Just as many Americans are wondering this week what will happen with their health insurance, Medicare beneficiaries are also concerned about their benefits and want to know if their Medicare benefits will be subject to the PPACA rules or if their premiums are going up.
For the most part, Medicare beneficiaries need not worry at this time. After all, Medicare is already a national health insurance program, so the healthcare industry rules that are affected by the Obamacare legislation apply mostly to individual and group health insurance policies for Americans under age 65 and not yet eligible for Medicare.
Let’s quickly address some of the more common questions we are hearing:
- Are the Medicare Part B premiums going up to $247/month in 2014? This is a myth. The PPACA legislation does not change how Medicare Part B premiums are determined. Each year the Centers for Medicare and Medicaid Services determines what the new Part B premium for the coming year will be. The figure is based on the claims loss expenses incurred by Medicare in the prior year. It is possible that you could see an increase in premium if the government Medicare spending is higher from one year to the next, or if your income surpasses a certain threshold which then makes you owe the higher-income adjustment amount. These factors, however, are already in place and do not change do to Obamacare.
- Is the Part D coverage gap going away? Among the provisions of the Affordable Care Act are plans to slowly close the coverage gap between now and the year 2020. What we don’t know is how much your Medicare Part D premiums might go up if the gap is ultimately eliminated. It would seem logical that higher costs would occur if the gap were eliminated. Stay tuned.
- I’ve heard that I may lose some benefits in my Medicare Advantage plan – is this true? Congress did make some changes to the way that Medicare Advantage plans are paid. This was done, they say, to reduce what were considered “overpayments” to private Medicare insurance companies who offer Medicare Advantage plans. If the law stands as is and millions of dollars are stripped from Medicare Advantage funding, then yes, it would realistically make sense that in 2014 you may see some of Medicare Advantage plan benefits reduced. Keep in mind, however, that every fall, Medicare Advantage plan members receive an Annual Notice of Change letter around September that tells them about all the upcoming year’s changes in premiums, benefits, copays, etc. You then have the right to change your plan if the benefits no longer appeal to you.
Finally, keep in mind that nearly all of this remains to be seen based on the elections this fall. We have one political party that wishes to charge forward with the Healthcare Reform law and another which has promised to work to overturn or defund it. Much depends on the result of these elections. In the meantime, we suggest you make your coverage decisions based on today’s laws as they stand, and we’ll worry about 2014 when it gets here.