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What Obamacare Means for the Over 65 Crowd

What Obamacare Means for the Over 65 Crowd

Health care exchanges, a key part of Obamacare, opened October 1. Technical glitches have only added to the confusion around Obamacare. Many seniors are wondering how Obamacare does and doesn't affect them.

Here's a look at what Obamacare means to those 65 and over.

Know the basics

The Affordable Care Act does not raise the eligibility age for Medicare and health exchanges are not replacing Medicare, says Rebecca Rabbitt, vice president, government programs at Express Scripts, a pharmacy benefit management company.

“If you are over 65 and do not have prescription drug coverage for 2014 through an employer or other provider, enroll in a Medicare prescription drug benefit,” she adds.

You're covered, if...

If you have Medicare you are covered under the requirements of Obamacare. As long as you're enrolled in Medicare, either through traditional Medicare or a Medicare Advantage plan, you won't have to pay a penalty under the Affordable Care Act, says Jacqueline Garry Lampert, a consultant to yourhealthcaresimplified.org, a site devoted to explaining health care reform.

The good news

Under the new law, Medicare now covers recommended preventive services, like mammograms or colonoscopies, without cost-sharing, such as applying a deductible or charging co-insurance, says Lampert. In addition, beneficiaries will now receive an annual “wellness” visit with their doctor, similar to the current “welcome” to Medicate preventive visit, without cost-sharing.

Seniors also now have access to vaccines – such as flu, hepatitis and pneumonia.

The “donut hole” closes by 2020. If your Medicare prescription drug plan includes a gap in coverage, popularly called the “donut hole”, it will be eliminated by 2020, says Lampert.

What you might not like

If you receive your benefits through a private Medicare Advantage plan, you should know that the way the government reimburses these plans for providing your care is changing, says Lampert. Under the current payment system, the government pays about 14% more for beneficiaries enrolled in Medicare Advantage than it pays to provide the same benefits for those enrolled in traditional Medicare.

“The Affordable Care Act makes a complicated series of changes to these payments to Medicare Advantage plans, but the net result will likely mean lower reimbursements for plans with lower quality ratings,” she says.

The impact of these payment changes on you, the Medicare beneficiary, remains to be seen, and the impact is expected to vary across the country, she adds. “Be sure to explore all your plan options during open enrollment each year. Plans change their benefit offerings each year, and these benefit changes could be more pronounced as the payment changes take effect,” she warns.

Beware of scams

“Financial scams of the elderly have been well documented for reasons that are obvious, loneliness (and welcome chatting with a caller); sometimes decline in mental facilities and more trusting natures,” says Debra Speyer, managing partner of Speyer Law, these factors help make the elderly a target for Obamacare scams.

The latest scams she says, include swindlers who pose as government officials, call seniors and tell them they need to sign up again for Medicare, or that they need a new card. They offer to help them fill out the application over the phone. “Armed with the Social Security number, they can open charge cards in that person's name, buying thousands of dollars of merchandise – or, along with a bank statement, a house. Do not speak to anyone calling on behalf of the government. They are not making calls to confirm your information in order for you to stay on Medicare.”

Lampert sees Obamacare as mostly a good thing for those over 65. She says, “The Congressional Budget Office estimates that the changes to Medicare made by the Affordable Care Act extended the life of the Medicare Trust Fund, stabilizing the program for current and future Medicare beneficiaries.”

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paoli2   |     |   Comment #1
Obama made it very clear that Obamacare would not affect anyone on Medicare (thank goodness!).  We can still keep or select a new Advantage Plan as we always have and have no concern for the problems of dealing with Exchanges etc.
Maecl   |     |   Comment #2
Don't count on Medicare Advantage.  United Health sent letters to some providers & their subcribers in CT informing them that their provider would be dropped.  They won't give the #. Here is the link:


