Obamacare and Medicare FAQs

Since the Affordable Care Act (ACA), more widely known as the ObamaCare, was constituted, there have been a lot of questions on what the health reform means to the existing Medicare. To help clarify these concerns, we have gathered here a list of useful FAQs.

How Will The Obamacare Or The Health Reform Affect Medicare In General?

A simple answer is that the ObamaCare is making substantial improvements to Medicare by shoring up the program’s finances and improving coverage.

How Does The Obamacare Affect Medicare’s Quality Of Care?

The ObamaCare is designed to maintain and even better Medicare’s quality of care, where it includes provisions to achieve such goal. One of the health reform’s objectives is to cut down the number returning patients to hospitals due to the facilities not being able to provide the proper plan of care before discharge by holding hospitals financially responsible to ensure Medicare patients are receiving the right care and treatment after the check out. Moreover, the ACA also increases Medicare payments for visits with medical specialists and primary care doctors, as well as provides additional payments to physicians who are coordinating care with specialists to improve their patients’ well-being.

Is Medicare Part of the ObamaCare?

Though the ACA makes some changes to Medicare, it does not replace Medicare, which is not part of any health insurance marketplace (otherwise called a health exchange) of any state. This means that if you already have Medicare, you can keep it and still receive all the new rights, benefits and protections the ObamaCare provides on your current Medicare Advantage Plan or your original Medicare. However, it is important to know that there are exceptions, such as in a case where you are not old enough for Medicare, but have retiree insurance which you do not like, you will have the option to use the health exchange to replace that insurance. Also, if you are over the age of 65, you can only take out the ObamaCare if you do not have access to employer-based coverage or Medicare.

Does The Obamacare Make My Health Coverage More Expensive?

No. In fact, the health care reform is making Medicare more affordable by eliminating deductibles and copays for preventive treatment services, such as annual wellness visits, flu shots and health screenings; adding annual wellness visits with primary care providers to the Medicare benefit, where Medicare pays for the visit’s full cost; allowing those who have Medicare and are earning low income to receive financial support with prescription drug and medical costs, while still being able to keep modest retirement savings; and disallowing Medicare private health plans from charging more than the original Medicare for home health care, hospital admissions and other related services.

Is Medicare Minimum Essential Coverage?

If you have Medicare Part A or C, hospital insurance or Medicare advantage respectively, you are considered to receive minimum essential coverage and will not owe fees for not having a health coverage in 2014. If you only have Medicare Part B, which is medical insurance, it does not count as minimum essential coverage. Also, having a Medicare Part D drug plan or Medigap insurance does not affect whether or not you owe fees for not having insurance under the ACA, as having any of these two programs means that you already have Medicare Part A.

Is Medicare Part Of The ACA Health Insurance Marketplace?

No. Medicare is not part of any health insurance marketplace by the ObamaCare, so you do not have to replace your Medicare coverage with any health exchange-based insurance. Whichever means you got your Medicare, whether it is through the Medicare Advantage Plan or the Original Medicare, you still receive the same security and benefits you are currently having, without having to make any changes.

In Addition To Medicare, Can I Get a Marketplace Plan?

The answer is a big “no”, as it is against the law for any person to sell you a Marketplace plan while knowing that you already have Medicare, and this is true in all programs, even if you only have Part A or B. If you want a policy that is designed to supplement Medicare, you can look at Medicare Advantage Plans, Medigap policies and Part D drug coverage.

How Does The ACA Affect The Prescription Drug Coverage Of My Medicare?

The coverage gap, or the so-called “doughnut hole”, in coverage for prescription drugs, where you move into once you have reached the limit for your total drug costs in a year, will be discontinued in 2019. This is speculated to help millions of Medicare beneficiaries, who are reaching their coverage gaps and might be tempted to split pills and skip doses, to save more money. Also, the ObamaCare offers additional assistance by authorizing Medicare to negotiate for lower drug prices and requiring brand-name drug manufacturers to provide a 50-percent discount for those who are in the coverage gap.

How Does The Obamacare Affect The Financial Outlook Of Medicare?

The ObamaCare includes provisions to aid in slowing the growth rate of Medicare spending and shoring up the Hospital Insurance Trust Fund, which was forecast to run short of money for paying claims by 2017. Now, the ACA is designed to strengthen Medicare’s finances, primarily by cutting the yearly increases in payments to home health agencies, nursing homes and hospitals. These changes are made based upon the recommendations of the non-partisan Medicare Payment Advisory Commission.

What Do I Need To Do Regarding The “Covered California” Or The Health Care Exchange?

The Health Care Exchange, also known as Covered California, is different than Medicare in a way that those who are enrolled in Medicare are not eligible for a Health Care Exchange plan and those who are Medicare-eligible will not be able to get tax credits through the exchange. Also, Medicare beneficiaries are allowed to continue with using the Medicare annual open enrollment period as an opportunity to drop, switch or join a Medicare Prescription Drug plan or a Medicare Advantage plan.

How Can I Sign Up For Medicare?

You can sign up for Part and B of the Original Medicare online in under 10 minutes through your local Social Security office website or by calling the office.

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