Are you still uncertain about what health care reform means for you? According to the National Council on Aging, most seniors are still confused about or may be completely unaware of what the Patient Protection and Affordable Care Act provides. That can make a big difference in the type of Medicare Supplement Insurance you need.
The act is usually just called health care reform, and it has already made a big difference in Medicare. Before the act was signed into law, Medicare automatically paid for 80 percent of doctor services, but it mandated that all services be billed at a fixed rate. Your doctor could bill you in accordance with Medicare’s pre-approved rate and Medicare would pay for 80 percent. That left you to pick up 20 percent unless you used a Medigap Plan to pay for that 20 percent as well.
Your doctor was completely free to bill you at a higher rate, though. That meant Medicare only paid 80 percent of the fixed rate and you had to pay for more than 20 percent of the actual bill. To resolve that, you could again rely one of the Medigap policies to cover the excess so you’d have no out-of-pocket costs.
So, what did health care reform change? Medicare now pays for 100 percent of doctors’ care that’s considered regular preventive care to keep you well. There’s no 80/20 split. While your health is good, you’ll have no out-of-pocket costs to see a doctor. Your doctor can bill Medicare for your annual check-up and many common screening procedures to be sure you’re not succumbing to common diseases like cancer, cardiovascular disease or diabetes. The bottom line is that you may be able to use a less expensive Medigap Plan now that Medicare coverage has expanded. If you’re not sure, just give us a call. We offer free consultations to help you see where you stand with the changes in Medicare.
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.