Taking the scare out of Medicare post-President Obama's Health Care Reform was on the agenda last Friday at a forum presented by At Home in Greenwich, Inc. The talk featured the town expert on the subject: Sam Deibler, director of the Greenwich Commission on Aging, who is also on the At Home in Greenwich advisory board.
Before the nearly 50 members of At Home in Greenwich and quests gathered in the Fletcher Hall of the Second Congregational Church, Deibler spelled out the good news and set the record straight about the changes and misinformation being dispensed he said "by the press and TV panels." He also handed out a slew of background material.
"The over-all message is that Medicare is strengthened by the Health Care reform," he said. "Much of the criticism is based on pre-voting partisan misinformation, ie `death panels'." Contrary to rumors, he said "death panels would not be determining whether to keep relatives alive."
"The issue was whether doctors could be reimbursed for the time they take to talk to seniors about `advance directives,'" Deibler said. "Doctors can now talk to patients about the end-of-life care and be reimbursed."
To learn about the most effecting Medicare changes and improvements that Deibler shared with his audience the Citizen posed him a few questions
How is the Obama Health Care Reform making Medicare more secure?
Health Care reform adds nine years to the life of the Medicare Hospital Insurance Trust Fund by increasing the payroll tax for upper-income wage earners. Also, reform ends a 14% disparity between the government's costs under traditional Medicare and Medicare Advantage private enterprise plans. A 14% bonus was created as a short-term stimulus for private insurers to enter the Medicare market, but has persisted past its original intent. Reform brings Medicare Advantage plan costs in line with traditional Medicare.
What, if any, do you think are the immediate benefits resulting from the Obama Health Care plan?
Medicare Part D drug coverage will be improved by a two-part reduction in the donut hole and in the cost of prescriptions purchased in the donut hole. Beginning this year, seniors who reach the donut hole will automatically receive a $250 cash rebate. By 2020 the donut hole will be phased out completely. Beginning next year, the cost of brand name drugs will be reduced by 50% with progressive annual reductions totaling 75% by 2020. Generic prescriptions purchased in the donut hole will be reduced by 7% next year with a full 75% reduction by 2020. Seniors' health status will be enhanced by 100% coverage for an annual preventive physical and by the elimination of co-pays and deductibles for preventive care.
What should we expect with the immediate changes in the Medicare Part D prescription drug program?
The plan includes a $250 reduction in the Medicare Part D donut hole this year. This reduction will come via rebate checks to those who fall into the donut hole. The first of those $250 checks have started going out to Medicare beneficiaries who've hit the donut hole as of June 15. Subsequent checks will be mailed roughly every six weeks till the end of the year. Beneficiaries do not need to do anything in order to receive a check. If they hit the donut hole, they will get the check.
Don't be fooled by anyone who may call or mail you anything saying they are with the federal government and that you must first fill out a form or provide any personal information in order to get the check. There are a lot of scammers out there looking to take advantage of seniors who are anxious to get their $250 check promising them a quick delivery of their check if they provide them with the "needed information".
What changes require decisions by Medicare holders?
If you are a member of a private insurance Medicare Advantage plan you may see an increase in your premium or a reduction in some of the benefits not available under traditional Medicare. Medicare Advantage plans are prohibited from imposing higher cost-sharing on benefits that parallel traditional Medicare. If a senior wishes to disenroll from a Medicare Advantage plan due to these changes and be covered under traditional Medicare, they may do so in the Annual Enrollment Period -- November 15th through December 31st.
There are also significant changes to the Medicare Supplement (or Medigap) insurance program. These are not related to the recent health care reform changes but are related to legislation from 2008. In the past, Medigap policies were required by law to conform to one of 12 standardized plans designated A through L. All plans within a lettered category are identical by law, so seniors can choose a plan by premium price knowing that benefits in those plans are identical.
Beginning June 1st, insurers with plans E, H, I and J are no longer permitted to accept new enrollees. Seniors currently in those plans are permitted to continue in them, but, with no new enrollees, members will be aging and using more medical services with no newer, healthier members joining. Since premium prices are related to payouts, members in those plans can expect premiums to rise at a rate faster than plans that admit new enrollees.
Premium increases will not happen immediately but seniors in those plans should monitor any premium increases to compare them to other plans. To add to the confusion, four of the companies that had provided Medigap plans in Connecticut are not doing so after June 1. Unless otherwise notified, seniors will be able to remain in their plan, but should understand that, with no new enrollees permitted, their premiums may begin to rise at a rate faster than other plans.
In addition, two new plans have been created: M and N. These plans introduce new types of benefits and costs, including co-pays for doctor and emergency room visits.
Seniors who want to review their coverages can call the Commission on Aging office at 203-862-6710 to arrange for no-cost counseling
What were your audience's chief concerns?
Rumors and misinformation about the changes under health care reform had a particularly unsettling effect on seniors. Many received mailings from opponents of reform warning of cuts in their "Medicare Advantage." For seniors who didn't know that "Medicare Advantage" refers specifically to the private enterprise part of Medicare that had been receiving a 14% bonus, and that the cuts would bring the program into line with traditional Medicare, thought that their traditional Medicare was going to be cut. The reduction in the Medicare Advantage bonus will help enhance traditional Medicare.
If any seniors have questions about their Medicare, Medicare Advantage or Medigap coverages, call the Commission on Aging office at 203-862-6710 to arrange for free, confidential counseling.