The Affordable Care Act is bringing a lot of changes to healthcare and health insurance in the U.S. including some important changes to Medicare that you may not be aware of.
Here are five important things you may want to know about Medicare and the ACA:
1. YOUR MEDICARE COVERAGE IS PROTECTED
Medicare is not part of the health insurance exchanges established by the ACA, so there’s no need for you to replace your coverage. In fact, as a Medicare recipient, you may already get a better deal for your insurance than most other Americans. It doesn’t matter how you get Medicare – through Original Medicare or a Medicare Advantage Plan – you are still guaranteed coverage.
2. YOU CAN STILL CHOOSE YOUR DOCTOR
You can still see your current doctor or any healthcare provider that takes Medicare. The ACA will not change your ability to choose your own doctor. Some doctors may independently change their Medicare acceptance policies, so it’s always wise to check in regularly with your healthcare providers.
3. MEDICARE NOW COVERS MORE SERVICES, FOR LESS
Most Medicare insurance plans will now cover preventive services like mammograms, colonoscopies, and annual wellness visits, which are very important for staying healthy and avoiding diseases. You may be able to take advantage of these services without paying the Part B coinsurance or deductible; however, if your doctor performs additional tests or services, you may have some out-of-pocket costs. The services available to you depend on what kind of Medicare coverage you currently have; visit www.medicare.gov for more information about covered services.
4. YOU WILL GET MORE COMPREHENSIVE SUPPORT
The ACA is propelling new initiatives to support care coordination, meaning that doctors will get additional resources to make sure that your treatments are consistent. The goal is to make sure that patients, particularly those with chronic needs, get the right care at the right time while preventing medical errors. You’ll see the benefits when your doctors, specialists, and hospital are better able to work together to give you the right care in the right setting.
5. YOU MAY SAVE MONEY ON MEDICINE
The donut hole, the gap in drug coverage under Medicare Part D, is shrinking. Right now, Part D only covers up to $2,970 for medicines each year. Once you reach that limit, your prescription benefits decrease significantly, putting you in the donut hole. Currently, your copay increases to 47.5percent for brand-name prescriptions and 79percent for generic drugs until you have spent $4,750. Under the ACA, if you fall into the donut hole, you’ll get a 50percent discount when buying Part D-covered brand-name drugs. Every year, the percentage you pay for the gap in coverage will decrease and the donut hole will be closed completely by 2020, meaning that you will pay a flat 25percent copay for all generic and brand name prescriptions.
Even though the ACA may benefit most Medicare recipients, there are still some changes to watch out for that could affect your coverage and out-of-pocket costs. If you have any questions about how your Medicare plan may change under the ACA, visit Medicare.gov or contact a trusted insurance specialist.