Obamacare is a disaster & who knows what's to come.  It has already taken money from Medicare
paoli2   |     |   Comment #4
#2  We are with Humana and they have made it clear we can keep our same Advantage Plan.  They are still advertising them daily on tv.  I do not like United Healthcare and would not be surprised what they are doing.  We also have been given choices where we live of 9 other Advantage Plans but none are with United Healthcare.
carly   |     |   Comment #3
True, it's not making changes to Medicare, but a huge chunk of funding for ObamaCare is coming directly from cuts in payment rates to Medicare providers.  At a time when more baby boomers are entering Medicare, it's going to be felt.
Maecl   |     |   Comment #5
Paoli2: I have Anthem BC & BS Medicare Supplemental. So far I don't know what's coming.  I do know that they and others aren't going to participate in Obamacare in CT.  Some things may stay the same this year, but the worse is yet to come.  As far as United Healthcare is concerned I stay away from them and AARP.
paoli2   |     |   Comment #6
Maeci:  I think Anthem BC is not participating in Obamacare especially in CT so that they can try to keep their plans from being destroyed by being involved.  They are trying to stay seperate for their customers.  As you posted, we don't know yet what nightmare may still ensue from Obamacare and how it will affect any of the Advantage or Supplement Plans.  However, Pres. Obama has stated we Medicare beneficiares are not supposed to be affected by Obamacare and can just have what we always had.  Whether he keeps his word is another story.  They have enough problems with the Exchanges, they surely don't need to get Medicare people or their providers involved.  Let's hope all goes well for everyone when sanity ever returns to Washington.
Maecl   |     |   Comment #7
Paoli2: His goal is to have everyone on single payer.  I don't know exactly when he said that. It may have been before if ran.  I think it was a radio interview.  Sadly, in my view it is the goal of many on the left.
paoli2   |     |   Comment #8
Maeci:  I, personally, don't think Obama is going to bring in the numbers he needs of buyers for his Obamacare even with the Mandate.  So  he will probably want to go for single payer but since this is his last term (thankfully), he may not have time to get it prepared, passed, and set up.  It will be something for the next President to be willing to do "if" we actually get anyone who is willing to take over this mess left behind for him.  This week will tell us if we have a country for him to take over.  The one thing in our favor is that our senators and congressmen finally know we are serious about wanting to dump ALL of them and start over with a new crop.  The news is out that they will probably wait until the last day or so and stop the default.  It infuriates me that they know how costly it is to our country and still wait until as late as possible to stop any default!
paulaj   |     |   Comment #9
Dear paoli2 and Maecl:

I do not think that Obamacare is a disaster. The effectiveness of a program will not be decided by computer and technolggy glitches in connection with its rollout. It will ultimately be decided by the cost savings and enhancements it will or will not deliver overtime. The real disaster, however, is a republican controlled house of representatives--practically all of whom are from gerrymandered congressional districts that ensure zero reelection challenges- that is insanely convinced that Obamacare is the greatest evil America faces. They lost on Obamacare in the 2012 election (Rommney/Ryan campaign was literally based on repeal) and they lost in the conservative leaning Supreme Court. You do not hijack the country over ideology and sour/bitter grapes. If Republicans want to get rid of Obamacare, win the Senate in the upcoming elections and the presidency in 2016. 

    However, most independent voters I know will do everything to ensure either the House of Representatives changes hands and the Senate remains as is. This is not a knee-jerk partisan reaction. It has been well documented in conservative and liberal media that powerful conservatives (i.e Koch brothers;Heritage Foundation,etc) advocated and devised a kill Obamacare strategy that included using the debt ceiling and government shutdown as a primary weapon to kill Obamacare.Well ,Obamacare has not been shutdown-just most of government.
paoli2   |     |   Comment #10
Paulaj:  I am not against Obamacare.  I just think it needs certain changes.  I also have written emails to my Republican senators letting them know that Americans will catch on to what they are doing concerning Obama and Obamacare.  It has been obvious from the start they bragged about getting Obama out of office and they never intended on allowing Obamacare to be enacted.  Now it has come back to hunt them because Obamacare did pass and now I think Pres. Obama is determine to make sure they get blamed for the Shutdown etc.  This "pay-back" stuff has got to end and we need to get our government open and working again.  My concern is Obamacare does have problems (which can be resolved) but the Republicans are not concerned about resolving them and that is why we have so much head-butting.  This week will show us if both parties really care about saving our government or not.  IMO, both parties bear a portion of blame for what is happening but the Republicans started the ball rolling downhill the first term when Obama was elected.
QED   |     |   Comment #11
I believe Sheryl has missed an important impact of Obamacare on seniors.  It's less about plans or costs, and more about availability in the first place of quality care for folks, seniors, most likely to need care.  Here are the facts:

