Hello Toni:
I hear so many rumors about how Obamacare is going to affect Medicare. Mainly, doctors are not accepting Medicare and that the Part B premium is going to be over $200 in a few years. Can you please tell me what is true and what is myth or rumor? Thanks, Abbey
Good Day Abbey:
I get this question all the time, especially from those who watch TV and do not know the difference between Obamacare (which is mainly for those under 65) and Medicare. Medicare beneficiaries need not to worry at this time because Medicare is already a national health insurance program. Obamacare rules apply mostly to individual and group health insurance policies for Americans under 65 and who are not yet eligible for Medicare.
One thing Obamacare is affecting is how your Medicare dollars are being spent and they are watching those dollars very closely. Here are some of the facts and myths that are circling around.
Let’s explore some of the common questions and myths that I am receiving:
- Doctors will not be accepting Medicare because of healthcare reform? This is a fact and a tricky one. Many of your “smaller” clinics that do not specialize in those that are 65 or older, are not processing Medicare claims and thus not accepting Medicare assignment…but there are plenty of primary care physicians or PCPs that are still accepting Medicare patients. For those turning 65 soon should establish a relationship with a primary care physician as well as a specialist. Do not wait until the last minute to start going to the doctor because it may be hard to find one that is accepting NEW patients. Many doctors are accepting current patients for Medicare with no problems, but have what is called a “closed panel” for new patients. Especially for the primary care physicians or family doctors because they have a hard time with all of the paperwork that Medicare is requiring.
- Is the Medicare Part B premium going up to $247/month in 2014? This is a myth that has been emailed for the past 2 years. PPACA (Patient Protection and Affordable Care Act) otherwise known as Obamacare does not determine Medicare Part B premiums. CMS (Centers for Medicare and Medicaid Services) uses a formula that has been in place for years to determine the new Part B premium for the coming year. This is determined on claims loss by Medicare in the prior year. You could see an increase in Part B premiums if the Medicare spending is higher from one year to the next. Or your income goes up and you might pay more.
- The Part D “Donut Hole” is going away? This is true… but the Patient Protection and Affordable Care Act or Obamacare is slowly closing the “Donut Hole” between now and the year 2020. Don’t know why it is taking so long!! What is an unknown is if Part D premiums will go up when the “Donut Hole” is eliminated. We will have to wait to see!
- I may lose some benefits in my Medicare Advantage Plan- Is this true? This is a myth. In 2014, you may see some Medicare Advantage plans reduce benefits because Congress made changes to how Medicare Advantage plans are paid from CMS and must reduce what were considered “overpayments” to private Medicare insurance companies who offer Medicare Advantage plans.
- Is the 2013 Medicare & You handbook on back order? This is true…when you call to order the handbook, after 2 weeks you will receive a card saying the book is temporarily out of the handbook due to overwhelming response. I’ve never seen this happen before. You can order my book the Medicare Survival Guide or email me any questions about Medicare or any advice.
Toni King is the author of Medicare Survival Guide is available only at www.tonisays.com and not sold in bookstores. Toni is an advocate/consultant for those “Confused about Medicare”. Email questions to toni@tonisays.com or call 832/519-TONI (8664).
