and 14 percent on generics, were predicted to ultimately close that gap in coverage.
For the moment, that discount is in limbo. Major drug manufacturers have indicated their desire to continue to offer these discounts, but for now it is not certain if that would even be legal.
If you’re struggling with the high cost of prescriptions or any type of healthcare, I’ve got a few suggestions. We’ll be talking about the future of Medicare plans next Tuesday during a live teleseminar, and we’ll take your questions at that time. You can get the phone number by clicking www.MedigapAdvisors.com/teleseminar.htm. You’ll also definitely want to visit our How to Pay Less Money for Prescription Drugs web page at http://www.MedigapAdvisors.com/member-benefits-rx.htm. And, you’re welcome to set up a free personal consultation for professional help to compare all of your options at www.MedigapAdvisors.com/instant-quote-med-adv.php.
Medicare Advantage Plans
Millions of individuals get their Medicare benefits from a private Medicare Advantage plan. These plans typically provide much more coverage than original Medicare, and the premiums are usually quite low (often zero!).
Had Obvamacare remained law, Medicare’s chief actuary has said that Medicare Advantage members would lose an average of $1,267 in Medicare payments in 2014. Some were predicting that up to half of all Medicare Advantage members would have lost their plans entirely.
Fortunately, we will not be facing these cuts, and we expect Medicare Advantage plans to continue to be a good option to consider for those on Medicare.
There is a shortage of physicians available to treat Medicare patients. This is because Medicare reimburses at below-market rates, causing many doctors to not want to accept Medicare patients.
Had the law withstood constitutional challenge, we were going to be looking at even more severe physician shortages due to further planned cuts in physician payments. We do expect this shortage of doctors to continue in the short term, which is why we highly recommend that you establish a relationship with a local physician so you don’t get stuck without access to a doctor.
What To Do Now
If you are covered by a Medicare Advantage or Medicare Supplement plan, and are happy with your coverage, then there is nothing you need to do, other than making sure you have access to a physician, and take care of your health so your need to see the doctor is minimized.
If you are not satisfied with your current situation, you can apply for a new Medicare Supplement plan at any time. Beware that if you are not in your open enrollment period (6 months following your 65th birthday), you will have to go through an approval process with the insurance company).
You can also sign up for a Medicare Advantage plan during the Annual Enrollment Period, starting on October 15th.
If you have more questions, post them here, or show up at our next live teleseminar where we’ll be talking about all this in more detail. Sign up at www.MedigapAdvisors.com/teleseminar.htm.
Jim McFadden has over 11 years of executive-level experience in the health insurance industry, is a youth baseball, softball and football coach, and has one of the worst fantasy football records in the world.