WALTEMATH LAW OFFICE

American Care Act, Medicaid and Medicare

For those people who are covered by Medicare or Medicaid, there is no need to go online to enroll in the Affordable Care Act (ACA).  Your coverage under Medicare and Medicaid will remain the same with some improvement.  The ACA is not replacing Medicare or Medicaid.  A 100-page guide was sent to 52 million Medicare beneficiaries containing information on their coverage which can be found at http://www.medicare.gov/Pubs/pdf/10050.pdf.  Nothing will stop a Medicare beneficiary from signing up for an ACA plan, but if you do you will be double insured and you will not qualify for premium tax credits or subsidies offered to low-income applicants.

            There are many misconceptions about how the ACA will affect Medicare.  Some information has indicated that Medicare beneficiaries will pay more for their medications under the ACA, but this is not true.  The Part D premium will increase slightly for Medicare beneficiaries with higher incomes (individuals with annual incomes over $85,000.00, or couples with annual incomes over $170,000.00), but the cost of prescriptions will not increase, actually the majority of Medicare beneficiaries have started paying less for their prescriptions.  See medicare.gov for more information.   Medicare beneficiaries may continue to see their own doctors and there are many incentives to encourage doctors to enter into the ACA program so there may be more doctors who will take Medicare patients in the future.

            I am hopeful that the ACA will improve the health of my senior clients.  The most beneficial provision of the ACA is the elimination of coverage denial for pre-existing conditions.  People need not hesitate to go to their doctor for treatment of a pre-existing condition because it must be covered by their insurance because of the ACA.  In addition, the ACA covers yearly wellness visits and screenings for many types of cancers and other illnesses.  Studies have shown that testing for colon cancer, breast cancer, and many other conditions lead to early treatment and often a cure.

            There will be some disadvantages of the ACA, especially for those who are transitioning from Medicaid to Medicare.  Medicaid provides full coverage for all health care costs.  Medicare requires premium payments and co-pays (out of pocket costs).  There will also be timing issues to ensure that coverage does not lapse and to avoid Medicare penalties resulting from delayed enrollment, but there will be far more people transitioning from Medicare to Medicaid as a result of the ACA.