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Understanding Medicare: Obamacare and Medicare

affordable care act causes questions for medicare beneficiaries

Many seniors and caregivers are confused about Obamacare and Medicare as the enrollment periods for both approach.

Obamacare and Medicare, what do you need to know?

As the Federal government starts to ramp up their marketing and education efforts around the Affordable Care Act, it can be easy for seniors to feel confused and left in the dark about what, if anything, the new laws require of them. Compounding the issue, both Obamacare and Medicare have enrollment periods approaching.

The first Affordable Care Act milestone is the open enrollment in health plan exchanges, beginning Oct. 1.

Confusion can occur because October 15th marks the beginning of the two-month sign-up period for private health plans for millions of Medicare recipients.  During this two month time, eligible seniors can select a Medicare Advantage plan, a drug insurance policy or buy a supplemental Medicare insurance plan, otherwise known as a Medigap plan. In some states seniors may qualify for both Medicare andMedicaid and may be looking into managed care plans. With all of these healthcare milestones looming and many private insurers offering policies in the exchanges as well as Medigap and/or Medicare Advantage policies, seniors are likely to be bombarded and overwhelmed with marketing messages, and have hard time understanding what is right for them.

The good news is that none of the above mentioned plans will be offered in the healthcare exchanges. 

The official Medicare message  is that there is no need for seniors covered under Medicare to do anything as they are already covered.  However, there is nothing that would prevent seniors with Medicare from signing up for marketplace plans. The important thing to keep in mind is that  if they do, they will not qualify for any tax breaks.

If they can, should they?

For most medicare recipients Medicare offers better coverage at more affordable rates than the marketplace can. However, some seniors who pay a higher premium based on their assets may find a better deal.

The big challenge will be fraud prevention as scams can be expected to try and take advantage of any confusion.

What does your parent or loved one need to know to help prevent being taken advantage of? 

  • They will not lose their benefits as the Affordable Care Act rolls out.
  • There is no need to re-enroll in any Medicare benefit through the marketplace, and no need for a new Medicare card.
  • They will not be fined for not enrolling as long as they have Medicare Part A.

The bottom line:

Medicare is not and will not be a part of the new health insurance exchange. The exchanges will have no impact on the way eligible seniors choose their Medicare benefits, and does not change any Medicare benefits. 

Next week we will look at Medicare Open Enrollment, which begins October 15th for eligible seniors.