Jul 11, 2012

Will your Medicare be impacted by the Affordable Care Act?

The Supreme Court ruled last week: The Affordable Care Act is constitutional. 

My elder law clients' longstanding concern has been how the ACA might impact Medicare. The best summary of this topic I've seen was published today by the non-partisan and non-profit Center for Medicare Advocacy, which concludes that seniors have nothing to lose, and everything to gain. I've excerpted the summary below:

Good News for Medicare: Supreme Court Upholds Affordable Care Act  

Effect of ACA on Medicare

The decision upholding ACA ensures that the many improvements to the Medicare program continue to be available for the millions of American families who rely on Medicare. Some of these improvements are already saving older and disabled Americans thousands of dollars in costs and improving their care:
  • Reducing Costs for Prescription Drugs.  People with Medicare are already benefiting from the phase-out of the "Donut Hole" coverage gap that requires Medicare Part D enrollees to pay the full price for their drugs after a certain threshold of coverage has been met and until a catastrophic limit has been met.  Beneficiaries now pay only 50% of the cost of brand name drugs in the Donut Hole and 86% of the cost of generic drugs. So far, beneficiaries have saved an average of $635 per person on their drug costs from this provision, a figure that is expected to rise to $4,200 per person by 2021. The Affordable Care Act is on track to fully eliminate the Donut Hole by 2020, ensuring that people enrolled in Part D plans have better access to the drugs they need.
  • Improving Accountability and Value of Medicare Advantage (MA) Payments.  ACA more fairly reimburses private Medicare plans.  Pursuant to the law, Medicare Advantage payments were restructured to better match payment in traditional Medicare.  Prior to the restructuring, MA payments were, on average, 13% higher than those for traditional Medicare...  Also, MA plans are prohibited from charging higher cost-sharing than traditional Medicare for skilled nursing facility care, chemotherapy and kidney dialysis.  Further, starting in 2014, MA plans will be required to spend a specific percentage of premiums on actual coverage rather than on administration, marketing or profits.
  • Saving Lives with Preventive Health Services for Medicare Recipients. ACA added coverage for preventive care and made most preventive screenings and services free for people with Medicare. So far, over 24 million women with Medicare have received recommended preventive screenings and services with no co-pays or deductibles. ACA also added an annual Wellness Visit, all at no cost to the beneficiary.
To see the complete summary on the organizations' website, click here

1 comment:

christine said...

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