Rumors about the Affordable Care Act and Medicare?

 

Toni:

            I will be 70 on June 20, 2014 and have decided to retire effective June 1.  I have always had company benefits and because of healthcare reform my company is no longer covering retirees.  Now I have to make new Medicare choices.

            I would like to know how healthcare reform is affecting Medicare because of all the rumors I hear such as Medicare is going away, friends tell me Medicare premiums are rising, and that prescriptions are costing more because of healthcare reform. 

            Can you help me feel a little more confident in retiring at 70..Thanks, Joseph,Houston,TX

Happy New Year!!  Joseph:

The Affordable Care Act (ACA) better known as Obamacare began on Wednesday, January 1.  Americans who are currently on Medicare or the 10,000 turning 65 every day for the next 20 years are all very concerned with how the Affordable Care Act (ACA) will affect their Medicare benefits.

Let’s discuss the few rumors that you have brought to my attention about Medicare and the ACA.

1.  Medicare is ending…Big Rumor!!  The Affordable Care Act (ACA) is not replacing Medicare. When someone is enrolled or can enroll in Medicare it is illegal for them to enroll in the Affordable Care Act (ACA).   The ACA is for those under 65 and uninsured. Medicare as you know is for those over 65, those with certain disabilities and those with End-Stage Renal Disease (kidney dialysis) and is as strong as it has ever been.

            2.  Medicare premiums are rising…Partially true!!  Because you will be retiring, Joseph, you should be aware that you may pay more for your Medicare premiums depending on your income.  Those making more than $85,000 per individual or $170,000 per couple will continue to pay more for their Medicare Part B coverage.  The rise in Part B premiums is not related to healthcare reform because the increase began in 2007.  Most will pay $104.90 for 2014, but if you make more than mentioned in this article then you will pay more for Medicare Part B.

3.  Seniors will pay more for their prescriptions because of Obamacare… Rumor!!  Prescription drug cost is to go down because of the ACA, the donut hole begins to shrink.  The donut hole will be closed in 2020 and will be replaced with a 25% costs sharing across the board for all brand name and generic drugs.

Those who fall into the donut hole for 2014 will receive a 47.50 % discount on the Part D prescription drug plans brand name drugs and 21% discount on generic drugs until they reach the out of pocket limit of $2,850 for the 2014 donut hole also known as coverage gap.

4.  Many seniors are concerned that they will not be able to use their current doctor because of the (ACA) Rumor!!  Nothing in the ACA changes which doctor a Medicare patient sees if one is with Original Medicare Parts A and B with a Medicare Supplement to pick up what Medicare does not pay for. Those who use a Medicare Advantage plan, also known as Medicare Part C, may have to change doctors if your doctor is not in that plans network.  During 2013’s Medicare open enrollment, which ended December 7, 2013, many Medicare Advantage plans changed their networks dropping doctors.  This change was not because of the ACA, but because the Medicare Advantage plans are trying to improve their Star ratings. Medicare Advantage plans are striving to get a 3.5 Star rating or better.  A 5 Star rating is the top rating and currently Kelsey Seybold is the only 5 star rating Medicare Advantage plan in the Houston area.

Joseph, if you or any of my current readers have any more questions on healthcare reform and Medicare or are wondering the proper steps on retiring and enrolling in Medicare, just send me an email and I can do the research on that particular Medicare issue.

Toni King, author of the new Medicare Survival Guide®, which is a simple guide that puts Medicare in “people” terms, is on sale at www.tonisays.com  Email questions to www.tonisays.com/ask-toni or call 832/519-TONI (8664).

About the Author

Toni KingToni King is a recognized subject matter expert and a passionate advocate for those who are overwhelmed by Medicare rules and requirements. She is a published author (The Medicare Survival Guide), a workshop presenter (Confused About Medicare Workshops) and writes weekly articles for 14 area newspapers. Toni also offers one-on-one consulting services for those who need help sorting through the confusion of the enrollment process and choosing benefits.View all posts by Toni King →

  1. Maureen Taylor01-13-2014

    I always enjoy reading your articles in the Mirror. I was very impressed with your article published on January 8,2014. Many of my friends are confused because many commentators on talk radio and some in the tv media try to confuse the public. It is refreshing to find someone who writes so clearly and with such knowledge. I am certain that you received some negative replies because your answers spoke to facts. Please keep up the good work.

Leave a Reply

    No Twitter Messages.

Special Offer: Limited Time Only!