Medicare and The Affordable Care Act (ACA)

Top 5 things you need to know about Medicare and the Affordable Care Act (ACA) if you already have Medicare:Medicare Facts

  1. You will receive more preventive services, for less. Medicare now covers certain preventive services, like mammograms or colonoscopies, without charging you for the Part B coinsurance or deductible. You also can get a free yearly “Wellness” visit.
  2. You can save money on brand-name drugs. If you’re in the donut hole regarding coverage, you will also receive a 50% discount when buying Part D-covered brand-name prescription drugs. The discount is applied automatically at the counter of your pharmacy and you don’t have to do anything to get it. The donut hole will be closed completely by 2020.
  3. Your doctor will receive more support. With new initiatives to support care coordination, your doctor might get additional resources to make sure that your treatments are consistent.
  4. Your Medicare coverage is protected. Under the ACA, your existing Medicare-covered benefits will not be reduced or taken away. You also will continue to be able to choose your own doctor.
  5. The ACA ensures the protection of Medicare for many years to come. The life of the Medicare Trust fund will be extended to at least 2029, representing a 12-year extension due to reductions in waste, fraud and abuse, and Medicare costs, which will provide you with future savings on premiums and coinsurance.

The health insurance exchange Marketplace does not offer Medicare supplement (Medigap) insurance or Part D drug plans.

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

  • Medicare benefits have expanded under the health care law, especially with free preventive benefits, cancer screenings, and an annual wellness visit.
  • You can also save money if you’re in the prescription drug “doughnut hole” with discounts on brand-name prescription drugs.
Medicare isn’t part of the Health Insurance Exchange Marketplace, so you don’t need to do anything. If you have Medicare, you are considered covered.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.

More Information About Medicare and the Affordable Care Act

Still a mystery to many, Obamacare is almost upon us.  Starting October 1, 2013, the healthcare exchanges will present rates and information for everyone.  People wonder what the program will mean for those over 65 years old.  The country has over 49 million seniors on Medicare, and their confusion is bound to increase.  Here is some information to help clear things up.
  1. The Affordable Care Act is not replacing Medicare.  AARP thinks that Medicare will be stronger under the ACA.
  2. Seniors who currently have Medicare will not have to buy more health insurance coverage to comply with the ACA.  If they are satisfied with their current plan, they do not have to do anything at all, but they will still be able to change their plans and coverage during the regular Medicare open enrollment period (October 15 – December ).
  3. Some higher income Medicare recipients (about 5% of the population) will definitely be paying more for their medications under Obamacare.  Those earning over $85,000 per person or $170,000 per couple will pay slightly more for prescription drug coverage (called Medicare Part D).    The rest of Medicare recipients will see their drug costs go down as the ACA closes the ‘donut hole’ (a coverage gap which forces recipients to pay 100% of their prescription drug costs up to a certain amount).  It is expected that this gap will be closed completely by 2020.  Those who will fall into the gap this coming year will get a 47.5% discount on some brand-name drugs plus a 21% discount on generic drugs until they reach the out-of-pocket limit.
  4. Medicare recipients will still be able to see their current doctors.
  5. Medicare premiums will continue to rise, but will do so slower than premiums for private health insurance.


s2Member®