Obamacare is not great for doctors, of which there are two kinds.  Some doctors do what they do motivated solely by desire to make better the lives of their fellow man.  These are really great people.  They will not be impacted by Obamacare.  Other doctors want to "do well by doing good".  They enjoy helping others but they also care about their personal well being and that of their families.  The squeeze placed by Obamacare on the backs of such doctors, lower reimbursements combined with higher patient loads, will result - has already resulted - in their finding other ways to achieve their goals.  They will leave - have already left - the profession.  Doctors, speaking in general, are really smart individuals.  Some - too many - will not tolerate Obamacare. 

So what do seniors face?  Fewer doctors, increasing likelihood of need for care compared with the general population, more competition for the remaining available care from people of all ages. 

How will Obamacare cope?  Well, you'll be in great shape if you don't really need to see a doctor.  In the absence of the truly skilled and fully trained professionals Americans have always taken for granted, Obamacare will substitute lesser trained care givers.  Remember, in grade school, if you became ill you "went to see the nurse"?  Get ready for deja vu all over again.  And in some instances there will be no real loss of care.  Nurses, and nurse practitioners, are highly trained and capable care givers.  Oftentimes seniors will be OK.  But in some instances, when very highly skilled care is needed either for diagnosis or treatment, it will simply not be available because of Obamacare . . . and seniors will die as a result.  Obamacare advocates at high levels already know this.  They firmly, but quietly, believe such a sacrifice by seniors is justified in order the overall good of society best be served.  If you’re a senior perhaps you agree. 

My own view, both for seniors and even just for older persons not yet in the “senior citizen” category, is that the principal advantage of Obamacare is the answer it provides to an age old question faced by every individual:  “How will I die?”
paoli2   |     |   Comment #12
QED:  Why don't they resolve the entire problem with Obamacare and just add "Euthanasia" to it?  The "How will I die" question for seniors can be answered in ONE word!  If life is so sacred, why is our country making it such a mockery for SENIORS?  
Patricia Win
Patricia Win   |     |   Comment #13
I am a retired senior in Maryland (State of Md.) and was very disgusted to hear that in our great state, known to be BLUE and progressive, that the KOCH brothers got their very rich, greedy hands on our prescription program via Express Scripts.  I plan to write to our benefit program people about this with educational material.  How this happened is a puzzle to me.  Maryland is generally a Democratic if not progressive state.  So how did these multi-billionaires get into our health care system?  And I was told that in 1/14 Medicare will have Express Scripts as part of its program to handle drug benefits, so that is even worse !!   If someone knows more about this, please explain.  


Maecl   |     |   Comment #14
I wasn't going to post a comment, but I couldn't get this out of my mind.  The left is always looking to demonize successful conservatives as if they are the cause of all our problems.  Is there no greed on the left?  It isn't a crime to be wealthy.  If not for successful individuals we would be a 3rd world country.

Our healthcare costs are going up because of Obamacare, not because of the Koch brothers.
carly   |     |   Comment #15
To Post #13: Express Scripts is a publicly traded company with over 1,500 major shareholders, most in the form of mutual funds.  The company that holds my IRA's is a majority shareholder.  The Koch Brothers are not listed as having a direct ownership of the company, although they may certainly hold shares along with everyone else.

The Koch Brothers company also manufactures the majority of the toilet paper brands.  (I didn't know that, I thought they were just in oil/petroleum products.)

Returning to the point of this thread, the plan, while well meant, is no fiscally responsible and the funding isn't there.  There's been a lot of talk in the last few years about what year Social Security will run out of money, and how much MediCare is costing, and adding this huge entitlement program just isn't going to work without gutting the two other programs for money, raising taxes, and rationing.