Monday, November 18, 2013

The Bright Side of Obamacare: Understanding Obamacare for those 55+

Obamacare has gotten a lot of flack in the news lately due to the fumble of 

Nevertheless, the more I looked into the services it will actually cover for those 55+, the more I found the bright side:

1. Free Preventive Services: 
Preventative screenings, like cholesterol levels and diabetes screenings, help catch problems early while they are most easily treatable and less costly. In the past, deductibles and coinsurance kept many on Medicare from taking advantage of these potentially lifesaving services. For example, in 2008, 17% of women over age 65 hadn't received a mammogram for two years and one-third hadn't gotten a cholesterol screening. A free services, means little to no excuse for not getting these screenings.

2. Free Wellness Exams: Obamacare provides a free annual wellness exam, where you can meet with your doctor and create a personalized prevention plan to improve your health. In the first 7 months of 2012, 1.6 million seniors and people with disabilities on Medicare took advantage of this new benefit. This wellness exam goes hand in hand with preventive screening, and can catch things much sooner while they are easily treatable.

3. Managing Multiple Medications— The American Society of Consultant Pharmacists reported that last year, 65-69 year-olds took an average of 14 prescriptions a year, while 80-84 year olds took an average of 18 prescriptions. Taking multiple medications can result in adverse drug reactions, cumulative side effects, and is estimated to cause 28% of senior hospitalizations and 32,000 hip fractures each year. Under Obamacare, all Part D plans must offer medication therapy management services to seniors most likely to experience problems.Obamacare began eliminating the donut hole in 2011 and will completely end the gap in coverage by 2020. Already, seniors and people with disabilities have saved $4.1 billion (an average of $768 for every person who enters the donut hole) because of this change – and seniors are expected to save between $3,000 and $16,000 in drug costs through 2021 depending on the number of prescriptions they take. 

4. Help for Low-Income Seniors— Over 9 million low-income seniors and people with disabilities are covered byMedicare and Medicaid. Obamacare provides additional assistance to them, for example, eliminating Part D Prescription Drug cost-sharing for those receiving home- and community-based care (low-income nursing home residents were already protected under the law). Low-income seniors living with multiple chronic conditions will get new help through health homes designed to help them coordinate their care, and there will be additional long-term care options available to help them stay in their homes. A new Federal Coordinated Health Care Office is already working to help low-income seniors obtain all their eligible benefits – including new preventive services and wellness exams. 

5. Eliminating Overpayments to and Improving Medicare Advantage plans— Private insurers argued that they would be able to provide the same benefits as traditional Medicare at less cost. Once they were allowed into Medicare, however, the results proved quite different. Instead of costing less, private Medicare Advantage plans cost more than traditional Medicare. In 2009, the year before Obamacare was enacted, it was estimated that Medicare paid Medicare Advantage plans $14 billion more ($1,000 more for each person they enrolled) than if care had been provided through traditional Medicare – and about one-sixth (16.7%) of total payments went to profits and administration. Even seniors who didn't enroll in  plans paid more as a result because Part B premiums are based on total Medicare costs, which include those over-payments. Since Obamacare was enacted in 2010, Medicare Advantage premiums have dropped by 16% while enrollment is up by 17%. 

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