Seniors on Medicare Don’t Need to
Apply to the Health Law Marketplaces
Q&A by Kaiser Health News on what
senior citizens need to know about the Affordable Care Act (Obamacare)
By Mary Agnes Carey, KHN Staff Writer
Sept. 23, 2013 - Nearly 50 million
Americans are enrolled in Medicare, the federal health insurance program
for the elderly and disabled. The 2010 health care law, known as the
Affordable Care Act, will make some
changes to the program. Here are some answers to frequently asked
questions about Medicare and the health law.
Q: The health law creates
something called a health insurance marketplace. What is that and can I
apply for coverage on an exchange?
not part of the health insurance exchanges. Seniors will still get
health coverage through Medicare’s traditional fee-for-service program
or Medicare Advantage plans, private health insurance plans that are
approved by Medicare. Those who are enrolled in
Medicare Part A, which covers hospital care, or the Advantage plans
will meet the health law’s
mandate for individuals to have insurance.
Q: Does the health care law
offer any new benefits for Medicare beneficiaries?
A: Medicare spending will continue
to expand as increasing numbers of baby boomers reach 65. However, the
law does cut the expected growth of Medicare spending by about $716
billion over the next decade.
Those cuts are made by
lowering reimbursements to nursing homes, hospitals, home health
agencies and other providers. It also cuts payments to Medicare
Advantage plans to bring those payments closer to what Medicare pays for
care for beneficiaries enrolled in the traditional fee-for-service plan.
Medicare officials stress that the spending changes will not reduce
Some worry those cuts could lead to
access problems, if providers drop out of the program. In the most
recent Medicare Trustees
report, Paul Spitalnic, then acting chief actuary for the Centers
for Medicare and Medicaid Services, wrote that over the long term, some
of the health law's changes would cause Medicare payment rates for home
health, hospital and other services to drop below those now paid by the
Medicaid program, "which have already led to access problems for
Q: Does the health law require
higher-income Medicare beneficiaries to pay more for their Medicare
prescription drug coverage?
A: It does. Currently, Medicare
beneficiaries who earn more than $85,000 ($170,000 for a couple) pay
more for their
Medicare Part B premiums, which cover physician and outpatient
services. The health law brought that same sliding-scale approach to
beneficiaries' prescription drug coverage in Medicare
Part D for those with incomes of more than $85,000 ($170,000 for a
couple). Those income thresholds will be frozen through 2019.
Q: I've heard a lot about
something called the Medicare "doc fix." What is that and does the
health law fix it?
A: The "doc fix" refers to the
sustainable growth rate, or SGR, which is the payment formula based
on economic growth that Medicare has used to pay physicians since the
late 1990s. Over the past decade, the formula would have cut Medicare
physician payments but Congress has stopped the cuts. For example, it
calls for a 25 percent drop next Jan. 1. Doctors warn that if the pay
reductions were to take effect, fewer physicians will treat Medicare
The health law does not change that
formula, but there is bipartisan legislation pending on Capitol Hill
that would. The House Energy and Commerce Committee
passed a measure in July to repeal the SGR but the bill does not
specify how to finance a fix. The House Ways and Means Committee and
the Senate Finance Committee are working on legislation as well.
You may be eligible for money damages if you owned or leased one of these VW, Porsche or Audi vehicles.
In the major scandal of 2015, Volkswagen cheated you and the world. They rigged diesel emission controls so you, nor regulators, would know how much pollution their cars were adding to our environment.
They were caught and have reserved $7.3 billion to help "make it right" with victims.
If you owned or leased one of these vehicles, contact us now.
Janicek Law attorneys are actively pursuing these cases against VW. Do Not Wait...