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Affordable Care Act (ACA) Facts: Follow this Series

This is part 4 of our ongoing series, so please see Fact # 1 in a post dated, Feb 8, 2011, Fact # 2 in the post dated 2/24/11 and Fact # 3 in a post dated 3/8/11.

There is a lot of speculation and discussion about what affect health care reform legislation, the Affordable Care Act (ACA), will have on seniors and their families.

Fact # 4: The law will improve care for older adults in other ways besides changes to Medicare.

There are improvements beyond Medicare that will help you and your family.¬† In a previous blog post we discussed the long term care changes that will improve for older adults such as changes to Medicaid that will allow people the choice of home and community based care and regulations that will prevent a spouse from becoming impoverished if their spouse is receiving home and community based care through the Medicaid Program.

There are also measures written¬†in the Affordable Care Act (ACA) that will help early retirees. To help offset the cost of employer-based retiree health plans, the new law creates a program to preserve those plans and help people who retire before age 65 get the affordable care they need. By providing financial relief to businesses that provide health coverage to early retirees, health reform will make it easier for early retirees to obtain health care coverage. Health insurance reform will guarantee that you will always have choices of quality, affordable health insurance even if you retire early and lose access to employer-sponsored insurance. It will create a health insurance exchange so you can compare prices and health plans and decide which quality affordable option is right for you.

The ACA also sets up protections for people with pre-existing conditions. The new law provides affordable health insurance through a transitional high-risk pool program for people without insurance due to a pre-existing condition. The Dept. of Banking and Insurance in NJ as already begun working on the high-risk pool program. Insurance companies will be prohibited from denying coverage due to a pre-existing condition for children starting in September, and for adults in 2014. Insurance companies will be banned from establishing lifetime limits on your coverage, and use of annual limits will be limited starting in September.

And if you are concerned for the young people in your life who may be struggling to find a job in this economy, the ACA didn‚Äôt forget them either. According to the Law, young people up to age 26 can remain on their parents‚Äô health insurance policy starting in September of 2011.

Information in this blog was gathered from the Affordable Care Act, Centers for Medicaid and Medicare and the National Council on Aging.

Healthcare Reform information from

The White House:

http://www.whitehouse.gov/assets/documents/Pages_from_Health_Insurance_Reform_PDF-4.pdf

Medicare

http://www.medicare.gov/Publications/Pubs/pdf/11467.pdf

National Council on Aging

http://www.ncoa.org/public-policy/health-care-reform/straight-talk-for-seniors-on.html

There is a lot of speculation and discussion about what affect health care reform legislation, the Affordable Care Act (ACA), will have on seniors and more specifically, Medicare.

Fact # 1 ACA will not cut your basic Medicare benefits.

There are actually some improvements to Medicare benefits as a result of ACA. One immediate improvement, according¬†to the Law,¬†is more help with prescription drug coverage. In Medicare prescription drug coverage there is something commonly referred to as ‚Äúthe donut hole‚Äù which refers to a coverage gap where seniors end up paying 100% of prescription drug costs. The new law helps you pay these costs right away. If you enter the donut hole this year, Medicare will send you a check for $250. You don’t have to do anything to get the check. It will arrive around 45 days after you reach the gap. In 2011, if you enter the donut hole, you’ll pay only half of what your plan charges for brand-name drugs‚Äîa 50% discount. By 2020, the donut hole will be slowly phased out and completely eliminated because of the Affordable Care Act.

Also as a result of ACA, a free annual well visit is now available in 2011. The free annual wellness checkup will allow you and your doctor to develop a prevention plan to keep you healthy. And a range of prevention services, such as cancer and diabetes screenings, will be provided free, no more cost sharing.

Another improvement related to the ACA, better care when you get sick! 80% of older Americans, have at least one chronic medical condition such as heart disease, high blood pressure, or diabetes. If you are one of them, you probably see several doctors, who may not always work together. The law will invest in testing new models of care for people with chronic conditions in order to provide better care, better coordination, and more patient-centered services. If you must be hospitalized, the law also will help you return home successfully, and avoid going re-hospitalization, by providing incentives for hospitals to make sure that you get the services you need in your community and by teaching you ways to take good care of yourself.

There are more facts that seniors need to know about how the new healthcare legislation will impact you and your Medicare coverage, stay tuned for more information from NJFA.

The information in this blog was gathered from language in the Affordable Care Act, the Center for Medicare and Medicaid and the National Council on Aging.

For more information check out the following links:

A brochure from Medicare:

http://www.medicare.gov/Publications/Pubs/pdf/11467.pdf

Webpage from the National Association of States United for Aging and Disabilities (NASUAD):

http://www.nasuad.org/affordable_care_act/nasuad_materials.html

Answers from the National Association of Area Agencies on Aging (n4a):

http://www.n4a.org/advocacy/health-care-reform/

Straight Talk for Seniors from the National Council on Aging:

http://www.ncoa.org/public-policy/health-care-reform/straight-talk/

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