7 Things Every Medicare Beneficiary Needs to Know About Obamacare

Obamacare open enrollment starts on 1 October, and it’s confusing the heck out of millions of seniors. In today’s blog post, I’d like to clear up a bunch of misconceptions seniors have about Obamacare and how it affects their Medicare.

The most frequent question I get is “If I have Medicare, do I have to buy Obamacare health insurance?” The answer is no. The reason is quite simple. If you have Medicare, you already have qualifying health insurance. You’re covered!

People also seem to be confused about the open enrollment period for Medicare Advantage and Medicare Part D. Obamacare did not change the Medicare Annual Election Period (AEP), which starts on 15 October and runs through 7 December. It also didn’t change where and how you get your Medicare plans. If you have Medicare, you still go to your personal Medicare insurance agent or directly to Medicare.gov. Don’t bother going to your state’s health insurance exchange. They will simply send you back to Medicare.gov or redirect your call to the Medicare toll-free number.

Here’s another common misconception. Obamacare will not pay for your Medicare Supplement insurance, regardless of your income level. I’m not sure who started this rumor, but it sure did get around. If you fall below the national poverty line for income, and you need Extra Help to pay for your prescriptions, call your local Social Security Administration office.

I’ve received a couple of emails asking if Medicare beneficiaries can trade their Medicare for Obamacare? To this I say, and let me be polite, are you nuts? Your Medicare gives you a lot more coverage than Obamacare.

Also, Obamacare did not do away with the Medicare Part D coverage gap (aka, “doughnut hole”), at least not in 2014. The coverage gap is being phased out slowly. It’s still with us through 2020, then it will be gone for good.

Lots of seniors also seem to want to know how all of the money being diverted away from Medicare into Obamacare is going to affect the care they get and the costs. It’s a great question, but there are so many moving parts that it’s impossible to give a correct answer until we get into the program another year or two.

Many changes have been put into place by the U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid Services. The most significant changes impact how Medicare and Medicaid providers get paid. It is these changes, along with a crack down on Medicare fraud, that the government feels will allow them to take budget from Medicare and move it to Obamacare.

Some Medicare changes that might affect seniors simply won’t be known until the changes happen. For example, for plan year 2014, all Medicare Advantage (MA) plans must have a medical loss ratio of 85 percent. At the same time, the 14 percent overpayment that the government has been providing MA plans will go away at the end of 2014. This is a double whammy for the MA plans that is likely to have a pretty big impact. Two potential outcomes could be an increase in premiums, along with a reduction in benefits, or a massive consolidation of health plans that makes them more efficient.

I hope this has cleared up any misconceptions you might have about your Medicare in the new era of Obamacare. Medicare is virtually unchanged and it’s running more efficiently than it has in years past.

Mark your calendar. Medicare open enrollment begins 15 October.


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