Medicare and the ACA
Amid the ongoing rollout of the federal and state health insurance exchanges, it is important for seniors and caregivers alike to understand how Medicare fits with the Affordable Care Act (ACA).
It is an important time to understand the changes to the Medicare plans, now that open enrollment has ended, and you continue to help your loved ones make critical health decisions. Health Care Service Corporation (HCSC), the largest customer-owned health insurer in the United States, would like to help you understand the implications of the ACA on seniors, and the added benefits seniors can expect to receive.
Since Medicare is not a part of the Health Insurance Marketplace established by the ACA and Open Enrollment for Medicare coverage remains the same, seniors were not required to do anything different during enrollment. That said, the ACA provides many new benefits for seniors as it expands the Medicare coverage that they already have, including:
- Additional preventative benefits available.
Seniors can work closely with their doctor to set up a prevention plan that will include wellness visits and screenings for diabetes, certain cancers, mammograms, colonoscopies and more. - Improved primary care.
Initiatives to ensure primary care providers are available to give seniors quality care. Doctors may receive additional resources or incentives to verify that treatment is consistent. - Savings on brand-name prescription drugs.
Many seniors fall into the “doughnut hole” when they have prescription drug coverage under Medicare Part D and fall into the coverage gap. The new law will provide a 50 percent discount on prescriptions during 2014 and begin to close the gap.
Still, as is common each year, insurance companies will update and revise their Medicare products, which can often lead to changes in the providers, products and services available for a given coverage level.
While the Annual Enrollment Period (AEP) for certain Medicare products ended December 7, seniors turning 65 can still review Medicare coverage options throughout 2014. By spending time in advance, seniors and their caregivers to can help to ensure they are utilizing all of the benefits that Medicare has to offer. Seniors should take time to consider what is important to them, such as additional services that include wellness visits and diabetes screening, how to make the most of their prescription coverage, and selecting the best doctor for their specific health needs.
We hope these services will help make it easier for you and your loved ones to find additional value in Medicare coverage and enable a healthy 2014. For more information, visit Medicare.gov.
Health Care Service Corporation [TCV Update 5/8/2023: URL updated] is the largest customer-owned health insurance company in the United States. HCSC offers a wide variety of health and life insurance products and related services, through its operating divisions and subsidiaries; including Blue Cross and Blue Shield of Illinois, Montana, New Mexico, Oklahoma, and Texas, and through Dearborn National.
When my mother had her stroke, it was not open enrollment for her and her HMO was not able to provide the rehabilitation she desperately needed. I called and was able to change her over to straight MediCare so she could get the care she needed. This was in February. In March she was straight MediCare and off the HMO and I got her into a state-of-the-art rehabilitation center. She was released in April and I changed her to a different HMO which became effective in May. So I was able to circumvent Open Enrollment due to the change in my mother’s health condition. Something that your readers might find beneficial to know. It CAN be done!
Thanks for sharing this, Carmen. I do appreciate your taking the time to share your experience and how it may help our readers.
Thanks for this information. I will investigate and see what other help I can get to help me take care of my loved one. Trials for new medication should be started in less then 30 days. I am so excited about the possibility of having my loved one be able to beat this disease. I just received a book from NIH which confirms our beliefs that our loved one has Parkinson’s Dementia and not Lewy Body dementia. (Dementia is dementia so they say but, PD can be treated with drugs that LBD can not)
Keep us posted, Don. I hope what you feel in your heart comes to pass as you will bring hope to families living with other causes of dementia beyond Alzheimer’s.