The Health Care Law: What it Means for People with Medicare
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The Health Care Law: What it Means for People with Medicare
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The Health Care Law: What it Means for People with Medicare. Welcome. Agenda. What’s changing What’s not changing When will changes take place Questions and answers. How the Law Improves Medicare. Protects guaranteed Medicare benefits Improves Medicare benefits - PowerPoint PPT Presentation
Transcript of The Health Care Law: What it Means for People with Medicare
The Health Care Law: What it Means for
People with Medicare
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Welcome
What’s changing
What’s not changing
When will changes take place
Questions and answers
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Agenda
How the Law Improves Medicare
Protects guaranteed Medicare benefits
Improves Medicare benefits
• Lowers prescription drug costs
• Adds more preventive benefits
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What is the Doughnut Hole?
Medicare Part D coverage gap
• You fall into the doughnut hole after your totaldrug costs reach $2,970
•You leave the doughnut hole when your total out-of-pocket drug costs reach $4,750
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Medicare Drug Coverage
Discount:52.5% for
Brand
21% for Generic
Initial Benefit Catastrophic Benefit
You pay: Deductible and 25% of drug costs
You pay: 5% of drug costs
Doughnut Hole
Doughnut Hole Will Gradually Disappear 52.5% discount on brand name drugs
21% discount on generic drugs
By 2020, the doughnut hole will disappear
Part D cost sharing will remain
AARP’s Doughnut Hole Calculator
www.aarp.org/doughnuthole
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www.aarp.org/doughnuthole
Adds More Preventive Care Benefits Yearly wellness visit
Screenings for diabetes and certain cancers
No co-payments or deductibles
Call Medicare at 1-800-633-4227www.medicare.gov
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Improves Access to Primary Care Doctors
Primary care doctors who treat people with Medicare get bonus payments
Medicare gives extra payments in areas of the country with a shortage of providers
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Improves Care Coordination of Medicare Home Health Services Must have a face-to-face visit from certain health
practitioners
A physician must certify home health services
Visit must occur within 90 days before you receive home health care or 30 days after you start care
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What are Medicare Advantage Plans?
Alternative to Original Medicare
Offered by Medicare-approved private insurance companies
Pays for the same basic health care services as Original Medicare, but may also pay for additional services
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How the Law Changes Medicare Advantage Plans
Guaranteed Medicare benefits are protected
You can choose either a Medicare Advantage plan or Original Medicare
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Medicare Advantage Plans
More emphasis on quality and value:
• Plans will get bonuses for providing quality care
• Plans must use some of the bonus for extra benefits and rebates to people with Medicare Advantage
• Plans can’t charge more than Original Medicare for certain services
• Plans must limit how much they spend each year on administrative expenses
www.medicare.gov 14
Medicare Advantage Plans
How Medicare Advantage plans are paid
• Subsidies that Medicare currently pays to private insurance companies will be lower to bring payments more in line with Original Medicare
• Changes in Medicare Advantage payments will result in savings to the Medicare program
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Medicare Advantage Plans
What lower subsidies could mean
Some plans may drop extra services
Some plans may raise premiums and co-payments
Others may decide to leave the Medicare program
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Medicare Advantage Plans
What lower subsidies could mean
• You will receive a notice of changes, if any
• You can stay with your plan, switch your plan, or go to Original Medicare
Contact your Medicare Advantage plan or call Medicare at 1-800-633-4227
www.medicare.gov
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Other Changes to Medicare
Part D Income-related premiums
• Income levels for higher premiums start at $85,000 for a single person $170,000 for married couples filing joint tax
returns
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Other Changes to MedicareReduces waste, fraud and abuse
• Cuts inefficient care
• Identifies fraudulent providers
• Reduces overpayments to insurance companies
• Protects personal information
Call Medicare at 1-800-633-4227www.aarp.org/fightfraud
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Key Points to Remember About the Health Care Law
Helps lower your prescription drug costs
Protects guaranteed Medicare benefits
Improves Medicare-covered benefits
Makes some changes to Medicare Advantage plans
Reduces waste, fraud and inefficiencies
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For More Information on the Health Care Law
www.aarp.org/healthlawguide
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www.aarp.org/healthlawguide
For More Information on Medicare
Medicare
1-800-633-4227 www.medicare.govwww.aarp.org/medicare
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Has the Health Care Law helped you?
Share your personal storywww.aarp.org/shareyourthoughts
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Has the Health Care Law helped you?
Share your personal storywww.aarp.org/shareyourthoughts
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