Fact 1: Specific Medicare Benefits Will Not Be Cut
There has been a lot of news about how Medicare benefits will be cut due to ObamaCare, we hope to address this confusion. The Affordable Care Act actually prohibits cuts to Medicare medical benefits such as hospital or doctor visit payments. So, to be clear, Medicare will cover the exact same medical benefits after ObamaCare as before the law was enacted.
Here is where the confusion comes in: the plan reduces 10% of the Medicare budget ($716 billion) over the next 10 years. ObamaCare supporters claim that Medicare costs will be controlled by being vigilant about costly payments to providers, fraud, waste, as well as taxing high premium plans. The bulk of the cuts really come from eliminating a massive subsidy to Medicare Advantage Insurers (see fact 2 below) and gradually reducing the rate of growth in payments to some providers.
Doctors, Hospitals, and other Medicare providers will see Medicare payments grow more slowly than they have in the past. This could affect your medical access as some doctors and facilities may not accept Medicare reimbursement rates in the future but, once again, your actual covered benefits will not change. If you don’t currently have Medicare and would like to learn how to sign up go to our Medicare Overview Page.
Fact 2: Medicare Advantage Minimum Benefits Will Not Be Cut
Just to remind you, Medicare Advantage plans are administered by private companies and are required by law to, at a minimum, offer the same benefits offered under traditional Medicare. This minimum standard will not change under ObamaCare. A Medicare Advantage plan can still offer additional benefits such as such as prescription drugs, dental care and health club memberships. And, as before, these members may be limited to a smaller network of doctors and still be subject to certain deductibles and coinsurance.
What is changing is the subsidy the government gives to the private insurance companies who are providing these plans. The long term impact this reduced subsidy is still unknown but many claim that Medicare Advantage plans will not be as competitive without the addition government money.
Fact 3: You Are Not Mandated to Purchase Separate Insurance if You have Medicare
Seniors and anyone who is Medicare eligible do not purchase individual “exchange” plans. Under the new law that kicks in January 2014, the health care exchanges are for individuals under 65.
As before, those who are Medicare eligible will start with traditional Medicare when they turn 65. At that point they are still eligible to go with Medicare Advantage or select a Medigap plan. Medigap plan are designed to fill in the gaps that Original Medicare leaves open such as deductibles, coinsurance, additional days in the hospital and foreign travel. Visit our Medigap Getting Started page to learn more about this other type of private medicare insurance.
We would like to thank our readers for feedback on this page. We have made a few updates on this page based on your comments. Any further questions about ObamaCare and Medicare contact Senior65.com.