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Senior citizens need to know details of how Obamacare affects them; don’t join Marketplace plan

Sen. Nelson posts detailed information on how health care reform impacts senior citizens on Senate Select Committee on Aging website

By Tucker Sutherland, editor, SeniorJournal.com

Sen. Bill Nelson, D-Fla, Chair, Senate Special Committee on AgingSept. 5, 2013 – There is a daily barrage of news and advertising for and against the Affordable Care Act – better known as Obamacare – and it has left many senior citizens confused about what they should be doing. Basically, seniors are not involved in the major provision of the plan, which mandates insurance for all Americans and has established the Health Insurance Marketplace to help them locate plans that meet their needs at the best price possible. Seniors on Medicare, however, already have outstanding insurance coverage and should not enroll in a Marketplace insurance plan.

“The Marketplace won’t affect your Medicare choices, and your benefits won’t be changing. No matter how you get Medicare, whether through Original Medicare or a Medicare Advantage Plan, you’ll still have the same benefits and security you have now. You won’t have to make any changes,” according to HealthCare.gov, the government website for Obamacare.

 

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The website also notes that the Marketplace does not offer Medicare supplement (Medigap) insurance or Part D drug plans. For information on these programs, visit Medicare.gov.

There are some provisions of Obamacare that directly benefit seniors in Medicare:

   • Medicare benefits have expanded under the health care law - things like free preventive benefits, cancer screenings, and an annual wellness visit.

   • You can also save money if you’re in the prescription drug “donut hole” with discounts on brand-name prescription drugs.

More Medicare details

   • Medicare’s Open Enrollment Period (October 15-December 7) hasn’t changed.

   • To learn more about your Medicare coverage and choices, visit Medicare.gov.

Special Committee on Aging has details for seniors

U.S. Sen. Bill Nelson (D-FL), Chairman, Senate Special Committee on Aging, has prepared a special presentation for senior citizens on how health reform affects seniors.

 “The health and safety of America’s seniors are of paramount importance to me,” Sen. Nelson said. “This new law will strengthen Medicare and begin to reign in the cost of the program while also extending its solvency.”


Following are the details Sen. Nelson posted on the committee’s website outlining the provisions that relate directly to senior citizens.

Medicare and Medicare Advantage

Despite rumors to the contrary, no provision included in this new law will cut benefits to Medicare beneficiaries. It will transition Medicare to a more efficient system, where quality health care outcomes are rewarded and waste is reduced. In terms of the cuts to Medicare Advantage, this law will only cut back on overpayments to private Medicare insurers. No guaranteed benefits under Medicare will be cut.

Medicare Part D "Donut Hole"

This year, seniors will receive a $250 rebate check once they hit the donut hole. In 2011, seniors will begin to receive a small discount, 2.5 percent, on brand name drugs, increasing yearly until 2020, when the discount reaches 25 percent. For generic drugs, government subsidies will cover seven percent of costs starting in 2011, increasing to 75 percent by 2020. The donut hole will be completely phased out by 2020.

Preventive Care

For the 871,000 Medicare beneficiaries in Wisconsin, they will receive free annual wellness visits under Medicare beginning this year. Any out-of-pocket costs are eliminated for preventive care and screenings, such as mammograms.

Long-Term Care and Nursing Homes

The new law will give seniors and their families safer and more transparent long-term care options.  Below are long-term care provisions that I sponsored in the health care law.

   • A provision to provide consumers with more information about individual nursing homes and their track record of care; offer the government better tools for enforcing high quality standards; and encourage homes to improve on their own.

   • A provision that will prevent those with violent or criminal histories from working with vulnerable elders in long-term care settings through the creation of a comprehensive nationwide system of background checks. We will be expanding a highly successful three-year pilot program instituted in seven states that kept more than 9,500 serial predators out of the long-term care workforce.

   • Key provisions to help expand, train, and support the health care workforce focused on older adults. 

   • A provision to provide states with financial incentives and more flexible plan options for restructuring their Medicaid programs in order to provide an increasing number of beneficiaries with cost-effective home and community-based (HCBS) services.

The new law will improve health care quality for all Americans and begin to reduce health care costs over time.  Insurance companies will no longer be able to deny coverage for people who have preexisting conditions, drop coverage when someone gets sick and needs health insurance the most, or put annual or lifetime limits on benefits.  This legislation will be implemented responsibly over the course of ten years, but many of these important insurance reforms have already begun. 

Below you will find information and links to other sites that I hope you will find helpful.  

To learn more about the provisions I personally worked to include in health reform, please click here.  As always, should you have additional questions or comments about health reform, please feel free to contact me.

The federal government's health care website, HealthCare.gov.

Links to Legislation and Summaries

  Click here for the text of the “Patient Protection and Affordable Care Act”

  Click here for the text of the “Health Care and Education Reconciliation Act”

  Click here for summaries of the legislation

For more information on how health reform will affect certain groups, click on the links below:

Small Business

Women

Children & Young Adults

Americans with Disabilities

Early Retirees

Health Care Workforce

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