Guest Post by Cara V. James, PH.D.
October 15 marked the start of the Medicare Open Enrollment period. It will end on December 7, 2013. During this time, all people with Medicare are encouraged to review their current health and prescription drug coverage, including any changes in costs, coverage and benefits that will take effect next year, and decide whether they would like to change their coverage.
Webinar Opportunity: Please join Dr. Cara James, Director of the Office of Minority Health at CMS on December 5, 2013 at 2:00pm EST for a webinar that will highlight how the Affordable Care Act strengthens Medicare and provide an overview of the Health Insurance Marketplace for older Americans of color: https://12-5acaandmedicare.eventbrite.com
You may have heard about the Health Insurance Marketplace created by the Affordable Care Act (ACA). Many Medicare beneficiaries are unclear as to how the ACA will affect them. As explained below, Medicare Open Enrollment is not part of the Marketplace, but there are a number of other ways in which the ACA helps Medicare beneficiaries. Listed below are the Top 5 things beneficiaries should know about the ACA helps to strengthen Medicare, followed by some frequently asked questions:
- Your Medicare coverage is protected. Medicare isn’t part of the Health Insurance Marketplace established by the ACA, so you aren’t able to replace your Medicare coverage with Marketplace coverage. 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. The Marketplace open enrollment overlaps with the Medicare open enrollment period, but you don’t need to do anything with the Marketplace during Open Enrollment.
- You get 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.
- You can save money on brand-name drugs. If you have Medicare prescription drug coverage (Part D), and you’re in the gap in coverage known as the “donut hole”, you’ll get a 50% discount when buying Part D-covered brand-name prescription drugs. The discount is applied automatically at the counter of your pharmacy—you don’t have to do anything to get it. The donut hole will be closed completely by 2020.
- Your doctor gets more support. With new initiatives to support care coordination, your doctor may get additional resources to make sure that the treatments you get from different health providers are consistent.
- The ACA ensures the protection of Medicare for years to come. Medicare payments come from the Medicare Trust Fund. The life of the Medicare Trust fund will be extended to at least 2029—a 12-year extension due to reductions in Medicare costs, as well as reductions in waste, fraud and abuse.
FREQUENTLY ASKED QUESTIONS:
- Can individuals who have Medicare enroll in coverage through the Marketplace?
Medicare isn’t part of the Health Insurance 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.
- What should I do if I’m contacted about signing up for a Marketplace plan?
It’s against the law for someone who knows that you have Medicare to sell you a Marketplace plan. DO NOT share your Medicare number or other personal information with anyone who knocks on your door or contacts you uninvited to sell you a health plan. You may report Medicare fraud and abuse to 800-HHS-TIPS (1-800-447-8477).
- What do Medicare beneficiaries need to know about Medicare and the Marketplace?
Individuals with Medicare need to know that if they have Medicare, a Marketplace plan is not appropriate for them.
- Will Medicare Advantage Plans still be available?
Yes. The Medicare Advantage program is still growing under the health care law. Learn more about Medicare Advantage plans.
WE ARE HERE TO HELP
- If you have questions about Medicare, visit Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
- If you have a question about the Marketplace, you can call 1-800-318-2596, 24 hours a day, 7 days a week. Assistance is available in 150 languages. TTY users should call 1-855-889-4325.
- To contact CMS OMH, please email firstname.lastname@example.org.