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How Does The Affordable Care Act Affect Seniors?

If you watch too much cable news, you might come away with the idea that the Affordable Care Act has bankrupted Medicare, or that benefits were being...
How Does The Affordable Care Act Affect Seniors?

If you watch too much cable news, you might come away with the idea that the Affordable Care Act has bankrupted Medicare, or that benefits were being pulled from seniors. With more than 40 million people aged 65 and older in the United States, this would be a major concern, but it simply isn't true. In fact, many Medicare benefits are getting better because of the Affordable Care Act. Plans to potentially repeal the ACA may negatively impact medicare.

That said, there still were some changes in Medicare due to the healthcare reform laws. For one thing, you should be able to pay less for your medicines. Plus, you can still choose your own doctor, just as before. The most notable changes will be with Medicare Advantage plans and hospital care. Medicare Advantage plans are basically "managed Medicare" plans that simplify the most popular Medicare supplements.

More free care is available through Medicare

Just like every other health plan sold in the United States, Medicare now includes free preventive care. In fact, this is one of the hallmarks of Obamacare, and it is expected to help seniors stay well and avoid some serious illnesses. The Medicare Advantage plans will allocate the free healthcare differently from plan to plan, but original Medicare makes it very simple: you can go for a free wellness exam every year and map out a plan with your doctor to stay healthy. Wellness exams include basic blood tests and other basic health assessments.

The Affordable Care Act has also allowed seniors to get most screenings for free. For example, seniors can get a colonoscopy to check for colon cancer, a mammogram to screen for breast cancer and also be checked for diabetes, hypertension and high cholesterol. In addition to health screenings, seniors can get free counseling to help them quit smoking.

Seniors can save money on prescription drugs

One thing is for sure, since the implementation of Obamacare the "donut hole" is shrinking. In case you are not familiar with this concept, the donut hole is a gap between Medicare Part D drug coverage and the actual cost of medicine. Right now, Part D plans cover up to $2,970 per year toward medications, after which prescription drug benefits decrease and copays go up to 47.5% for brand-name and 79% for generics. This is what is known as the "donut hole," because benefits increase again once you have spent $4,750.

Over the next several years, through 2020, the donut hole will go away. Seniors will pay a flat 25% copay for all prescriptions, and it won't matter if you buy generic or brand name drugs.
What about changes to Medicare Advantage Plans?

The Affordable Care Act gives insurance companies an incentive for improving their Part C plans, but this means your coverage could change for the better or the worse. Since these plans are managed by independent insurance companies, they are in control of packaging and pricing the plans. This means some Medicare Advantage plans might cut benefits, such as dental care, or they could increase what seniors pay for co-insurance and copays. Be sure to compare your Medicare Advantage plans with similar plans from other insurance companies.

How does your personal income impact Medicare pricing?

About 95 percent of everyone on Medicare fall into the income level of $85,000 per year or less ($170,000 per year for a couple) and will pay $104.90 per month for Medicare Part B. This cost includes Part D prescription coverage. However if your income is between $85,000 and $107,000 ($170,000 to $214,000 for a couple) the cost of coverage will increase by $42 per month for Part B and $11.60 per month for Part D. There are additional tiers for higher incomes too.

Will your doctor benefit from changes in Medicare?

Your doctor may be helped by the Affordable Care Act, too. That's because doctors can earn a financial bonus for giving you good-quality care. Or, they could get a larger fee from programs like Medicare.

One way your doctor can earn this money is for all the doctors you see to work as a team. Your primary care doctor and any specialists you see need to work together so they all know what the others are doing for you. With improved communication, you may be able to stay healthier and out of the hospital. And, your doctor may be rewarded for that.

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