MEDICARE

 

HOW THE HEALTH CARE REFORM LAW AFFECTS MEDICARE

The Affordable Care Act will NOT cut traditional basic Medicare benefits.

 

You can now receive free preventive care, including a free annual wellness visit and prevention plan.

 

The law closes the Medicare Part D Prescription drug coverage gap, known as the "donut hole:"

• 3.8 million seniors who entered the donut hole in 2010 received a check for $250 from Medicare.

If you enter the donut hole, you will pay only half of what your plan charges for brand-name drugs – a 50 percent discount.

• By 2020, the donut hole have been phased out and completely eliminated.

 

The Affordable Care Act will achieve better care for you if you get sick:

The new law invests in testing new models of care for people juggling multiple chronic illnesses and treatment by multiple doctors in order to provide better care, better coordination, and more patient-centered services.

• If you must be hospitalized, the law also will help you return home and avoid going back into the hospital by providing incentives for hospitals to make sure that you get the services you need in your community and by teaching you ways to take good care of yourself.

The law extends Medicare's solvency and reduces the deficit:

• The Congressional Budget Office (CBO) projects that the new law will extend the solvency of the Medicare Trust Fund until 2029.

• This historic legislation will reduce the deficit by $210 billion over the next ten years, with $1.2 trillion in additional deficit reduction in the following 10 years.

HOW THE HEALTH CARE REFORM LAW AFFECTS MEDICARE ADVANTAGE PLANS (MA)

Medicare has paid Medicare Advantage plans over $1,100 (13 percent) more per person than it pays original Medicare to take care of the same person. People with Medicare pay higher monthly premiums to fund this overpayment. The new law will gradually lower these overpayments to insurance companies.

 

If MA plans provide high-quality care, they will be eligible for bonus payments.

 

Because of these changes, some MA plans may cut some of the extra benefits they offer that original Medicare does not cover—such as eyeglasses or hearing aids. Some MA plans may increase premiums. And some plans may drop out of the Medicare program completely.

 

However, MA plans cannot cut any benefits that Medicare guarantees, such as hospital care or doctors' visits.

 

If you are in an MA plan, you will have the same right you have now to switch to another plan or go back to original Medicare. You will never lose your traditional Medicare benefits because of the new law.

 

If you need expensive care from your MA plan—such as kidney dialysis, chemotherapy, or skilled nursing home care—your plan will no longer be allowed to charge you more than you would pay if you were in original Medicare.

 

FIND OUT MORE: WWW.HEALTHCARE.GOV

The large grey button at the top of the page on the right hand side that says, "Information for You" includes information specifically for people on Medicare.

 

This website includes in-depth information on Medicare, doctors, long-term care, prescription drug coverage, and other topics.