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June 18, 2012  |  By Diane Walker, RN, MS, CSA In Healthcare Law & Advocacy

Seniors and Health Care Reform: FAQs

Health care in America is changing. In 2010, President Obama signed the Patient Protection and Affordable Care Act. This year, the Supreme Court is hearing arguments about the constitutionality of the Affordable Care Act, and is expected to issue its ruling this summer.

If the bill is upheld, health care providers and individuals will be impacted. How will these changes affect you and your loved ones? Paying for home care and understanding your options when it comes to affordable quality home care should be a top priority for both seniors and their families.

Learn about the health care reform and its impact on seniors with these frequently asked questions.

Q: How does the Affordable Care Act affect my Medicare benefits?

A: There are no reductions in your traditional Medicare benefits. Most of the changes focus on Medicare Advantage, which is a program through which people use private health insurance to receive Medicare benefits.

There are some favorable proposed changes to your Medicare benefits. Medicare will pay for annual wellness visits. You will also receive free prevention screenings, such as cancer and diabetes screenings.

Q: Will I be able to keep my Medicare Advantage Plan?

A: You will not be required to drop your Medicare Advantage Plan. However, Medicare Advantage Plans are not guaranteed renewable. Payments will be cut to Medicare Advantage plans, making it likely that carriers could pull out, forcing you to return to Medicare or find a different carrier.

Q: What about my prescriptions?

A: As of 2011, if you and your Part D prescription drug plan collectively spend more than $2,930 in 2012, you will hit the so-called “coverage gap,” and the Affordable Care Act helps to pay these costs. If you hit the coverage gap, you’ll pay half of what your plan charges for your prescriptions, plus a dispensing fee. You’ll also get a 14% discount on any generic drugs.

By 2020, the coverage gap will be phased out. If your drug costs are high, you’ll start by paying about 25% of the cost of your drugs, and then your costs will be very low as you enter the catastrophic coverage period.

Q: Will the Affordable Care Act reduce Medicare spending?

A: Only time will tell, of course, but the law is projected to slow the rate of Medicare spending growth from 76% to 5.1% over the next 10 years. The Congressional Budget Office projects that the law will save Medicare about $400 billion over those 10 years.

The law will slow payment increases to Medicare providers, such as hospitals, nursing homes, and home health agencies. More money will come from people with Medicare who have higher incomes. The law requires them to pay higher premiums for prescription drug coverage. About 5% of people with Medicare will be affected by this change. They are single people with incomes above $85,000 and couples with incomes above $170,000.

Q: How will the law affect long-term care at home?

A: The Affordable Care Act provides extra federal funds to states that provide in-home services through Medicaid. Starting in 2014 through the end of 2019, the law will increase protection for the spouses of those who receive Medicaid home care.

Q: Will nursing home care be affected?

A: Yes. There will be increased training programs for nursing home workers, and new protections against elder abuse.

Make sure to stay abreast of the Affordable Care Act as it is debated by Congress by reading the latest updates to the health care reform timeline as documented by the U.S. Department of Health & Human Services.

If you have anything you’d like to share concerning the ACA please do so in the comments below.

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