Tiptastic Tuesday: Medicare Beneficiaries and the New Health Law

  • Medicare beneficiaries do not need to apply to the new health law’s exchanges: exchanges are online marketplaces for uninsured individuals and small employers to find coverage. Medicare is not a part of the insurance exchanges.
  • The health law offers new benefits to Medicare recipients such as preventative care services, mammograms, colorectal screening, savings on prescription drug coverage, and by 2020, beneficiaries will be responsible for 25 percent of their prescription drug costs.
  • In the next decade, the health law will cut Medicare spending by $715 billion due to lower reimbursement rates to nursing homes, hospitals, home health agencies and other providers.  It will also cut payments to Medicare Advantage plans to bring the payments closer to what Medicare pays. Officials ensure the spending decrease will not decrease benefits.
  • Medicare recipients with income’s more than $85,000 ($170,000/couple) will pay more for their prescription drug coverage.
  • The House Energy and Commerce Committee, the House Ways and Means Committee and the Senate Finance Committee are working on legislation which would change the “doc fix” (the payment formula Medicare has used to pay physicians) or SGR but as of yet, nothing has been finalized.

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