When news of passage of the Affordable Care Act, also known as Obamacare, hit, many older Americans wondered about their benefits. How does Obamacare affect Medicare recipients? The new law requires that Americans maintain health insurance, whether through private plans, networked plans, or employer-sponsored plans. While rumors of what Obamacare would mean to seniors continued to make seniors worry about their benefits, now that the plan is in place we have a better understanding of what it means to seniors and other Medicare recipients.
Will Obamacare Eliminate Coverage?
If you currently have Medicare, you will not lose it. In fact, Medicare itself is not a component of the Health Insurance Marketplace that was established by this new law. The marketplace allows individuals without insurance to purchase plans to fit their needs. Seniors do not have to replace Medicare with a new plan. No matter whether you have original Medicare or Medicare advantage plans in place, you can keep the same coverage. In fact, you really do not have to do anything to keep getting your current coverage.
How Does Obamacare Care Affect Medicare Recipients and Their Benefits?
One key way that seniors will see differences is in the preventive care they get. If you are on a government-funded plan like this, you will see an increase in the preventive services available to you and you'll pay less for them. This includes colonoscopies and mammograms. Additionally, you'll get a wellness visit each year, at no charge. Prior to this law going into effect, Part B coinsurance would have been charged or out-of-pocket payment would have been required for these services.
Additionally, some discounts may be available to you on medications. Some people will get a 50 percent discount when they buy medications covered under Part D of Medicaid, including brand name products. If this affects you, you'll see a decrease in your medication costs the next time you pick them up.
What About Medicare Costs?
For the many seniors living on very strict budgets, the thought of medications and doctor care going up doesn't sound good. The good news is that Obamacare does not raise premiums for seniors. AARP indicates that it may help to keep Part B premiums lower, too. It is important to note that the cost of Medicare may go up, but this increase in costs is not directly linked to the Affordable Care Act. These rises are instead attributed to factors such as budget challenges and rising costs of healthcare.
Will Obamacare Replace Medicare?
How does Obamacare affect Medicare recipients in the long term? Though there has been some speculation about what the Affordable Care Act might mean for the long-term management of Medicare, it is unlikely it will ever be a replacement. In some ways, it will help to protect Medicare for years. That is because it extends the life of the Medicare trust fund currently in place. The new law extends this fund through at least 2029. This extension is possible due to changes in the system, including reductions in waste and fraud. It also helps to reduce overall Medicare costs. All of this savings has helped to ensure the fund will remain in place for many more years.
How Does Obamacare Affect Medicaid?
Medicaid, which is a government insurance program, provides healthcare coverage to seniors and children who otherwise could not afford it. It also covers some people who have mental illness and disabilities. Those who are on this plan are enrolled in private health plans, which provides a monthly fixed-rate premium. Nearly all of the individual's healthcare costs are covered under this plan. Under Obamacare, Medicaid will be expanded, providing additional coverage and including more people.
The Medicaid expansion provides more coverage to some of the poorest people in the U.S. This will help provide coverage to almost half of all those who are uninsured in the U.S. Here's a look at some of the impacts of this change.
- Medicaid provides coverage to about 60 million people. It is a joint program funded by the federal government and state governments. States can opt out of the expansion.
- Eligibility for this coverage differs from state to state. Qualifications depend on age, income, dependents and other factors.
- The costs of the expansion are 100 percent covered for the first three years and 90 percent covered after 2022. Many people who do not want the Medicaid expansion indicate that costs are a big factor. While this is true, it may help to reduce the toll of unpaid medical bills on individuals and hospitals.
Obamacare does significantly impact Medicaid. Starting in 2014, eligibility in states that accept the expansion will include all U.S. citizens with an income that is within 133 percent of the poverty line. Notably, the expansion also provides doctors with payment, or higher payment, for providing services to patients with Medicaid. Previously, many doctors received no payment in such situations. The law raises payments to meet the same level as provided through Medicare.
If You Have Medicaid, What Happens Now?
For those who do not have Medicaid, qualifying for it may be easier than ever. If you already have it, you may see improvements in the preventive services offered to you. You may also see more access to tests for medical conditions such as high cholesterol and diabetes. Medicaid recipients also can receive counseling and support for weight loss, alcoholism and smoking. It is unlikely you will see any reduction in services. You also do not have to do anything to see these benefits play out.
How Does Obamacare Affect TRICARE?
TRICARE, the health care insurance program in place for military families, usually meets the requirements under the Affordable Care Act. Individuals who have any of the following types of TRICARE plans will meet the requirement to maintain insurance.
- TRICARE Prime
- TRICARE Prime Remote
- TRICARE Prime Overseas
- TRICARE Prime Remote Overseas
- TRICARE Standard and Extra
- TRICARE Standard Overseas
- TRICARE For Life
- TRICARE Reserve Select
- TRICARE Retired Reserve
- TRICARE Young Adult
- US Family Health Plan
Individuals who are moving out of the military may have a transitional plan. If you have a Transitional Assistance Management Program or Continued Health Care Benefit Program in place, you also meet the requirement for maintaining minimal essential coverage. This means you do not have to purchase additional insurance or pay a penalty for not having coverage. However, you will need to maintain this insurance plan, no matter whether you pay for it out of pocket or are entitled to it otherwise. If you are not in good standing with the insurance provider, you may not be meeting the requirements under the law.
If you are a current TRICARE recipient, TRICARE will send you a letter each January notifying you whether or not you have maintained coverage and have met the minimum essential requirements set under the Affordable Care Act. You can also call to ensure that this is the case.
Do You Need to Purchase a New Insurance Plan?
Obtaining health insurance remains important for those who do not qualify for Medicaid or Medicare or may not have a TRICARE plan in the military. If you do not get health insurance, the new law may require you to pay a penalty levied on your income taxes each year. To avoid this, work with Trusted Choice® independent insurance agents. Our agents can help you get the coverage you need to both meet the requirements under the new law and help ensure you have the healthcare coverage you need. Working as independent agents, our Trusted Choice members represent you in the selection of insurance, not carriers or the federal government. Call an agent today and speak openly about your needs, concerns and options.